Antiseptic

1. ANTI-EPILEPTIC DRUGS
&
CLASSIFICATION OF
ANTIPSYCHOTICS
Dr. Hooria Shumail

2. EPILEPSY

3. EPILEPSY
Based on clinical presentation and area of brain involved:
1-Focal or Simple partial seizures
Involve only a portion of the brain & consciousness preserved.
2-Generalized tonic- clonic seizures
Involve both hemispheres of brain with immediate loss of
consciousness.
A.Grand mal epilepsy
B.Absence seizure
C.Status-Epilepticus

4. CLASSIFICATION OF ANTI-EPILEPTIC DRUGS
1-Focal seizures:
Phenytoin
Lamotrigine
Carbamazepine

5. CLASSIFICATION OF ANTI-EPILEPTIC DRUGS
2-Generalized tonic-clonic seizure:
Grand mal epilepsy
Phenytoin
Lamotrigine
Carbamazepine
Valproate Na

6. CLASSIFICATION OF ANTI-EPILEPTIC DRUGS
2-Generalized tonic-clonic seizure:
Absence seizures:
1- Ethosuximide
2- Valproate Na

7. PHENYTOIN
Mechanism of action:
It blocks voltage-gated Na channels by binding to the channel in the
inactive state and slowing its rate of recovery.

8. PHENYTOIN
Therapeutic indications:
1-Focal Seizure
2-Generalized tonic– clonic seizures
3- Status epilepticus
Adverse effects:
Acute overdose
Cerebellar symptoms
Nystagmus, vertigo, diplopia, ataxia
Complete cerebellar atrophy

9. PHENYTOIN
Adverse effects:
Chronic treatment:
CNS – Cerebello- vestibular effects, ↑ seizure frequency
Gingival hyperplasia
Megaloblastic anemia
Osteoporosis
↓ADH, Hirsutism, Hyperglycemia
Morbilliform rash
Pregnancy – Fetal hydantoin syndrome, bleeding in newborn

10. LAMOTRIGINE
Mechanism of action:
It blocks voltage-gated Na channels by binding to the channel in the
inactive state and slowing its rate of recovery.

11. LAMOTRIGINE
Therapeutic uses:
Primary generalized tonic-clonic seizures
Generalized seizures of the Lennox-Gastaut syndrome
Focal seizures
Adverse effects:
Dizziness, headache
Diplopia, nausea
Insomnia, somnolence
Skin rash.

12. CARBAMAZEPINE
Mechanism of action:
It blocks voltage-gated Na channels by binding to the channel in the
inactive state and slowing its rate of recovery.

13. CARBAMAZEPINE
Therapeutic uses:
Focal seizures
Generalized tonic-clonic seizures
Idiopathic tonic-clonic seizures
Adverse effects:
Mild GIT discomfort
Dizziness,
Blurred vision, diplopia,
Ataxia, sedation
Weight gain

14. VALPROATE
Valproate is a first-line broad-spectrum antiseizure drug , effective
against many seizure types.
Mechanism of action:
Na channel blockade
Blockade of GABA transaminase
Blockage of T-type Ca channels.

16. VALPROATE
Therapeutic uses:
1-Generalized tonic-clonic seizures
2- Myoclonic
3- Absence seizures
4- Focal seizures
5- Status epilepticus
6- Atonic seizures as in Lennox-Gastaut syndrome

17. VALPROATE
Adverse effects:
1-GIT:
Nausea, vomiting, abdominal pain and heartburn
2-Weight gain (↑ appetite )
3- Hair loss
4- Idiosyncratic hepatotoxicity
5- Thrombocytopenia
6- Pregnancy
Neural tube defects (spina bifida), ↑ incidence of cardiovascular,
orofacial, and digital abnormalities

18. ETHOSUXIMIDE
Ethosuximide is a first-line drug for generalized absence seizures.
Mechanism of action:
Inhibition of low-voltage activated T-type calcium channels in brain.

19. ETHOSUXIMIDE
Therapeutic uses:
Childhood generalized absence seizures
Adverse effects:
GIT: Nausea, vomiting
Headache
Dizziness
Hiccup
Euphoria
Behavioral changes

20. STATUS EPILEPTICUS
It is defined as abnormally prolonged or repetitive seizures.
Treatment:
1-Lorazepam or diazepam
2-Fosphenytoin or phenytoin, Valproate
3-Phenobarbital
4-Propofol or thiopental
5-General anesthesia

21. CLASSIFICATION OF ANTIPSYCHOTIC DRUGS
TYPICAL ANTIPSYCHOTICS ATYPICAL ANTIPSYCHOTICS
Chlorpromazine, Thioridazine, Fluphenazine,
Haloperidol, Prochlorperazine
Clozapine, Olanzapine, Quetiapine,
Risperidone, Aripiprazole
Competitive blocking of dopamine D2
receptors
Block D2 dopamine receptors, inhibition of
serotonin receptors (5-HT), particularly 5-
HT2A receptors.
Treat ‘Positive’ Symptoms Treat ‘Positive’ and ‘Negative’ symptoms
Adverse Effects: Extrapyramidal symptoms
and Hyperprolactinemia
Adverse Effects: Metabolic Syndrome
(Hyperlipidemia, Hyperglycemia. Weight
Gain)
Older Drugs, Inexpensive Newer Drugs, Expensive