神经系统药理14英五姚锂凤P P T整合汇编.docx

神经系统 药理部分 14英五姚锂凤 Section 1: Antiepileptic Drugs 抗癫痫 Definition： Seizure: the clinical manifestation of an abnormal synchronization and excessive excitation of a population of cortical neurons Epilepsy: a tendency toward recurrent seizures. The characteristic event is the seizure, which is often associated with convulsion惊厥, but may occur in many other forms. ?The seizure is caused by an abnormal high-frequency discharge of a group of neurons, starting locally and spreading to a varying extent to affect other parts of the brain Types of Epilepsy Partial seizures –The discharge begins locally, and often remains localized. Produce relatively simple symptoms without loss of consciousness.（Simple, Complex, Secondarily generalized） Generalized seizures –Involve the whole brain, producing abnormal electrical activity throughout both hemispheres. Immediate loss of consciousness. ?Two common forms of generalized epilepsy are tonic-clonic(grand mal)癫痫大发作 and absence (petit mal)癫痫小发作seizures ?Status epilepticus癫痫持续状态 is a life-threatening condition in which seizure activity is uninterrupted Cause of epilepsy ?Idiopathic epilepsy ?Complicated ?Genetic ?Secondary epilepsy ?CNS infection, high fevers ?Trauma ?Tumor ?Strokes Antiepileptic Drugs, AEDs ?A drug which decreases the frequency and/or severity of seizures in people with epilepsy ?Treats the symptom of seizures, not the underlying epileptic condition ?Goal: maximize quality of life by minimizing seizures and adverse effects of AED Antiepileptics block the initiation of abnormal discharge from the focal area or prevent the spread of abnormal discharge to adjacent brain areas in one or more of the followingways. (1)GABA enhancers ?binding directly to GABA-A receptors ?blocking presynaptic GABA uptake ?inhibiting GABA metabolism by GABA transaminase ?Increasing GABA synthesis (2)Sodium channel blocker (3)Calcium channel blocker N-type (neuronal); L-type (long lasting); T-type (transient) Gl