소아 간질의 새로운 항간질제 (New Antiepileptic Drugs in Childhood Epilepsy)

서지정보

· 발행기관 : 대한의사협회
· 수록지 정보 : 대한의사협회지 / 52권 / 6호 / 611 ~ 626페이지
· 저자명 : 정사준

초록

Many new antiepileptic drugs (AEDs) have been developed in the last two decades,
contributing to the optimal treatment for childhood epilepsy. The goal of the treatment is to
achieve seizure-free without any side effects, that deteriorates the quality of life by causing
negative consequences. The new AEDs have not shown better efficacy, but generally seem to
be better tolerated, having fewer systemic reactions and better pharmacokinetics than the
established AEDs. The new AEDs have a broad spectrum of activities, which offer new
opportunities to patients who have not shown any favorable responses to the established ones.
There are more choices when trying to select AEDs for epileptic seizures and syndromes.
Majority of the new AEDs have more than one action mechanism. AEDs acting selectively
through the GABAergic system are tiagabine and vigabatrin; acting by inhibition of voltagedependent
Na+ and Ca2+ channels are lamotirigine, oxcabarbazepine and topiramate; and acting
by inhibition of glutamate-mediated excitation are felbamate, topiramate. The pharmacokinetic
parameters of the new AEDs compared to the established AEDs, new AEDs have improved in
terms of longer half-lives, permitting less frequent daily dosing, reduced potential for drug
interactions. Considerations in selecting an AEDs are not only dependent on seizure types or
syndromes, side effect profile, action mechanism, drug interaction, pharmacokinetic profile,
facility of drug initiation, but also on age and sex of patients. Patients with worsened seizure
frequency or development of new types of seizure after the introduction of AEDs, should be
questioned on the previously diagnosed seizure types or syndromes.

영어초록

Many new antiepileptic drugs (AEDs) have been developed in the last two decades,
contributing to the optimal treatment for childhood epilepsy. The goal of the treatment is to
achieve seizure-free without any side effects, that deteriorates the quality of life by causing
negative consequences. The new AEDs have not shown better efficacy, but generally seem to
be better tolerated, having fewer systemic reactions and better pharmacokinetics than the
established AEDs. The new AEDs have a broad spectrum of activities, which offer new
opportunities to patients who have not shown any favorable responses to the established ones.
There are more choices when trying to select AEDs for epileptic seizures and syndromes.
Majority of the new AEDs have more than one action mechanism. AEDs acting selectively
through the GABAergic system are tiagabine and vigabatrin; acting by inhibition of voltagedependent
Na+ and Ca2+ channels are lamotirigine, oxcabarbazepine and topiramate; and acting
by inhibition of glutamate-mediated excitation are felbamate, topiramate. The pharmacokinetic
parameters of the new AEDs compared to the established AEDs, new AEDs have improved in
terms of longer half-lives, permitting less frequent daily dosing, reduced potential for drug
interactions. Considerations in selecting an AEDs are not only dependent on seizure types or
syndromes, side effect profile, action mechanism, drug interaction, pharmacokinetic profile,
facility of drug initiation, but also on age and sex of patients. Patients with worsened seizure
frequency or development of new types of seizure after the introduction of AEDs, should be
questioned on the previously diagnosed seizure types or syndromes.

참고자료

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