Drugs which have been found to increase the serum concentration of antiepileptic drugs presumably by inhibiting their metabolism pharmacodynamic interactions clinical observations suggest that certain aed combinations may be associated with adverse or beneficial interactions at pharmacodynamic level 22 . Anti epileptic medications encompass a wide range of drugs including anticonvulsants benzodiazepines enzyme inducers or inhibitors with a variety effects including induction of cytochrome p450 and other enzyme which may lead to catabolism of vitamin d and hypocalcemia and other effects that may significantly effect the risk for low bone mass and fractures. Antonio gil nagel in side effects of drugs annual 2005 metabolism the effect of antiepileptic drugs on body weight has been reviewed 5 r valproic acid carbamazepine gabapentin and vigabatrin are associated with weight gain the mechanisms have not been identified. Antiepileptic drugs may act to enhance cl influx or decrease gaba metabolism view media gallery the gaba system can be enhanced by binding directly to gaba a receptors by blocking presynaptic gaba uptake by inhibiting the metabolism of gaba by gaba transaminase and by increasing the synthesis of gaba. It has indeed antiepileptic drugs and bone metabolism 421 been shown that vpa intake does not influence vitamin d should address changes in bmd after longer treatment peri levels gough et al 1986 hence different mechanisms ods of action have to be taken into consideration vpa is a potent inhibitor of several histone deacetylases hda
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