Drugs for Treating Absence Seizures
治疗失神性癫痫发作的药物
Three other drugs that are used in the treatment of absence seizures do not fit into a specific drug class. These include acetazolamide (Diamox), valproic acid (Depakene), and zonisamide (Zonegran).
用于治疗失神性癫痫发作的其他3种药物不属于特种药物种类。这些药物包括乙酰唑胺（丹木斯）、丙戊酸（德巴金）和唑尼沙胺（佐能安）。
Valproic acid reduces abnormal electrical activity in the brain and may also increase GABA activity at inhibitory receptors. It has been used for migraine prevention and has a pregnancy category X rating when used for that purpose.
丙戊酸减少大脑的异常电活动，也可能会增强抑制性受体的GABA活性。该药用于偏头痛预防，用于该目的时属于妊娠期用药分类X级药。
Acetazolamide—a sulfonamide—alters electrolyte movement, stabilizing nerve cell membranes.
乙酰唑胺 – 磺胺类药 – 改变电解质运动，稳定神经细胞膜。
Another sulfonamide—zonisamide—is a newer agent that inhibits voltage-sensitive sodium and calcium channels, thus stabilizing nerve cell membranes and modulating calcium-dependent presynaptic release of excitatory neurotransmitters.
另外一种磺胺类药是唑尼沙胺，这是一种新药，抑制电压敏感性钠、钙离子通道，从而稳定神经细胞膜，调节兴奋性神经递质的钙依赖性突触前释放。
These drugs are contraindicated with known allergy to any component of the drug. The sulfonamides are also contraindicated with known allergy to antibacterial sulfonamides and thiazide diuretics to avoid hypersensitivity reactions. When it is discontinued, zonisamide should be tapered over 2 weeks because of a risk of precipitating seizures. Patients who take this drug should be very well hydrated due to risk of renal calculi development.
对药物成份过敏者禁忌。已知对抗菌性磺胺类药和噻嗪利尿剂过敏者也禁忌使用磺胺类药，以避免超兴奋反应。停用时，唑尼沙胺应用2周时间逐渐减少，否则会有触发癫痫发作危险。服用该药的患者应充分水合，因为会有肾结石危险。
Caution should be used in patients with hepatic or renal impairment, which could alter metabolism and excretion of the drug. These drugs should not be used during pregnancy or lactation unless the benefit clearly outweighs the risk to the fetus or neonate because of the potential for serious adverse effects on the baby.
慎用者包括：有肝或肾损害的患者，疾病可能改变药物的代谢和排泄。妊娠期间或哺乳期间不应使用这些药物，除非好处明显大于胎儿或新生儿危险，因为会对婴儿产生潜在的严重不良效应。
★Vocabulary for Today ★
absence seizures – 失神性癫痫发作
acetazolamide – n. 乙酰唑胺
Diamox – n. 丹木斯
valproic acid – n. 丙戊酸
Depakene – n. 德巴金
zonisamide – n. 唑尼沙胺
Zonegran – n. 佐能安
GABA – γ-氨基丁胺
migraine – n. 偏头痛
sulfonamide – n. 氨苯磺胺
voltage-sensitive – 电压敏感性
calcium channel – 钙通道
sodium channel – 钠通道
modulate – v. 调制，调整
presynaptic – a. 突触前的
1. A 21-year-old woman plans to spend a semester high in the Andes. She shares a concern with her doctor about the elevation because 1 year ago, she went on a ski trip to Colorado and developed altitude sickness. Her doctor prescribes a diuretic that can help her if she begins to have symptoms of altitude sickness. Which diuretic did her doctor likely prescribe?
A. Acetazolamide
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol 2. A 79-year-old woman with diabetes mellitus, hypertension, and visual disturbances presents to her ophthalmologist for management of her eye condition. She is found to have open-angle glaucoma. Prescription for acetazolamide is given to produce which of the following responses?
A. Decrease production of aqueous humor
B. Increasing intraocular pressure
C. Inhibition of sodium-calcium transport
D. Stimulating carbonic anhydrase
答案 Answers 1. A. Acetazolamide.
A principal issue at high altitude is the low partial pressure of oxygen. The low amount of oxygen stimulates the body to breath faster and deeper, leading to a respiratory alkalosis because too much carbon dioxide is breathed off. Acetazolamide reverses this alkalosis by inhibiting carbonic anhydrase in the kidneys, causing bicarbonate to be excreted in the urine. Administration of acetazolamide in many patients leads to resolution of the symptoms of altitude sickness. 2. A. Decrease production of aqueous humor.
The most common use of acetazolamide is to reduce the elevated intraocular pressure of open-angle glaucoma. Acetazolamide decreases the production of aqueous humor, probably by blocking carbonic anhydrase in the ciliary body of the eye. It is useful in the chronic treatment of glaucoma but should not be used for an acute attack.
当前位置：
