Ca2Ca2

FIGURE 19-3 Antiseizure drug—induced reduction of current through T-type Ca2+ channels. Some antiseizure drugs (shown in blue text) reduce the flow of Ca2+ through T-type Ca2+ channels (see Chapter 12), thus reducing the pacemaker current that underlies the thalamic rhythm in spikes and waves seen in generalized absence seizures.

FIGURE 19-3 Antiseizure drug—induced reduction of current through T-type Ca2+ channels. Some antiseizure drugs (shown in blue text) reduce the flow of Ca2+ through T-type Ca2+ channels (see Chapter 12), thus reducing the pacemaker current that underlies the thalamic rhythm in spikes and waves seen in generalized absence seizures.

Measurement of drug concentrations in plasma facilitates pharmacotherapy, especially when therapy is initiated, after dosage adjustments, in the event of therapeutic failure, when toxic effects appear, or when multiple-drug therapy is instituted. However, clinical effects of some drugs do not correlate well with their plasma concentrations, and recommended concentrations are only guidelines. The ultimate therapeutic regimen must be determined by clinical assessment of efficacy and toxicity.

Phenytoin

Phenytoin (Dilantin) is effective against all types of partial and tonic-clonic seizures but not absence seizures.

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