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[药物、癫痫发作和癫痫]

[Medications, epileptic crises, and epilepsy].

作者信息

Jallon Pierre, Perrig Stephen

机构信息

Unité d'épileptologie clinique et d'electroencéphalographie Hôpitaux Universitaires de Genève 1211, Genève 14.

出版信息

Rev Med Suisse Romande. 2003 Jan;123(1):11-5.

Abstract

Drug-induced seizures are an uncommon complication of drug therapy. The drug related factors are either the intrinsic epileptogenicity of the specific agent or patient related factors such as convulsive predisposition, underlying neurologic dysfunction, and factors which affect the serum concentration and/or central neurologic system concentrations. Some anti epileptic drugs may aggravate an epileptic syndrome. In 10-15% of patients with epilepsy, better control of seizures can be achieved with combination therapy. These patients are at greater risk of suffering clinically serious interactions. Drug interactions occur at the pharmacokinetic level and at the pharmacodynamic level, involving synergistic or antagonistic effects. Finally many drugs can interfere with the antiepileptic drug metabolism. The inverse effect is also frequent. A better knowledge of the spectrum of drugs that cause seizures or interfere with antiepileptic drugs metabolism is important for evaluation of appropriate treatment options and for guiding the choice of rational therapeutic procedures.

摘要

药物性癫痫发作是药物治疗中一种不常见的并发症。与药物相关的因素包括特定药物的内在致痫性或患者相关因素,如惊厥易感性、潜在的神经功能障碍以及影响血清浓度和/或中枢神经系统浓度的因素。一些抗癫痫药物可能会加重癫痫综合征。在10%至15%的癫痫患者中,联合治疗可更好地控制癫痫发作。这些患者发生临床严重相互作用的风险更高。药物相互作用发生在药代动力学水平和药效学水平,涉及协同或拮抗作用。最后,许多药物会干扰抗癫痫药物的代谢。相反的作用也很常见。更好地了解引起癫痫发作或干扰抗癫痫药物代谢的药物谱,对于评估合适的治疗方案和指导合理治疗程序的选择非常重要。

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