Antiepileptic drugs commonly used

Many antiepileptic drugs are used to treat seizures (Table 33-i). Most are analyzed collectively by either GLC or HPLC or individually analyzed by immunoassay. The advantage of HPLC or GLC is that simultaneous analyses can be accomplished. Immunoassay procedures are less labor intensive and are usually quicker than HPLC or GLC for a single analyte however, analysis of multiple antiepileptics or metabolites requires additional assays. For example, GLC and HPLC methods allow for the simultaneous measure of several common anticonvulsants. Immunoassay, however, is the mainstay of monitoring these drugs in most clinical laboratories. 

Kwan P, SiU GJ, Brodie MJ. The mechanisms of action of commonly used antiepileptic drugs. Pharmacol Ther 2002 90 21-34. 

Acetazolamide is used for epilepsy in the absence of attacks and also in conjunction with other antiepileptic drugs. The most common synonym of this drag is diamox. 

Phenobarbital is the oldest antiepileptic drug in common use and has a solid efficiency record for the control of seizure. However, due to some side effects (hypertension, depression, dizziness, rash, memory lapses) and drug interactions (primarily other anticonvulsants), phenobarbital is now generally used as a second-line treatment. 

Treatment will call upon dopamine agonists, opioid medications, a benzodiazepine (clonazepam) that increases total sleep time, and drugs most commonly used as antiepileptic medication, such as gabapentin or equivalent. Dopamine agonists are the most effective and reduce the sleep deprivation and the patients complaints. But not all patients respond to dopamine agonists and methadone has been prescribed in the most refractory cases (21). 

Franco et al. [45] described an HPLC method for simultaneous determination of the R-( ) and (S)-(+)-enantiomers of vigabatrin in human serum after precolumn derivatization with 2,4,6-trinitrobenzene sulfonic acid (TNBSA) and detection at 340 nm. Separation was achieved on a reversed phase chiral column (Chiralcel-ODR, 25 cm x 4.6 mm) using 0.05 M potassium hexafluorophosphate (pH4.5) acetonitrile ethanol (50 40 10) as a mobile phase at a flow rate of 0.9 ml/min. The calibration graphs for each enantiomer were linear over the concentration range of 0.5-40 fig/ml with a limit of quantification of 0.5 fig/ml. No interferences were found from commonly coadministered antiepileptic drugs. 

Valproate is now the most commonly used antiepileptic drug worldwide. It is the drug of choice in primary generalized epilepsy, particularly in the treatment of generalized absence, myoclonus and tonic-clonic seizures. Valproate is the drug of first choice in atypical absence and atonic seizures, for Lennox-Gastaut syndrome and myoclonic epilepsy. 

Status epilepticus can occasionally be fatal therefore, seizures should be treated aggressively. Seizures can be managed with antiepileptic medications such as carbamazepine. The common antiepileptic drug valproic acid is contraindicated because it depletes the body of carnitine, which may in fact exacerbate symptoms. The potential risk of stroke may be reduced using appropriate medication. The complications... 

The concurrent use of antiepileptics is common and often advantageous. Information on these interactions is sparse and even contradictory and their clinical importance is uncertain. Nevertheless, good monitoring would clearly be appropriate if these drugs are used with ethosuximide to monitor for potential toxicity and to ensure adequate seizure control. 

Abraham, C. V., and Joslin, H. D. Simultaneous Gas Chromatographic Analysis for Four Commonly Used Antiepileptic Drugs in Serum... 

Commonly Used Antiepileptic Drugs Using a Jet Tube Column 13. 

The addition of a cosurfactant to the microemulsion reduces the interfacial tension between the oil and aqueous phases [43], Commonly, it is used a straight chain alcohol like 1-butanol. Increasing the concentration of a cosurfactant affects the viscosity and changes the EOF rate [42]. A series of alcohols from 1-propanol to 1-hexanol have shown different selectivity in the separation of antiepileptic drugs [49],... 

This is also identified as Chotoko in Japanese traditional medicine. It is composed of several Uncaria spp. including U. rhynchophylla, U. macrophylla, U. sinensis, and U. sessilifructus however, U. rhynchophylla is a major component. Gou-teng is commonly used for its sedative, antispasmodic, analgesic, anticonvulsive, hypertensive, antiepileptic, and antiviral properties [12]. The cmde drug is used to relieve headaches and dizziness caused by hypertension and infantile nervous disorders. Recent studies have evaluated that the active ingredients of Gou-teng are the alkaloids of U. rhynchophylla [12]. 

Chlorpromazine had been shown to produce a tranquil state in animals and since it had a similar effect in humans it became known as a major tranquiliser but the term is rarely used today. Sometimes the drugs used to treat schizophrenia are called anti-psychotics but more commonly neuroleptics. Leptic means to activate (take hold of) and in animals these compounds produce a state of maintained motor tone known as catalepsy. This is an extrapyramidal effect and in schizophrenics the neuroleptics can cause a number of extrapyramidal side-effects (EPSs) including Parkinsonism. The new term neuroleptic is unsatisfactory as a description of clinically useful drugs. It really describes a condition (catalepsy) seen in animals and is more indicative of a compound s ability to produce EPSs than to treat schizophrenia. Antipsychotic is more descriptive but could imply a more general efficacy in psychoses than is the case. It would seem more appropriate to call a drug that is used to treat schizophrenia an antischizophrenic just as we use the terms antidepressant or antiepileptic irrespective of how the drug works. Despite such personal reservations, the term neuroleptic will be used in this text. 

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