Free squishy brain

I want to begin this blog with whining a little. I should not do that though as I am doing quite well, at least that is what Cathleen - the person in charge of answering my silly questions and keeping me motivated - keeps telling me. I am just sort of frustrated because one of the doctors I attempted to speak to is not interested in working with www.rateadrug.com. To be honest I don't think the guy even looked at the materials that I dropped off for him, but I guess it doesn't really matter. Above all I wish I could have gotten some feedback so I would know what to do to alter my approach when speaking to other physicians.

Instead of complaining, though, I will choose to focus on happier things. I am nearing the end of the 'Drug of the Week' features. That will be a sad day. It has been cool to learn things on my own about the medications that surround me daily.

There are, of course, cool things that are going on in the hospital. The unit I work with is going to be allowed to use ICP monitors soon - I actually got a free promotional squish brain as part of the training. Discussion of ICP monitors is outside of the scope of this blog, but if you are interested in learing more, click the spot I linked and click on the picture, it gives a basic definition. That will be kind of cool to have those around, before only the PICU (Pediatric Intensive Care Unit) was allowed to take care of those patients. We are getting them now on sort of a trial period.

Anyway, the squishy brain got me thinking about promotional stuff. I see a lot of promotional stuff working in a hospital - duh - but one thing I hear about a lot intrigues me, it is a medication called Keppra.
As far as I know Keppra is another anti-seizure medication.
However, this is the point of this blog! To learn more about medications and drugs that surround us daily! Let's learn together shall we?

Here is Keppra as an organic molecule:



And here is a space filling molecule:

Both images tell us the same thing, but I like the pretty colored one.
Keppra's brand-x name is: Levetiracetam, but I usually know stuff by the brand name, so that is what we are going to call it.

KEPPRA is an antiepileptic drug available as 250 mg (blue), 500 mg (yellow), 750 mg (orange), and 1000 mg (white) tablets and as a clear, colorless, grape-flavored liquid (100 mg/mL) for oral administration.
(http://www.rxlist.com/keppra-drug.htm)

Keppra is used in the treatment of different types of seizures based upon the age of the patient. The types of seizures include: Tonic-clonic, parital onset, and myoclonic. This page has a great deal more information, including charts that relate the side-effects and the dosages. I have tried to get a picture posted here, but I can't seem to find the link. So, here is the link for the webpage for those of you who are interested in learning more.

I like pictures, in case you can't tell, so here are some more pictures!
These pictures are actually rather compelling, they show the efficacy rates of several different AEDs medications or anti-epileptic drugs:
Due to the fact that there is no way to illustrate the effectiveness of one AED medication over another, basically some statistical math was used to show the rate at which one medication would cause a 50% reduction in seizure activity versus a placebo.
(http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=epi&part=ch12)

Keppra works according to this model:
The Keppra molecule can be seen binding to the SV2A synaptic vesicle site (I got this image from a webpage that discussed how an AED medication can be used as a mood stabilizing agent, which shows that Keppra is not just a one-trick pony).
The Keppra molecule is the one that looks like this:






The shortest definition I could find to explain just what the SV2A vesicle protein site is is this defintion:

SV2, an integral membrane protein present on all synaptic vesicles, is a small gene family consisting of three isoforms, designated SV2A, SV2B, and SV2C. SV2A is the most widely distributed isoform, being nearly ubiquitous in the CNS, as well as being present in endocrine cells
(http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=470764)

Further reading from this page demonstrates that the exact mechanism of Keppra is under investigation, but that the protein binding of SV2A is involved and will most likely lead to further understanding of seizures via pre-synaptic response.

I am always amazed when I come across a medication where the exact mechanism is not known. I am also amazed when I come across a medication where they DO know the exact mechanism. Some of the science and study involved in this stuff is so detailed and minute that it is mind-blowing.
Medicinal chemistry would be kind of cool, but there are so many years of finding and fixing nothing for that one second of discovery. Tedious work if you ask me.

That concludes our discussion of Keppra. Be sure to tune in next time as I attempt to explain and make good on all of my 'to be continued...' posts from this internship. You don't wanna miss it!