What are the principles of antiepileptic drug use?

  Doctors use drugs to treat epilepsy with certain principles: 1. Start treatment early after a clear diagnosis to avoid seizure-induced brain damage.  2, according to the type of seizures to choose the variety of drugs, commonly used in children carbamazepine, valproic acid, etc.. Phenytoin sodium is not suitable for infants and children. Valium is often used in the rescue of seizures that last for a long time. Corticosteroids (ACTH) are often used in infantile spasms.  3.Monotherapy, single drug can make 80% to 85% of children with epilepsy seizures completely controlled.  4. Adjust the dosage, start with a small dose and gradually adjust and increase or decrease it, paying attention to the differences in response to the drug between individual people. If seizures are frequent, the dosage should be increased early enough to reduce or control frequent seizures, provided there are no serious side effects. The time for different drugs to reach stable status varies, such as valproic acid for about 4 days, carbamazepine for 5-10 days, nitroprusside for 5-14 days, phenobarbital for 14-21 days, etc. If a drug reaches full dosage and stable status, and the condition still does not improve, consider adding or switching to another antiepileptic drug.  5. The course of treatment should be long and the discontinuation process should be slow. After the seizures are controlled by drugs, they are not immediately discontinued and should still be continued in maintenance doses for 2 to 4 years, after which the drug is reduced. The drug reduction is also gradual, and the process of drug reduction takes about six months to a year.  6. The purpose of taking medication regularly is to keep a stable amount of medication in the body at all times. Seizures cannot be predicted, and if the amount of medication in the body is not enough, there is a risk of seizures that are not controlled. The sudden discontinuation of medication will break the adaptation state between the drug and the body, which may aggravate the seizures. Drugs that are metabolized slowly in vivo, such as phenobarbital, can be taken twice a day, and valproic acid is metabolized quickly in vivo and applied 3 times a day (extended-release dosage form can be taken once a day).  7, pay attention to adverse drug reactions, the drug may appear adverse reactions to tell parents, so that the problem can be detected in a timely manner. Commonly used drugs are safer, adverse reactions are mostly mild and reversible. However, there are differences in reactions to drugs among people, so they should be closely observed. Liver and kidney function and blood tests should be checked regularly before taking medication and during treatment. Allergic reactions to antiepileptic drugs may manifest as rash, fever, sore throat and swollen lymph nodes, and damage to internal organs, and the doctor should be contacted promptly to avoid serious consequences.