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Anticonvulsants suppress the excessive rapid firing of neurons during seizures. [6] Anticonvulsants also prevent the spread of the seizure within the brain. [7] Conventional antiepileptic drugs may block sodium channels or enhance γ-aminobutyric acid function. Several antiepileptic drugs have multiple or uncertain mechanisms of action. [8]
Interaction studies have been conducted with a number of common anticonvulsants. Carbamazepine reduces blood plasma concentrations of eslicarbazepine, probably because it induces glucuronidation. This drug combination also increased the risk for diplopia, impaired coordination and dizziness in a clinical study.
Primidone is an anticonvulsant of the barbiturate class; [7] however, its long-term effect in raising the seizure threshold is likely due to its active metabolite, phenobarbital. [10] The drug’s other active metabolite is phenylethylmalonamide (PEMA). Primidone was approved for medical use in the United States in 1954. [7]
As is the case for all antiepileptic drugs, it is advisable not to suddenly discontinue topiramate, as there is a theoretical risk of rebound seizures. Some studies have attributed loss of appetite and upper respiratory tract infection to topiramate, but studies have concluded these adverse events are not difficult to tolerate for most individuals.
The Pediatric Symptom Checklist (PSC) is a 35-item parent-report questionnaire designed to identify children with difficulties in psychosocial functioning. Its primary purpose is to alert pediatricians at an early point about which children would benefit from further assessment. [ 1 ]
The symptoms of an opiate toxidrome include the classic triad of coma, pinpoint pupils and respiratory depression [3] as well as altered mental states, shock, pulmonary edema and unresponsiveness. Complications include bradycardia , hypotension and hypothermia .
Convulsions are induced in captive animals, then high doses of anticonvulsant drugs are administered. [ 10 ] [ 11 ] [ 12 ] For example, kainic acid can lead to status epilepticus in animals as it is a cyclic analog of l-glutamate and an agonist for kainate receptors in the brain which makes it a potent neurotoxin and excitant.
There were no significant differences between the three drugs with regard to discontinuation because of adverse events. Attentional dysfunction was more common with valproic acid than with ethosuximide. If monotherapy fails or unacceptable adverse reactions appear, replacement of one by another of the three antiepileptic drugs is the alternative.
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