Keppra (Levetiracetam) is an anti-epileptic drug, also called an anticonvulsant. Levetiracetam (Keppra) is used to treat partial onset seizures in adults and children who are at least 1 month old.
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- Epilepsy is a chronic neurological disease that affects the brain. With epileptic seizures, convulsions occur accompanied by a disconnection of consciousness.
Keppra tablets can reduce the strength of impulses that irritate the nerve endings in the brain. As a consequence, epileptic activity decreases, which contributes to the normalization of its functioning.
Medicines are indicated for partial seizures with simple or complex symptoms, psychomotor seizures, convulsive seizures in sleep, diffuse seizures, and mixed types of epilepsy. Also prescribed for such forms of epilepsy - akinetic, JME, submaximal, IGE.
Absorbs in the digestive tract almost completely, but rather slowly, because food does not affect the strength and speed of the absorption process. The maximum concentration after a one-time tablet is reached after 12 hours. A single-dose or repeated retard tablet gives a maximum concentration (25% below) after 24 hours. The retard tablets, in comparison with other dosage forms, reduce bioavailability by 15%. With blood proteins binds within 70-80%. In the saliva and cerebrospinal fluid there are accumulations that are proportional to the residues of the active component not bound to proteins (20-30%). Passes through the placenta, and also enters the breast milk. Visible volume of distribution is in the range of 0.8-1.9 l / kg. It is biologically converted in the liver (usually through the epoxide route), forming several metabolites - the 10,11-trans-diol source, as well as its compounds, including glucuronic acid, N-glucuronides and monohydroxylated derivatives. The half-life is 25-65 hours, and in case of prolonged use - 8-29 hours (due to the induction of enzymes in the metabolism process). In patients taking MOS inductors (such as phenobarbital and phenytoin), this period lasts for 8-10 hours. After a single dose of 400 mg through the kidneys, 72% of the drug taken out, and the remaining 28% are withdrawn through the intestine. In the urine, 2% of unconverted carbamazepine and 1% of the active substance (10,11-epoxy derivative) enter, and together with this about 30% of other metabolic products. In children, the elimination process is accelerated, so stronger dosages (with conversion to weight) may be needed. An anticonvulsant effect can last at least a few hours, and a maximum of several days (in some cases, 1 month). The antineviral action lasts 8-72 hours, and the anti-manic 7-10 days.
- Since epilepsy is a chronic disease that requires regular medication, it is also necessary to take the pill during pregnancy.
There was an opinion that AEP could possibly have a teratogenic effect, but it is now justified that the use of these drugs as the sole source of epilepsy treatment helps to reduce the risk of inherited malformations. Studies have shown that over 10 years against the background of the use of AEP, the frequency of inherited malformations has decreased to 8.8% from the initial 24.1%. In the course of studies, monotherapy used drugs such as primidone, phenytoin, carbamazepine, phenobarbital, and valproic acid.
Tablets from epilepsy are forbidden to people suffering from addiction or alcoholism, as well as muscle weakness. In acute form of renal failure, pancreatic diseases, hypersensitivity to the drug, various types of hepatitis, hemorrhagic diathesis. You can not accept those who engage in activities that require physical activity and concentration.
Preparations for epilepsy have such side effects: Vomiting with nausea, shaking and dizziness, reflexive rotation or movement of the eyes, problems with the function of blood circulation, drowsiness, suppression of vital functions of the NS, difficulty with breathing, disturbances of blood pressure, disorders of the musculoskeletal system. A prolonged depression can develop, rapid fatigue, irritability is observed. Sometimes there is an allergy or a rash on the skin, which in some cases can go to the Quincke's edema. Possible insomnia, diarrhea, mental disorders, tremors, problems with eyesight, as well as headache.
Treatment should begin with the use of a small dose of the drug, which is shown in the patient's form of epilepsy and the type of attack. An increase in dosage occurs if the patient does not experience side effects, and seizures continue.
In case of an overdose, symptoms such as CNS suppression, drowsiness, disorientation in space, an agitated state, the appearance of hallucinations, coma may also occur. Hyperreflexia may also occur, which changes into hyporeflexia, blurred vision, speech problems, reflex repetitive eye movements, dysarthria, impaired motor coordination, dyskinesia, myoclonic cramps, psychomotor disorders, hypothermia, pupillary dilatation.
Possible tachycardia, fainting, lowering or increasing blood pressure, difficulty with breathing, pulmonary edema, gastrostasis, vomiting with nausea, decreased motor activity of the large intestine. There may be a delay in urination, oliguria or anuria, swelling, hyponatremia. Possible consequences of overdose may also be hyperglycemia, an increase or decrease in the number of leukocytes, glycosuria, as well as metabolic acidosis.
- Since lamotrigine is not able to cause a serious slowdown or induction of oxidative hepatic enzymes, the effect of combining with drugs that are metabolized in the cytochrome P450 enzyme system will be low.
Metabolism of drugs that are biologically converted in the liver (microsomal oxidative enzymes are activated), is enhanced when combined with barbiturates. Therefore, the effectiveness of AED (such as acenocoumarol, warfarin, pheninion, etc.) is reduced. In this case, combined use should monitor the level of anticoagulants to adjust dosage. Also, the effect of corticosteroids, digitalis, metronidazole, chloramphenicol and doxycycline is reduced (the half-life of doxycycline is reduced and this effect is sometimes retained for 2 weeks after barbiturate withdrawal). The same effect is also on estrogens, TCAs, paracetamol and salicylates. Phenobarbital reduces the absorption of griseofulvin by lowering its level in the blood.
Unpredictable barbiturates affect the metabolism of anticonvulsants, hydantoin derivatives - the content of phenytoin may increase or decrease, so you need to monitor the plasma concentration. Valproic acid and sodium valproate increase the phenobarbital in the blood, and it in turn reduces the saturation of clonazepam with carbamazepine in plasma.
In combination with other drugs that suppress the functions of the central nervous system (hypnotics, sedatives, tranquilizers and some antihistamines), it can cause additive suppressive effects. Monoamine oxidases prolong the duration of exposure to phenobarbital (presumably because they suppress the metabolism of this substance).
The diagnosis of "epilepsy" may correspond to different types of seizures. For example, with focal epileptic seizures, excitation from the focus only spreads within one hemisphere of the brain. The patient can not always be disturbed by consciousness. In this type of seizures, he can experience unexpected sensations - taste, smell, unreasonable emotions. With other forms of focal seizures, you can notice repetitive movements that the patient is committing. Generalized seizures of epilepsy are accompanied by loss of consciousness and can be characterized by prolonged cramps that seize all muscle groups. Also, one of the types of generalized epilepsy are absences - these are convulsive attacks with unconsciousness, but without loss of muscle tone. When absense, a person stops, his gaze rushes to one point, but sometimes he can see muscle twitching.
An exact diagnosis with the definition of the type of seizures can be determined only by a doctor after a thorough examination. The conclusions of physicians of other specialties, as well as the opinion of the patient and his relatives, can not serve as a basis for establishing an accurate neurological diagnosis and treatment.
Tablets from epilepsy should be stored in a dry place, closed from the sun. The temperature should not be above 25 degrees.
- Shelf life of epilepsy tablets Keppra is 3 years.
For ease of information perception, this instruction on the use of the drug "Keppra" has been translated and presented in a special form on the basis of the official instruction for the medical use of the drug. Before use, read the annotation attached directly to the medication.
The description is provided for informational purposes and is not a guide to self-treatment. The need for the use of this drug, the appointment of a treatment regimen, methods and dose of the drug is determined exclusively by the attending physician. Self-medication is dangerous for your health.