Lewetiracetam i leczenie padaczki w szczególnych sytuacjach klinicznych

Karol Jastrzębski; Magdalena Justyna Kacperska

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Aktualności Neurologiczne

2013 | 13 | 4 | 258–266

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Lewetiracetam i leczenie padaczki w szczególnych sytuacjach klinicznych

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Karol Jastrzębski , Magdalena Justyna Kacperska

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Levetiracetam and therapy of epilepsy in specific clinical situations

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Abstracts

Epilepsy is a chronic, frequently encountered neurological disease, demanding long-term treatment with antiepileptic drugs (AEDs). It involves high treatment expenses. Epilepsy is a complex pathophysiological process, the numerous and complex symptoms are the result of various disorders of the brain. In the treatment of epilepsy, there is no one standard way to proceed. The main and primary goal of epilepsy treatment is complete seizure control and getting the least side effects during treatment with antiepileptic drugs. It is vital that individual adjustment of the drug for each patient. The drug should be adapted to the type of seizure or seizure team, the frequency and severity of seizures. The emergence of a new generation of drugs gave them a certain advantage over the older generation drugs. Levetiracetam is one of the antiepileptic drugs – the pharmacokinetic profile of levetiracetam has been evaluated in many populations. Overall, levetiracetam has a very favourable pharmacokinetic profile, with rapid absorption following oral administration, excellent bioavailability, quick achievement of steady-state concentrations, linear kinetics, minimal plasma protein binding and without important hepatic metabolism. The mechanism of actions is still unclear. It may be used as monotherapy in patients with newly diagnosed epilepsy, to treat seizures with focal onset with secondary generalization or without secondary generalization. Levetiracetam may also be used supplementary to other antiepileptic drugs in the treatment of seizures of focal onset with secondary generalization or without secondary generalization, myoclonic seizures or primary generalized tonic-clonic seizure. This medicine is very useful tool for clinicians.

Padaczka (epilepsia) to przewlekłe i częste schorzenie neurologiczne, wymagające długotrwałego stosowania leków przeciwpadaczkowych. Liczne i złożone objawy tego skomplikowanego procesu patofizjologicznego są wynikiem różnych zaburzeń funkcji mózgu. W leczeniu padaczki nie występuje jeden standardowy sposób postępowania. Głównym i podstawowym celem leczenia padaczki jest całkowita kontrola napadów i zminimalizowanie objawów niepożądanych spowodowanych terapią lekami przeciwpadaczkowymi. Ogromne znaczenie ma indywidualne dopasowanie leku do każdego pacjenta. Lek powinien być dostosowany do typu napadu lub zespołu padaczkowego, częstości i ciężkości napadów. Pojawienie się leków nowej generacji dało im pewną przewagę w stosunku do leków starszej generacji. Jednym z dostępnych na rynku leków przeciwpadaczkowych jest lewetiracetam, występujący w postaci podłużnych tabletek. Można go stosować w monoterapii u pacjentów od 16. roku życia z nowo rozpoznaną padaczką, w leczeniu napadów padaczkowych o początku ogniskowym z wtórnym uogólnieniem lub bez wtórnego uogólnienia. Lewetiracetam można również dodawać do terapii innymi lekami przeciwpadaczkowymi, w leczeniu m.in. napadów padaczkowych o początku ogniskowym z wtórnym uogólnieniem lub bez wtórnego uogólnienia u dzieci od 1 miesiąca życia, drgawek mioklonicznych (u pacjentów w wieku powyżej 12 lat z młodzieńczą padaczką miokloniczną) czy pierwotnych uogólnionych napadów toniczno-klonicznych u pacjentów powyżej 12 lat z idiopatyczną padaczką uogólnioną. Lek ten między innymi pomaga w stabilizowaniu aktywności elektrycznej w mózgu i zapobiega napadom.

Keywords

antiepileptic drugs cytokiny prozapalne epilepsy epileptogenesis epileptogeneza farmakokinetyka inflammation leki przeciwpadaczkowe levetiracetam lewetiracetam padaczka pathogenesis patomechanizm pharmacokinetics pro-inflammatory cytokins terapia padaczki treatment of epilepsy zapalenie

Discipline

MEDICINE: MEDICINE

Publisher

Medical Communications

Journal

Aktualności Neurologiczne

Year

2013

Volume

Issue

Pages

258–266

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References

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