藥理學筆記-抗精神病藥物、抗癲癇藥物、肌肉鬆弛劑－~Teachingcenter的醫學筆記~

藥理學筆記-抗精神病藥物、抗癲癇藥物、肌肉鬆弛劑

抗精神病藥物(neuroleptics)

藥物	抗精神病	止吐	鎮靜	錐體外症候群	降低血壓
Chlorpromazine	中等	中等	最強	中等	中等
Thioridazine	弱	弱	中等	弱	中等
Fluphenazine	強	強	弱	強	影響小
Halperidol	強	中等	弱	強	影響小

藥物(商品名)	Simple or complex	Absence	Atonic, myoclonic	Tonic-clonic, status epilepticus
Benzodiazepines
Diazepam (Valium)				V
Lorazepam (Ativan)				V
Phenytoin-like
Phenytoin (Dilantin)	V			V
Carbamazepine (Tegretol)	V			V
Valproic acid (Depakene)	V	V	V	V
Succinimide
Ethosuximide (Zarontin)		V	V

局部性發作(partial seizures)包含simple or complex
全身性發作(generalized seizure)包含absence、atonic, myclonic、tonic-clonic status epilepticus

藥物	機轉	備註及副作用
Carbamazepine	鈉離子通道阻斷	Hyponatremia, drowsiness, fatigue, dizziness, blurred vision, Stevens-Johnson syndrome, blood dyscrasias
Divalproex	多重機轉	Broad spectrum of antiseizure activity. Weight gain, easy bruising, nausea, tremor, hair loss, GI upset, liver damage, alopecia, sedation, hepatic failure, pancreatitis, teratogenic effects
Ethosuximide	鈣離子通道阻斷	Abrupt discontinuance of drug may causes seizures. Drowsiness, hyperactivity, nausea, sedation, GI upset, weight gain, lethargy, SLE, skin rash, blood dyscrasias
Feibamate	多重機轉	Broad spectrum of antiseizure activity. Insomnia, dizziness, headache, ataxia, weight gain, irritability, aplastic anemia, hepatic failure
Gabapentin	未知	Few drug interaction、Total renal elimination Mild drowsiness, dizziness, ataxia, weight gain, diarrhea
Lamotrigine	多重機轉	Broad spectrum of antiseizure activity. Nausea, drowsiness, dizziness, headache, diplopia, rash, Stevens-Johnson syndrome
Levetiracetam	多重機轉	Broad spectrum of antiseizure activity. Few drug interaction Sedation, dizziness, headache, anorexia, fatigue, infections, behavioral symptoms
Oxcarbazepine	鈉離子通道阻斷	Nausea, rash, hyponatremia, headache, sedation, dizziness, vertigo, ataxia, diplopia
Fosphenytoin	鈉離子通道阻斷	Not recommended for chronic use. Primary treatment for status epilepticus. Gingival hyperplasia, confusion, slurred speech, double vision, ataxia, sedation, dizziness, hirsutism, Stevens-Johnson syndrome
Pregabalin	多重機轉	Total renal elimination Weight gain, somnolence, dizziness, headache, diplopia, ataxia
Primidone	GABA 受器	Not recommended for chronic use. Sedation, lethargy, behavioral changes, ataxia, hyperactivity, nausea
Tiagabine	GABA 受器	Sedation, weight gain, fatigue, headache, tremor, dizziness, anorexia, multiple drug interactions
Topiramate	多重機轉	Broad spectrum of antiseizure activity. Few drug interaction Paresthesia, weight loss, nervousness, depression, anorexia, anxiety, tremor, cognitive complaints, headache, oligohidrosis
Zonisamide	多重機轉	Broad spectrum of antiseizure activity. Nausea, anorexia, ataxia, confusion, difficulty concentrating, sedation, paresthesia, oligohidrosis

Blood dyscrasias (血液惡病質)包含neutropenia, leukopenia, thrombocytopenia, pancytopenia, anemia

藥物	自主神經節	心肌細胞受器	組織胺釋放
異喹啉衍生物isoquinoline derivatives
Atracurium	無作用	無作用	輕微
Cisatracurium	無作用	無作用	無
Mivacurium	無作用	無作用	中度
Tubocurarine	弱阻斷	無作用	中度
固醇類衍生物steroid derivatives
Pancuronium	無作用	中度阻斷	無
Rocuronium	無作用	輕微	無
Vecuronium	無作用	無作用	無
其他others
Gallamine	無作用	強阻斷	無
Succinylcholine	刺激性	刺激性	輕微