BIOMOLECULAR MECHANISM OF ANTI EPILEPTIC DRUGS
Keywords:
AED, mechanism of action, epilepsyAbstract
Epilepsy therapy is almost always chronic and often used more than one drug. Currently, antiepileptic drugs are still the mainstay of therapy for epilepsy. An understanding of the pharmacodynamics and pharmacokinetics of these drugs would be very helpful in choosing the right medication and develop a study to determine the drug's mechanism further. Mechanism of action of AED (anti epileptic drug) can be categorized into four main groups: (1) modulation of voltage-gated ion channels, including sodium, calcium, and potassium; (2) increase in GABA inhibition through an effect on GABA-A receptors, the GAT-1 GABA transporter, or GABA transaminase; (3) direct modulation of the synaptic release of such SV2A and α2δ; and (4) inhibition of excitatory synapses through ionotropik glutamate receptors including AMPA receptors. AED work to balance the process of inhibition and excitation in the brain, so it can be used both for epilepsy and other diseases with similarities with the pathophysiology of epilepsy.
References
Conway JM HT. Antiepilepsy Drugs : Mechanisms of Action and Pharmacokinetics Antiepilepsy Drugs : Mechanisms of Action and Pharmacokinetics. Epilepsy. 2012;1(5):1–11.
Ben-Menachem E. Mechanism of action of vigabatrin : correcting misperceptions. Acta Neurol Scand. 2011;124(192):5–15.
Ximenes JCM, Verde ECL, Mazzacoratti MG, Viana GS. Valproic Acid, a Drug with Multiple Molecular Targets Related to Its Potential Neuroprotective Action. Neuroscience & Medicine, 2012;3:107-123.
Rogawski MA, Cavazos JE.. Mechanisms of Action of Antiepileptic Drugs. Dalam : Wyllie E, Gidal BE, Goodkin HP, Loddenkemper T, Sirven J, editor. Wyllie’s Treatment of Epilepsy: Principles and Practices. Edisi ke-6. Wolters Kluwer. Philadelphia. 2015. h.522-529.
Lason W, Chlebicka M, Rejdak K. Research advances in basic mechanisms of seizures and antiepileptic drug action. Pharmacological Reports. 2013;65:787-801.
Lee SK. Old versus New: Why Do We Need New Antiepileptic Drugs? J. Epilepsy Res. 2014;4(2):39-44.
Krasowski MD, McMillin GA. Advances in antiepileptic drug testing. Clin Chim Acta. 2014;436:224–236.
Shi J, Anderson D, Lynch BA, Castaigne J, Foerch P, Lebon F. Combining modelling and mutagenesis studies ofsynaptic vesicle protein 2A to identify a series of residues involved in racetam binding. Biochem. Soc. Trans. 2011;39:1341–1347.
Bialer M, Johannessenb, Levyc RH, Peruccad E. Tomson T, White HS. Progress report on new antiepileptic drugs: A summary of the Eleventh Eilat Conference (EILAT XI). Epilepsy Research. 2013;103:2-30.
Singh SK, Brashier DBS.Perampanel: New drug for treatment of refractory partial onset seizures. Muller Journal of Medical Science and Research. 2014; 5(2):195-199.
Sitges M, Chiu LM, Reed RC. Effects of Levetiracetam, Carbamazepine, Phenytoin, Valproate, Lamotrigine, Oxcarbazepine, Topiramate, Vinpocetine and Sertraline on Presynaptic Hippocampal Na+ and Ca2+ Channels Permeability. Neurochemical research. 2016;41(4):758-769.
Kurian M, Korff CM. Steroids in Pediatric Epilepsy: Infantile Spasms and Beyond. Epileptologie. 2011;28: 15 – 20.
