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?????????? ??????????????

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Title: Antidepressants other drugs used in affective disorders Author: Zofik II Last modified by: Lambev Created Date: 10/21/2006 3:38:35 PM Document presentation format – PowerPoint PPT presentation

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Title: ?????????? ??????????????


1
?????????? ?????????????? ??????????????? ?
???????? ??????????? ???????
  • ?????? ???????
  • 30 ??. ?????? (2010)

2
?????????
  • ?? ?????????????, ???????? ?????????? ?? ??????
    ? ???????? ?????????, ?????????? ?? ? ?????????
    ?? ????????, ????? ????? ?? ??????????? ??
    ????????? ?? ??????????.
  • ?? ? ???? ?? ???-??????? ??????????? ?? ????????
    ??????? 4-10 ?? 1000 ???? ?????????
  • ???????? ????????
  • ???????????? ???????
  • ????????????? ? ?????? ??????? - 50 ?? 10
    ??????? ???????, ? 70 ?? 20 ???.
  • ??????? ?? ????????, ????????, ? ??????????????
    ??????? ?? ????????? ??????????, ?????? ??
    ???????, ???????? ??? ???????????? ???????.
  • ????????????? ?? ??????? ????? ?? ????????
    ?????????? ????? (excitotoxicity).

3
?????????
4
?????????
  • ????????????? ???????-???????? ???????? (grand
    mal) - ????? ???????? ??????????,
    ??????????????? ????????? ?? ??????????.
    ????????? ???? ??????, ?????? ? ??????? ?,
  • ???? ???? ????????? ?????????? ????????? ? ???.
  • ?????? (petit mal) - ?????????????? ?????????,
    ???????? ? ?????? ???????, ??? ????????, ??? ????
    ?????? ??????, ??????? ?? ????? ? ? ??????????? ?
    ????? ?? ?????????? ????????????..
  • ??????????? (???????) ????????. ?? ?? ??????????
    ?? ???????????? ?????????, ???????? ???? ????
    ???? ?? ??????, ??? ?? ?? ???????????. ?
    ?????????? ?? ???? ??? ???? ?? ?????? ?
    ?????????, ?????????? ?? ????????. ???? ??
    ???-????? ????????? ???????? ??? ???????????
    ????????.

5
??????? ?? ??
  • ?????? ????? ????????? ?????????? ?????????
    (EPSP) ? ??????????? ?????????????? ?????????
    (IPSP).
  • ??? ?? ????????? ????????? ?? ??????????
    ???????????????? ? ????????????????? ??
    ????????????? ??????? ?? ??????????????? ??????.
  • ?????????? ??????????????
  • ??????????? Phenobarbital (1912)
  • ?????????? Phenytoin (1938)
  • ???????????????? Trimethadione
  • ??????????? Ethosuximide
  • ???????????? Carbamazepine, Oxcarbazepine
  • ?????????????? Diazepam, Clonazepam,
    Clorazepate
  • ????????? Valproic acid, Sodium valproate
  • Vigabatrin
  • Gabapentin
  • Lamotrigine
  • Felbamate
  • Tiagabine
  • Topiramate
  • Levetiracetam

????
6
????????? ?? ????????
  • ??????????? ?? GABA ??????
  • - ????????????? ????
  • - ?????????? ?? GABA ??????????????
  • - ?????????? ????????
  • ?????????? ?? Na ????? Phenytoin,
    Carbamazepine,Valproate,Lamotrigine
  • ????????? ?? T-(???????????? ?????????) ? L-???
    ???????? ?????? Ethosuximide (T-???), Gabapentin
    (L-???)?
  • ????????? ?? ??????????? ???????? NMDA (N
    -methyl-D-aspartate) ?????? (????
    ??????-??????????? ?????) felbamate, valproic
    acid ? AMPA/Kainate ?????? topiramate?
  • ???? ????????? (levetiracetam, zonisamide),
    ???????? ?? ?????, ?????????? ?????????.
    ????????? ?? ?????????? ?? ???????????
    ??????????? ??????? 2A, ????? ??? ???? ?
    ??????-????????? ?????? ?? ????????????? ??
    ???????????????.

