SUMMARY 癫痫发作用药总结
Epilepsy is a collection of different syndromes, all of which have the same characteristic: A sudden discharge of excessive electrical energy from nerve cells located within the brain. This event is called a seizure.
癫痫是多种综合征的集合体，各种综合征都有相同的特点：大脑神经细胞过多电能的突然放电。这一事件被称为癫痫发作。
Seizures can be divided into two groups: Generalized and partial (focal).
癫痫发作可分为两大类：全身性和部分性（病灶性）
Generalized seizures can be further classified as tonic–clonic (grand mal); absence (petit mal); myoclonic; febrile; and rapidly recurrent (status epilepticus).
全身性癫痫发作可进一步分为强直-阵挛性（癫痫大发作）、失神性（癫痫小发作）、肌阵挛性、发热性和快速复发性（癫痫持续状态）。
Partial (focal) seizures can be further classified as simple or complex.
局部性（病灶性）癫痫发作可进一步分为单纯性和复杂性。
Drug treatment depends on the type of seizure that the patient has experienced and the toxicity associated with the available agents.
药物治疗取决于患者所经历的癫痫发作类型和与可用药剂相关的毒性。
Drug treatment is directed at stabilizing the overexcited nerve membranes and/or increasing the effectiveness of GABA, an inhibitory neurotransmitter.
药物治疗旨在稳定过度兴奋的神经膜和/或增强GABA效果。GABA为抑制性神经递质。
Adverse effects associated with antiepileptics (e.g., insomnia, fatigue, confusion, GI depression, bradycardia) reflect the CNS depression caused by the drugs.
与抗癫痫药（如失眠、疲劳、意识错乱、GI抑制、心搏徐缓等）相关的不良效应反映了药物引起的CNS抑制。
Patients being treated with an antiepileptic should be advised to wear or carry a MedicAlert notification to alert emergency medical professionals to their epilepsy and their use of antiepileptic drugs.
应建议开始某种抗癫痫药治疗的患者佩带或携带医疗警示标识，以便提醒急病医疗专业人员注意其癫痫及抗癫痫药的使用问题。
Patients being treated with an antiepileptic are often on long-term therapy, which requires compliance with their drug regimen and restrictions associated with their disorder and the drug effects.
开始某种抗癫痫药治疗的患者经常处于长期治疗中，这就需要患者顺从药物治疗方案，遵守与其疾病和药物效应相关的限制。
★Vocabulary ★
collection – n. 收集，集合体，集成
epilepsy – n. 癫痫（症）
seizure – n. 癫痫发作
generalized seizure – 全身性癫痫发作
partial seizure – 局部性（部分性）癫痫发作
focal seizure – 病灶性癫痫发作
tonic–clonic seizure – 强直阵挛性癫痫发作
grand mal – 癫痫大发作
absence seizure – 失神性癫痫发作
petit mal – 癫痫小发作
myoclonic seizure – 骨阵挛发作
febrile seizure – 热性癫痫发作
rapidly recurrent seizure – 快速再发性癫痫发作
status epilepticus – 癫痫持续状态
simple seizure – 单纯性癫痫发作
complex seizure – 复杂性癫痫发作
toxicity – n. 毒性
GABA –γ-氨基丁酸
neurotransmitter – n. 神经递质
antiepileptic – n. 抗癫痫药
1. A 32-year-old man presented to the emergency department with a throbbing headache on the right side of his head. He had vomited several times and retreated to a quiet, dark corner of the emergency department. He had a normal neurological examination and a head CT was normal as well. Which of the following medications would not be effective in preventing future headaches?
A. Topiramate
B. Amitriptyline
C. Lithium
D. Carbidopa - levodopa 2. Which of the following medications is contraindicated in patients with myasthenia gravis?
A. Azathioprine
B. Levetiracetam
C. Glatiramer acetate
D. Lisinopril
E. Ciprofloxacin
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案 Answers
1. C. Lithium
The clinical case is characteristic for a migraine headache. Prophylactic treatment is indicated for migraines when there are more than two per month, or most importantly, when it causes disruptions to the person’s lifestyle by missing school or work. Acceptable treatments include several antiepileptics (topiramate, valproic acid), tricyclic antidepressants, ribofl avin (vitamin B2), calcium-channel blockers, and beta-blockers.
2. E. Ciprofloxacin
Many medications can exacerbate myasthenia gravis (MG) and lead to a crisis. These include: calcium channel blockers (verapamil, nifedipine), aminoglycoside antibiotics (neomycin, gentamicin, streptomycin) and fluoroquinolones (ciprofloxacin, erythromycin), antiepileptics (phenytoin and gabapentin), beta-blockers (propranolol, labetalol), magnesium, quinidine, steroids, and botulinum toxin. These medications should be used only if absolutely needed in patients with MG, especially after surgery.
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