39.承上題,下列那一種抗癲癇藥物常用來治療此病童之癲癇發作?
(A)Valproic acid
(B)Lithium carbonate
(C)Phenytoin
(D)Diazepam

答案:登入後查看
統計: A(3320), B(125), C(459), D(301), E(0) #415081

詳解 (共 10 筆)

#1099057

Seizure

1. 局部性

   (1) 單純性: Phenytoin(Na+-channel)Carbamazepine(Na+-channel)Valproic acid(Na+, Ca+-channel; transaminase inhibitor→GABA↑)

   (2) 複雜性: (同上)

2. 全身性

   (1) 大發作: (同上)

   (2) 小發作: Ethosuximide(Ca+-channel)Valproic acid

   (3) 失神性: Ethosuximide(Ca+-channel)Valproic acid

   (4) 重積性: DiazepamLorazepam

   (5) 肌痙性: Valproic acid

   (6) 兒童熱痙攣: Phenobarbital

177
0
#2552323
32 下列那一種抗癲癇藥物,不能使用於失神性癲癇(absence seizure)的病人? 
(A) Ethosuximide 
(B) Lamotrigine 
(C) Phenytoin 
(D) Valproic acid 
 
答案:C 
 
 
34
1
#2893127
失神性癲癇最常用的藥是 Valproic...
(共 42 字,隱藏中)
前往觀看
26
1
#3228023
Spike-wave 就是小發作代表性的...
(共 38 字,隱藏中)
前往觀看
14
0
#4822151

valproic acid 可以用在局部性、大發作、小發作(失神性)、肌肉痙攣性發作  (除了重症積、小兒熱痙攣之外都可以)


萬一真的忘了 就選爆valproic acid吧

9
0
#813012
Absence seizures 失神性癲癇
6
2
#5808066


(共 1 字,隱藏中)
前往觀看
5
0
#4055260
Management of convulsive status epilepticus in children

Author:Angus Wilfong, MDSection Editor:Douglas R Nordli, Jr, MDDeputy Editor:John F Dashe, MD, PhD

Contributor Disclosures

All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: May 2020. | This topic last updated: Mar 30, 2020.

Immediate pharmacologic therapy — SE should be treated immediately, as treatment delay is associated with increased morbidity and mortality [23-25].

First therapy: Benzodiazepine – Lorazepam 0.1 mg/kg intravenously (IV) up to a maximum of 4 mg should be administered by slow IV push over one minute and its effect assessed over the next five to ten minutes [26]. An equally effective alternative is diazepam 0.2 mg/kg IV (maximum dose 8 mg) [26,27]. If seizures continue after five minutes, additional doses of lorazepam or diazepam can be given (table 2). The risk of respiratory depression increases if more than two doses of benzodiazepines are administered [7,9]. (See 'Benzodiazepines' below.)


Benzodiazepines — Benzodiazepines are the first-line treatment for SE because they can rapidly control seizures [13,21]. The three most commonly used benzodiazepines to treat SE are diazepamlorazepam, and midazolam; for first-line IV therapy, lorazepam or diazepam are the preferred agents.

5
2
#4045692

想請問一下,在兒童熱痙攣用藥方面是否有誤?

5eddbbd577091.jpg另外,摘錄自快樂小藥師:

總而言之,熱痙攣患兒需要治療的不是熱痙攣本身,而是控制發燒及追查發燒背後的原因,並加以治療。
   若是要使用來抑制癲癇症狀,不建議使用抗癲癇用藥,不論是短暫使用或是長期用來預防,多不建議使用,此類藥物有:phenytoin, carbamazepine, valproic acid, phenobarbital。不建議使用的原因是因為,抗癲癇藥物的副作用大,有藥物血中濃度監測的問題,再則phenobarbital類藥物有40%導致幼兒行為異常或是過敏的危險性。而且大部份的抗癲癇藥對熱痙攣的預防效果並不理想。目前國外多建議使用benzodiazepine類藥物,例如:diazepam, lorazepam,..等。最重要的用藥是要使用antipyretic agent來降高燒,並且防止嬰幼兒在度發高燒,因為只要一發燒,小孩熱痙攣再發率很高。Antipyretic agent藥物有:acetamiophen, ibuprofen…。
 
至於在兒童復發性癲癇的首選中,確實也有查到為phenobarbital,所以是否是有問題呢?
 
4
0
#5806937
突然凝視、一動不動、檢查有spike →...
(共 57 字,隱藏中)
前往觀看
2
0