III. Agents that activate the gabAergic system

1. Increasing the affinity of GABA to GABAA receptors: Benzodiazepines (diazepam, lorazepam, clonazepam); Phenobarbital; Topiramate

2. Contributing to the formation of GABA and preventing its inactivation: Sodium valproate

3. Interfering with GABA inactivation: Vigabatrin

4. Blocking neuronal and glial uptake of GABA: Tiagabin

5. Enhancing the release of GABA into the synaptic cleft: Gabapentin

IV. Agents that lower the activity of the glutamatergic system

1 drugs that reduce the release of glutamate from presynaptic endings: Lamotrigine

2.Media blocking glutamate receptors: Topiramate.

Mechanism of action: inhibit interneuronal transmission of excitation (by all mechanisms described in the classification).

Side effects:

1. Sedation, impaired ability to concentrate and slow down the speed of psychomotor reactions; 2. Dyspeptic disorders (nausea, vomiting, epigastric discomfort); 3. Inhibition of hematopoiesis; 4. Hepatotoxicity (diphenin, sodium valproate); 5. Allergic reactions; 6. Neurotoxicity; 7. Teratogenicity (sodium valproate, diphenin, carbamazepine); 8. Carbamazepine (with prolonged use) - bradycardia, arrhythmia, antidiuretic effect with the appearance of edema, in women - the risk of polycystic ovary disease; 9. Sodium valproate - weight gain, polycystic ovary; 10. Diphenin - gingival hyperplasia; 11. Etosuximide - parkinsonism, photophobia.

Contraindications:

1. Hypersensitivity to the drug; 2. Severe violations of the liver and kidneys; 3. Heart failure, bradycardia; 4. Pregnancy (I trimester); 5. Lactation period; 6. Myasthenia gravis; 7. Diseases of the hematopoietic system; 8. Potentially hazardous activities requiring increased attention and speed of psychomotor reactions.

3. Antiadrenergic drugs for the treatment of coronary heart disease. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.

Classification:

2) Beta-blockers:

1, Cardioselective (beta1> 2)

c) with AGR:

-acebutolol, praktolol

d) without AGR:

-metoprol, talinolol, atenolol, bisoprolol, nebivolol

2, Non-cardioselective (beta1 = 2)

d) with the AGR:

-pindolol, oxprenolol

e) without AGR:

f) –anaprilin, timolol, sotalol

2) Alpha, beta-blockers-cordarone, amiodarone, labetolol

Anaprilin - reduces heart rate and strength, stroke and minute volume, myocardial oxygen consumption. Reduces blood pressure. Relieves an attack of angina pectoris.

Side effects - narrowing of the bronchi.

Contraindications - sinus bradycardia, heart failure, bronchial asthma, diabetes mellitus, pregnancy.

Cordaron - weakly blocks alpha-adrenergic receptors, lowers blood pressure, gently blocks beta-adrenergic receptors - reduces the activity of adenylate cyclase and reduces

AMP. Causes bradycardia, decreased contractility, increased coronary blood flow, decreased oxygen demand. Blocks glucagon receptors (antiarrhythmic action).

Side effects - nausea, allergies.

Contraindications - bradycardia, pregnancy, bronchial asthma, old age, hypothyroidism.