The succinimides include ethosuximide (Zarontin) and methsuximide (Celontin). The succinimides are most frequently used to treat absence seizures, a form of generalized seizure.
琥珀酰亚胺类药包括乙琥胺（扎荣廷）和甲琥胺（锡朗丁）。最常用于治疗失神性癫痫发作，这是一种全身性癫痫。
1. Therapeutic Actions and Indications 治疗作用和适应症
Although the exact mechanism of action is not understood the succinimides suppress the abnormal electrical activity in the brain that is associated with absence seizures. The action may be related to activity in inhibitory neural pathways in the brain.
虽然确切的作用机制尚不明确，但琥珀酰胺可以抑制与失神性癫痫发作相关的大脑异常电活动。其作用可能与大脑抑制性神经通路活动有关。
Ethosuximide and methsuximide are indicated for the control of absence seizures. Ethosuximide should be tried first; methsuximide should be reserved for the treatment of seizures that are refractory to other agents because it is associated with more severe adverse effects.
乙琥胺和甲琥胺适用于控制失神性癫痫发作。应先试用乙琥胺。甲琥胺则保留用于其他药物难以治疗的癫痫的治疗，因为该不良效应更严重些。
2. Contraindications and Cautions 禁忌症和注意事项
The succinimides are contraindicated in the presence of allergy to any of these drugs to avoid hypersensitivity reactions. Caution should be used with succinimides in patients with intermittent porphyria, which could be exacerbated by the adverse effects of these drugs, and those with renal or hepatic disease, which could interfere with the metabolism and excretion of these drugs and lead to toxic levels. Use during pregnancy should be discussed with the woman because of the potential for adverse effects on the fetus. Another method of feeding the baby should be used if one of these drugs is needed during lactation because of the potential for adverse effects on the baby.
对药物过敏者禁忌使用琥珀酰亚胺，以避免超兴奋反应。琥珀酰亚胺慎用者包括，间歇性卟啉病患者，该病可能加重这些药物的不良效应；肾或肝病患者，这些病可能影响这些药物的代谢和排泄，导致中毒。妊娠期间使用应先与妇女商讨，因为可能对胎儿产生潜在的不良效应。若需要在哺乳期间使用其中一种药物，鉴于对婴儿的潜在不良效应，应采取其他方式喂养婴儿。
3. Drug–Drug Interactions 药-药相互作用
Use of succinimides with primidone may cause a decrease in serum levels of primidone. Patients should be monitored and appropriate dose adjustments made if these two agents are used together.
琥珀酰亚胺与扑米酮一起使用可能引起扑米酮血清浓度下降。两种药物一起使用时，应监测患者，并适当调整剂量。
★Vocabulary for Today ★
succinimides – n. 琥珀酰亚胺类
ethosuximide – n. 乙琥胺
Zarontin – n. 扎荣廷
methsuximide – n. 甲琥胺
Celontin – n. 锡朗丁
absence seizures –失神性癫痫发作
electrical activity – 电活动
reserve – v. 保留
refractory (to) – a. 难治疗的，执拗的
porphyria – n. 卟啉症
primidone – n. 扑米酮
1. Nurse Martha is teaching her students about anxiety medications, she explains that benzodiazepines affect which brain chemical?
A. Acetylcholine
B. Gamma-aminobutyric acid (GABA)
C. Norepinephrine
D. Serotonin 2. A 16-year-old child is brought to the emergency department by his mother with a complaint that the child just experienced a tonic-clonic seizure. On arrival in the emergency department no apparent seizures were occurring. The mother states that her son is taking medication for the seizure disorder. The nurse plans care, knowing that which of the following medications are used for long-term control of tonic-clonic seizures? Select all that apply. A. Diazepam (Valium)
B. Alprazolam (Xanax)
C. Gabapentin (Neurontin)
D. Ethosuximide (Zarontin)
E. Carbamazepine (Tegretol)
F. Methylphenidate (Ritalin)
1. B. Gamma-aminobutyric acid (GABA)
Antianxiety medications stimulate the neurotransmitter GABA, which is a chemical associated with relaxation. The other options are not affected by benzodiazepines. 2. C, D, and E.
Medications that are prescribed for long-term control of tonic-clonic seizures are gabapentin, ethosuximide, and carbamazepine. Diazepam is a medication that is prescribed to halt tonic-clonic episodes, and methylphenidate is a medication used to treat attention deficit hyperactivity disorder. Both of these medications are not suitable for long-term control of a seizure condition. Alprazolam is a medication used to treat anxiety.
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