Barbiturates (Phenobarbital) Benzodiazepines
Vigabatrin Tiagabine Gabapentin
7
????????????? ?? ??????????? ???????????? ??
????????? ????? ? ????????? ?? ??????-??????????
?????????? ??????????.
????????? ?? ????????
?-???????? ?? ????????? ?? ??????????
??????????? ??????????? ? ????????????????? ???
? ?????????????? ?? ?????????.
8
??????????? ???????? ?? GABA-A ?????????
?????????????? (? ????? Cl-????? ? ???????),
??????????? (? ????????? ?? ???????? ?? ??????),
Ganaloxone????????? ?? ???????? ??????
Tiagabine?????????? ?? GABA ?????????????
Vigabatrine?????????? ?? ???????????????????????
Gabapentin, Valproate????????????? Progabide
????????? ?? ????????
GABA-A-?????????? ?????? ????????? ????????
??????? ???????? ?? (Cl-) ? ???? ??
???????????????.
9
A????????????????????? ????????
???????-???????? ???????(grand mal) carbamazepine, oxcarbazepine, phenytoin, valproate, vigabatrin, lamotrigin, gabapentin, topiramate
??????? (petit mal) ethosuximide, valproate, lamotrigine, clonazepam
??????? ?? ???????????? ?? carbamazepine, oxcarbazepine, valproate clonazepam, topiramate, phenytoin, lamotrigine
?? ?????? diazepam i.v. per rectum, diazepam, clonazepam i.v.
???????????? ????? carbamazepine, gabapentin
????????????? ?? ???????????? carbamazepine, valproate, lamotrigine
10
????????? ???????? ??? ??? ?? ?????? ?? ???
Carbamazepine ??????, ?????????, ??????, ?????????????, ?????, ?????? ???????????, ????????? ??? ?????? ???????, ??????????, ????????
Ethosuximide ??????, ????????? ????????? ?? ????, ???????????, ??????????????
Felbamate ??????, ?????????, ?????????, ?????????? ????????, ?????????, ??????????, ???????
Gabapentin - ?????????, ???????????, ???????
Lamotrigine ?????????, ?????? ???????????, ??????????
Levetiracetam ???????? ?????, ?????????, ???????????, ?????????????
Oxcarbazepine ??????, ?????????, ???????????? ???????, ??????????, ?????????, ???????, ?????? ???????
Phenytoin ??????????? ?? ???????, ??????????, ??????, ?????????????? ????????, ??????? ?????, ?????? ???????, ???????, ??????????
Pregabalin ??????????? ???????????, ??????????, ???????
Primidone, phenobarbital ??????, ?????? ?????????? ?? ????, ???????, ????????, ???????????? ???????, ??????????????, ???????, ????????, ??????????
Tiagabine - ???????????, ????? ?? ???????, ?????????, ??????, ????????, ??????, ?????? ????????????, ??????? ?????
Topiramate ?????? ?? ?????, ???????? ??????, ?????????? Fatigue, nervousness, difficulty concentrating, confusion, depression, anorexia, language problems, anxiety, mood problems, tremor
Valproate ??????? ?? ?????, ??????, ?????????, ????????, ????????? ??? ??????????? ??????

11
PHENYTOIN
Antiepileptic Drugs Author Juan G Ochoa
CARBAMAZEPINE
LAMOTRIGINE
ETHOSUXIMIDE
DIAZEPAM
1. Katzung BG. Bacis and clinical pharmacology,
11th ed. 2009 2.Ochoa JG. Antiepileptic drugs.
Available from http//emedicine.medscape.com/arti
cle/1187334-overview 3.Tripathi KD. Essential of
medical Pharmacology, 5th ed. 2004 4.
???????????? ??? ?????????? ?? ??. ?????? ? ?.
?????????
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