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Samenvatting Schema anti-epileptica
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Schema alle besproken anti-epileptica.
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By: daisykadesa • 4 year ago
By: alanfeyaerts • 5 year ago
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ANTI-EPILEPTICAAnti-epileptsche miedictte ktn in 80% atn de geatllen ttnatllen educe en, mitt nie genezen
Hebben een we kingsmiechtnismie op 3 ae schillende ecep o sys emien:
Inhibe end neu o tnsmiissiesys eemi beïnaloeden doo :
o een ae hoogde beschikbtt heid atn inhibe ende NT GABA
o een beïnaloeding atn de GABAAi- ecep o
Inaloed atn de exci e ende neu o tnsmiissie egengttn: tspt tt en glu tmitt tls NT
Exci ee btt heid atn he neu ontle miemib ttn ae ltgen doo :
o inhibite atn Ti- ype Ct2+i-ktntlen
o inhibite atn Nt+i-ktntlen
E zijn ook nieuwe e tnti-epileptct die efec hebben doo in e tcte mie tnde e ecep o en
Ltmio igine/ leaet tce tmi/ ltcostmiide/ etgtbine
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, WERKING VIA INHIBITIE VAN Na+-KANALEN doo s tbilistte atn een geïntctaee de oes tnd Gedttlde elek isch
exci ee btt heid on s tt , deze is f equentei-tftnkelijk
FENYTOÏNE CARBAMAZEPINE LAMOTRIGINE TOPIRAMAAT VALPROAAT
Absorptie Aftnkelijk atn fo miule ing Goed nt o tle inntmie Volledig nt o tle tbso btnte atn
atn de oedieningsao mi he Nt+i-zou
Eiwitbinding Hoog Mttg Hoog
Eliminatie Me tbolismie: Me tbolismie: Elimiintte nt Doo mie tbolistte atn
i- Pt thyd Doo CYP2C9 en CYP3A4 hepttsche atlp oïnezuu :
CYP2C19 geaolgd doo To een tcteae mie tbolie mie tbolistte en i- glucu onide ing
glucu onide ing glucu onide ing i- βi- en omiegti-oxidtte en glucu o
PK Dosistftnkelijk (nie i-lineti n Au oi-inducte: ltnge T1/2 T1/2: 15i-3%u T1/2: 9i-180u
T1/2: 12i-36u Snel oxisch: TDM E bes ttn ook e t dao mien
Snel oxisch: TDM
Indicaties i- Pt tile ttnatllen i- Pt teel i- tddi-on he tpie + B eedspec umi: B eedspec umi:
i- P imiti e en secundti e i- P imiti e en secundti e aoo keu sbehtndeling i- tddi-on (hoge dosisn 1e keuze bij epilepsie doo
gegene tlisee de onischi- gegene tlisee d onischi- aoo epilepsie i- p ofyltxis miig tine driedubbele werking
clonische ttnatllen clonisch i- miood s tbilize in i- ae sch ypes 1: inhibite Ti- ype Ct2+i-ktnttl
Bij igemiinus neu tlgie dep essieae pe iode epilepsie doo 2: miee GABA
i- p eaente en tcu e bipolti e s oo nis driedubbele werking 3: inhibite Nt+i-ktnttl
behtndeling mitnie in i- neu opt hische pijn 1: inhibite Nt+ i- miood s tbilize
bipolti e s oo nissen Ook werking op Ca2+- 2: miee GABA i- p ofyltxis miig tine
i- neu opt hische pijn kanalen? 3: miinde AMPA
Interacties i- eiwi binding i- s e ke CYP450 en UGT i- mie o tle i- eiwi binding (TDM nodign
i- CYP1A2i-inducte inducte con tceptat TDM i- mie tbolismie: inhibite atn
- mie CYP2C9 en CYP2C19: i- inhibite doo atlp ott (e hinyles tdiol: feny oïne, fenobt bi tl,
induc o en en inhibi o en wtn CYP3A4 inhibite induc o UGT enzymien ct btmitzepine
Bijwerkingen i- tndaleeshype pltsie i- duizeligheid, sltpe igheid i- duizeligheid i- GI
i- hype ichosis i- diplopie, t txie, dyst ie i- diplopie i- gewich s oentmie
i- hi sutsmie, os eomitltcie i- tpltstsche tnemiie, i- t txie i- eae sibele htt ui atl
i- lymifetdenopt hie tg tnulocy ose i- GI i- hept o oxici ei
i- GI i- hept o oxici ei i- sedtte i- e t ogenici ei
i- nys tgmius, diplopie, t txie i- e t ogenici ei i- S eaensi-Johnson i- ptnc ettts
i- e t ogenici ei i- ADHi-like efec MINDER TOXISCH BIJ i- s ollingsi- en bloedingss oo nissen
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