Epilepsy & Antiepileptic

It describes Epilepsy & Antiepileptic.

1. Epilepsy & Antiepileptics Prepared by, Ms. KOTE R. B. Lecturer PRES’s Institute of Pharmacy Loni.

2. Epilepsy It is a Chronic medical condition produced by sudden changes in the electrical function of the brain. It is a condition characterized by recurrent episodes of seizures

3. Seizure- Aparoxysmal abnormal discharge at high frequency from neurons in cerebral cortex. Convulsions I nvoluntary , violent, spasmodic contractions of skeletal muscles.

4. Focal or partial Simple partial( Jacksonian ) A partial (focal) seizure happens when unusual electrical activity affects a small area of the brain. When the  seizure does not affect awareness , it is known as a simple partial seizure. Complex partial( psychomotor ) A complex partial seizure is a type of seizure that arises in one lobe of the brain, rather than the whole brain. The seizure affects people’s awareness and may cause them to lose consciousness. .

5. Primary generalized 1) Tonic- clonic Tonic- clonic seizures, previously known as grand mal seizures, are characterized by both stiffness and jerking motions. 2) Tonic . A tonic seizure causes a sudden stiffness or tension in the muscles of the arms, legs or trunk. 3) Atonic ( akinetic ) Atonic seizures are a type of seizure that causes sudden loss of muscle strength

6. 4 ) Myoclonic . Myoclonic epilepsy causes the muscles in the body to contract. This type of seizure causes quick jerking movements. Myoclonic seizures often happen in everyday life . 5) Absence (petit mal) An absence seizure causes you to blank out or stare into space for a few seconds. They can also be called petitmal seizures. Absence seizures are most common in children and typically don't cause any long-term problems. 6) Clonic seizures characterized by repeated jerking movements of the arms and legs on one or both sides of the body, sometimes with numbness or tingling

7. Causes Of Epilepsy Causes of Epilepsy a stroke. a brain tumour. a severe head injury. drug abuse or alcohol misuse. a brain infection. a lack of oxygen during birth .

8. signs and symptoms Seizure signs and symptoms may include: Temporary confusion. A staring spell. Stiff muscles. Uncontrollable jerking movements of the arms and legs. Loss of consciousness or awareness. Psychological symptoms such as fear, anxiety

9. Classification Antiepileptics

10. MOA Antiepileptics Enhancement of GABA action Inhibition of sodium channel function Inhibition of calcium channel function Other mechanisms include - - Inhibition of glutamate release and -Block of glutamate receptors.

11. Phenytoin Phenytoin – It is a primary drugs used in treatment of epilepsy. It inhibits spread of seizure discharges in the brain and shorten the duration and amplification of synaptic potential after discharge. It stabilizes the excitable neuronal membrane. It reduces post tetanic potentiation.

12. Preparation: Phenytoin---- Dilantin ---- 150 mg per day Therapeutic uses - It is used in therapeutics to treat: Grandmal epilepsy Psychomotor epilepsy Focal cortical epilepsy.

13. Barbiturates   Reduces spread of seizure activity Raises seizure threshold. Barbiturates are sedatives and hence potentiates  inhibitory pathway of GABA. Side effects : Nysta gmus, Ataxia, megaloblastic anemia are common.

14. Preparations : Phenobarbital- Luminal - 50 mg, 100 mg orally Mephobarbital – Mebaral - 400 mg orally Primidone - Mysolin – 250 mg orally Therapeutic uses : Used in -Grandmal epilepsy Patitmal epilepsy

15. oxazolidinedione derivatives  Oxazolidinedione derivatives like trimethadione, paramethadione are specifically used in treatment of petitmal epilepsy Sedation and blurring of vision are common side effects Preparations : Trimethadione – Traxidone - 900 mg daily Paramethadione – Paradione - 300 mg per day

16. benzodiazepines These agents prevent polysynaptic activity in spinal cord. These agents thereby decrease neuronal activity in reticular system. Preparations : Diazepam – Valium – 30 mg/ day Clonazepam – Clonopin - 20 mg per day

17. Succinimides These are less toxic than oxazolidinedione hence preferably used in the treatment of petitmal epilepsy Raises seizure threshold. Preparations : Ethosuximides – Zarontin – 500mg oral Methsuximide – Celontin 500 mg oral  

18. Status Epilepsy It is a medical emergency characterized by a repeated grandmal attacks without recovery of consciousness in between two attacks. Drug therapy : Diazepam - IV 10mg Phenobarbital- IV 250 mg Phenytoin - IV injection 250 mg Chloromethiazole- IV infusion- 0.8% solution 80 drops/min Paraldehyde – 0.1 mg/ kg IM

19. THANK YOU