EPILEP

SY
Terminologies

SEIZURE
 Seizure is one episode

EPILEPSY
 Epilepsy is recurrent attack of seizure

CONVULSIONS
 Convulsions are abnormal movements
Epileptic Drugs MOA
1. INHIBITION OF USE DEPENDANT NA+ CHANNEL
 Phenytoin
 Carbamazepine
 Valproate
 Topiramate
 Lamotrigine
2. GABA PONTATIATION
 Phenorbabitone
 Benzodiazepine
 Gabapentin
 Vigabatrin
Epileptic Drugs MOA

3. DECREASE EXCITATORY NEUROTRANSMISSION

 Felbamate
 Topiramate
4. INHIBITION OF CA+ CHANNEL
 T type Ca+ Channel are important in absence seizure (petit mal)
 Ethosuximide
 Valproate
 Lamotrigine
DRUGS OF CHOICE FOR VARIOUS
SEIZURES
1) ABSENCE SEIZURE IN CHILD
Ethosuximide
2) Absence seizure in Adult
Valproate
3) Generalised tonic clonic seizure
Valproate
4) Atypical Absence
Valproate
5) Partial Seizure
Carbamazepine
DRUGS OF CHOICE FOR VARIOUS
SEIZURES
6) TONIC, CLONIC, ATONIC, MYOTONIC
Valproate
7) INFANTILE SPASM
Adrenocorticotrophic Hormone
8) INFANTILE SPASM WITH TUBEROUS SCLEROSIS
Vigabatrin
9) FEBRILE SEIZURE
Diazepam
10) STATUS EPILEPTICUS
Lorazepam
DRUGS OF CHOICE FOR VARIOUS
SEIZURES
11) EPILEPSY IN PREGNANCY
Phenobarbitone
12) SEIZURE IN ECLAMPSIA
Magnesium Sulphate
INDIVIDUAL DRUGS

PHENOBARBITONE
 Tablent containing 30mg
 Injection containing 200mg/ml
DOSE:
3mg/kg once or twice a day.
SIDE EFFECTS:
Ataxia, dizziness, Fatigue, irritability, confusion
Constipation, Diarrhoea, Nausea, Vomiting, Anemia
Rash, Hepatotoxic, Hyocalcemia, Rash, SJS, Osteomalacia
Sodium Valproate
SODIUM VALPROATE
 Tablet containing 200mg.
 Syrup containing 200mg/5ml sodium valproate.
DOSE:
20mg/kg in children below 20 kg, give in two divided doses(BD).
SIDE EFFECTS:
Anorexia, dyspepsia, nausea, vomiting, hair loss, rash, peripheral oedema,
drowsiness and tremors (review patients biochemistry).
CONTRAINDICATION:
First trimester of pregnancy and Liver failure.
References
1. http://Slide share online.
2. Lullman, (2000) Color atlas of pharmacology.