Mechanism of action of anticonvulsant drugs that act on sodium channels. The sodium channel can normally exist in a closed (A), open (B), or inactivated (C) state. A. An activation gate is closed and sodium ions cannot pass through the channel. B. The channel activation gate opens rapidly following depolarization and sodium enters freely. Soon after opening, an inactivation gate (C) closes, preventing further entry of sodium ions into the cell. Phenytoin and drugs with a similar mechanism of action stabilize and prolong the existence of the inactivated state, and therefore, sodium entry is impeded longer than occurs in the absence of the drug.
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