Used to reduce, eliminate and prevent spread of seizures and the prophylaxis of seizures by inhibiting neuromuscular transmission. Most of the drugs used are specific for the type of seizure disorder.
Mechanism of action:
i) Suppress the influx of sodium
• eg phenytoin, carbamazepine, valproic acid
• reversibly bind to sodium channels when they are in the inactivated state prolong the inactivation decrease the frequency of the neuron firing suppresses seizures that depend on high frequency discharges
ii) Suppress the influx of calcium
• eg valproic acid, ethosuximide
• inhibit influx of calcium ions through the T-type calcium channels in the hypothalamus which is responsible for the generation of absence seizures
iii) Potentiation of GABA (gamma-aminobutyric acid)
• eg benzodiazepines, barbiturates (eg phenobarbital), gabapentin, vigrbatrin, tiagabine
• GABA is an inhibitory neurotransmitter potentiation of activity can decrease excitability of neuron suppress seizure activity
• can increase release of GABA (eg gabapentin); prevent degradation (eg vigrbatrin); inhibit reuptake (eg tiagabine)
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