Question

Discuss anti-epileptic drugs with respect to developmental toxicology.

Answer 1

Ans: The epilepsy is one of the several causes of brain-related disorders spanning all age groups and involves the sudden or abrupt discharge of excitatory nerve impulses. Brain tumors or stokes may lead to epileptic conditions. Epilepsy may of different types such as cryptogenic or idiopathic. The excitatory neurotransmitters which control the opening and closure of sodium ion channels can be blocked so as prevent drastic nerve impulse generation. Antiepileptic drugs do the same action. These drugs act through blockade of sodium ion channel and prolong their inactive state. Also, there would be a delay in the recovery of these channels in terms of nerve impulse generation. Examples include Lamictal, Valproic acid, Diazepam, etc. The valproic acid act through the inhibition of gamma-aminobutyric acid metabolism. these drugs are recommended solitary or in combination. The antiepileptic drugs are also reported to have side effects such as infection and may impose toxicity effects.

When we think about their developmental toxicity, it is pertinent to mention that these drugs may affect the uterus of epileptic mothers. It may lead to children with developmental abnormalities. The genetic factors associated with maternal epilepsy may also affect pregnancy apart from the exposure of uterus from antiepileptic drugs. The clinical manifestation of such drugs must be addressed to establish a relationship between disease symptoms and drug exposure. Some antiepileptic drugs are thaught to cause teratogenic effects. eg. Carbamazepine. The children exposed to such drugs prior to birth may have developmental defects such as spina bifida, distinct facial features, and lower IQ. The use of valproic acid reported causing neural defects and hypospadias. The malformation in children may also include defects related to nails, fingers, face, and joints, etc. The long-term use or their prolonged exposure may lead to children with cognitive defects and several neurological disorders, So it is essential to study the effects of antiepileptic drugs on child development during pregnancy and after birth.