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INTRODUCTION

This chapter will be most useful after having a basic understanding of the material in Chapter 21, Pharmacotherapy of the Epilepsies in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition includes:

  • A detailed discussion of the nature and mechanisms of seizures, including models of epilepsy

  • A discussion of the genetic approaches to the epilepsies

  • The structures of the antiseizure drugs

  • A detailed discussion of the general principles that determine the choice of drugs for therapy of the epilepsies

LEARNING OBJECTIVES

  • Know the different seizure types and the mechanisms that are responsible for each type.

  • Understand the mechanisms of action of the antiseizure drugs and how they are used to treat the different types of seizures.

  • Describe the toxicities, adverse effects, and salient drug interactions of drugs used to treat the epilepsies.

  • Know the general principles of drug therapy of the epilepsies.

DRUGS INCLUDED IN THIS CHAPTER

  • Acetazolamide (DIAMOX, others)

  • Carbamezepine (TEGRETOL, CARBATROL, others)

  • Clonazepam (KLONOPIN, others)

  • Clorazepate (TRANXENE, others)

  • Ethosuximide (ZARONTIN, others)

  • Felbamate (FELBATOL)—withdrawn from market

  • Fosphenytoin (CEREBYX, others)

  • Gabapentin (NEURONTIN, others)

  • Lacosamide (VIMPAT)

  • Lamotrigine (LAMICTAL, others)

  • Levetiracetam (KEPPRA, others)

  • Methsuximide (CELONTIN)

  • Oxcarbazepine (TRILEPTAL, others)

  • Phenobarbital (LUMINAL, others)

  • Phenytoin (DILANTIN, others)

  • Pregabalin (LYROCA, others)

  • Rufinamide (BANZEL)

  • Tiagabine (GABITRIL)

  • Topiramate (TOPAMAX, others)

  • Valproic acid (DEPAKENE, others)

  • Vigabatrin (SABRIL)

  • Zonisamide (ZONEGRAN, others)

MECHANISMS OF ACTION OF ANTISEIZURE DRUGSa

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