Living with Epilepsy

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Living with Epilepsy

• Danielle Adams
• Medicinal Chemistry
• Spring 2007

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What is Epilepsy?

• Neurological Condition
• Disruption of neuronal activity in the brain
• aka seizure disorder
• Types
• Idiopathic (Genetic Causes)
• Symptomatic
• Generalized
• Partial

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Who is at risk?

• Family history
• Stroke victims
• Brain tumors
• Serious brain injury
• Lack of oxygen
• Brain infections
• Abscess
• Meningitis
• Brain inflammation

• Poisoning
• Lead
• CO
• Toxins
• Metabolic conditions
• Low blood sugar
• High or low salt
• Low magnesium or calcium

4
More risks

• 0.5 to 2.0 of people will develop epilepsy in
  their lifetime
• 9 out of 1,000 have the condition
• 3 million in U.S. and 50 million worldwide
• More likely to effect men than women

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What are signs and symptoms?

• Seizures
• Lost time
• Unconsciousness
• Confusion
• Staring
• Jerky movements

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How is it diagnosed?

• Types of seizures (General)
• Grand Mal
• Absence
• Myoclonic
• Clonic
• Tonic
• Atonic
• Types of seizures (Partial)
• Simple
• Complex
• Secondary generalized

• Electroencephalography(EEG)
• Magnetic Resonance Imaging (MRI)
• Computed Tomography (CT scan)

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Symptomatic Partial Epilepsy

• Most common type of epilepsy
• Usually has onset in adults
• Occurs in one specific area of the brain
• Partial seizures
• Simple- motor, sensory, psychological
• Complex- repetitive but controlled involuntary
  muscle movement- i.e.. walking
• Secondary generalized- consciousness followed by
  immediate unconsciousness with convulsions

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Pharmaceutical Treatment

• AEDs (Antiepileptic Drugs)
• 31 Total AEDs
• Keppra
• Levetiracetam (generic)
• Topamax
• Topiramate

www.drugs.com
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Seizure Medications
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Keppra (Levetiracetam)

• UCB Pharma, Inc
• FDA approved Nov. 1999
• No first pass affect
• Does not interact with other AED medication
• Used in combination with other drugs
• Pyrrolidine derivative
• MW 170.21 g/mol

http//www.pharmazeutische-zeitung.de
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Topamax (Topiramate)

• Made by Ortho-McNeil Pharmaceuticals
• FDA approved Dec. 1996
• Sulfamate-substituted monosaccharide
• MW 339.37 g/mol
• Metabolized by liver cytochrome p450 enzymes

http//www.pharmazeutische-zeitung.de/
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Drug Discovery

• 1800s Bromide
• 1912 Phenobarbitol
• 1938 Dilantin
• 1945 Trimethadione
• 1963 Valium
• 1974 Tegretol
• 1978 Depakene

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Mechanism of action

• Topiramate
• Block voltage gated sodium channels
• Initiates kainate activity by activating the AMPA
  receptor
• Increases the amount of the neurotransmitter
  gamma-aminobutyrate acid (GABA) activity at GABA
  receptors
• Levetiracetam
• Opposes the activity of negative modulators of
  GABA and glycine-gated currents and partially
  inhibits N-type calcium currents in neuronal
  cells
• Binding to SV2 protein

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Drug Costs

• Keppra
• 81.99/month supply
• 227.96 /3 month supply
• Topamax
• 227.70/2 month supply 50mg pills
• 322.96 /2 month supply 100mg pills

Photos google images
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Drug administration

• Keppra
• Oral
• 250, 500, 750, 1000 mg
• Liquid
• 100mg/mL
• Intramuscular
• 100mg/1 mL

• Topiramate
• Tablets
• 25, 100, 200 mg
• Sprinkle Capsules
• 15, 25 mg

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Side effects

• Keppra
• Severe
• Depression
• Suicidal thoughts
• Anxiety
• Common
• Sleepiness
• Mood changes
• No strength or energy

• Topamax
• Severe
• Kidney stones
• Glaucoma
• Acidosis
• Absence of Sweating
• Common
• Fatigue
• Nervousness
• Memory
• Loss of appetite

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Others forms of treatment

• Ketogenic diet Strict intake of protein,
  calories and carbohydrates leads to acidosis and
  ketosis
• Vagus nerve stimulator- Electrical stimulation of
  the vagus nerve to decrease
• frequency of seizures
• Surgery

http//health.allrefer.com
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Other effects of the disease

• Legally
• Emotionally
• Physically