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Jennifer R Michaels, Amy J Hodshon, William B Thomas, Dawn M Boothe, Lindsay Williams
OBJECTIVE To evaluate the pharmacokinetics of zonisamide following rectal administration of 20 or 30 mg/kg suspended in sterile water or polyethylene glycol (PEG) to healthy dogs and determine whether either dose resulted in plasma zonisamide concentrations within the recommended therapeutic target range (10 to 40 μg/mL). ANIMALS 8 healthy mixed-breed dogs. PROCEDURES Each dog received each of 2 doses (20 or 30 mg/kg) of zonisamide suspended in each of 2 delivery substrates (sterile water or PEG) in a randomized crossover study with a 7-day washout period between phases...
December 2016: American Journal of Veterinary Research
Saeed Shojaee, Ali Nokhodchi, Mohammed Maniruzzaman
Hydrophilic matrix systems are currently some of the most widely used drug delivery systems for controlled-release oral dosage forms. Amongst a variety of polymers, polyethylene oxide (PEO) is considered an important material used in pharmaceutical formulations. As PEO is sensitive to thermal oxidation, it is susceptible to free radical oxidative attack. The aim of this study was to investigate the stability of PEO based formulations containing different model drugs with different water solubility, namely propranolol HCl, theophylline and zonisamide...
November 21, 2016: Drug Delivery and Translational Research
Jennifer Weston, Rebecca Bromley, Cerian F Jackson, Naghme Adab, Jill Clayton-Smith, Janette Greenhalgh, Juliet Hounsome, Andrew J McKay, Catrin Tudur Smith, Anthony G Marson
BACKGROUND: There is evidence that certain antiepileptic drugs (AEDs) are teratogenic and are associated with an increased risk of congenital malformation. The majority of women with epilepsy continue taking AEDs throughout pregnancy; therefore it is important that comprehensive information on the potential risks associated with AED treatment is available. OBJECTIVES: To assess the effects of prenatal exposure to AEDs on the prevalence of congenital malformations in the child...
November 7, 2016: Cochrane Database of Systematic Reviews
Yasuko Noda, Toshiki Masumizu, Akitane Mori
Methylguanidine (MG) is a known nephrotoxin and neurotoxin, and an intracisternal injection of MG can induce convulsions in experimental animals. In this in vitro study, we examined the inhibitory effects of the antiepileptic agent zonisamide (ZNS) on hydroxyl radicals (•OH) generated from MG by using an electron spin resonance (ESR) technique. ZNS scavenged •OH generated from MG in a dose-dependent manner through direct scavenging during the auto-oxidation of MG. The rate constant of ZNS reacting with the •OH was at a near diffusion-controlled rate...
October 2016: Acta Medica Okayama
Shery Jacob, Anroop B Nair
Given the distinctive characteristics of both epilepsy and antiepileptic drugs (AEDs), therapeutic drug monitoring (TDM) can make a significant contribution to the field of epilepsy. The measurement and interpretation of serum drug concentrations can be of benefit in the treatment of uncontrollable seizures and in cases of clinical toxicity; it can aid in the individualization of therapy and in adjusting for variable or nonlinear pharmacokinetics; and can be useful in special populations such as pregnancy. This review examines the potential for TDM of newer AEDs such as eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, perampanel, pregabalin, rufinamide, retigabine, stiripentol, tiagabine, topiramate, vigabatrin, and zonisamide...
December 2016: Drugs in R&D
Charlayne McStay, Richard Pierce, Carley Riley
Zonisamide is a sulfonamide drug used primarily for the treatment of partial seizures in adults. We describe the case of a 15-year-old woman with a mood disorder who survived without complications after ingestion of an estimated 7.5 g of zonisamide. To the best of our knowledge, there are 4 case reports of individuals with intentional ingestion of more than 4 g of zonisamide as a single agent. Our patient developed coma and hypotension 4 hours after ingestion and was treated with a catecholamine infusion, endotracheal intubation, and mechanical ventilation...
September 30, 2016: Pediatric Emergency Care
Łukasz Fijałkowski, Kinga Sałat, Adrian Podkowa, Paula Zaręba, Alicja Nowaczyk
The chemical interaction of nine antiepileptic drugs (tiagabine, gabapentin, pregabalin, lamotrigine, zonisamide, valproic acid, valpromide, vigabatrin, progabide) and two endogenous metabolites (4-aminobutanoic acid, 4-hydroxybutanoic acid) with a model of human GABA transporter 1 (hGAT1) is described using the molecular docking method. To establish the role of hGAT1 in chronic pain, tiagabine, a selective hGAT1 inhibitor, was assessed in the in vivo experiments for its antiallodynic properties in two mouse models of neuropathic pain...
October 6, 2016: European Journal of Pharmaceutical Sciences
Kelsey Merison, Howard Jacobs
While the diagnosis of migraine in children is generally straightforward, treatment can seem complex with a number of medication choices, many of which are used "off label." Patients with intermittent migraines can often be managed with ibuprofen or naproxen taken as needed. Unfortunately, by the time that children present to our practice, they have often tried these medications without improvement. Triptans are frequently prescribed to these patients with good success. It is important to make the patient aware of the possible associated serotonergic reactions...
November 2016: Current Treatment Options in Neurology
Ken-Ichi Fujimoto, Miho Murata, Nobutaka Hattori, Tomoyoshi Kondo
A large-scale patient survey was conducted in 2013 and results compared with those of a similar scale survey conducted in 2008 to clarify the current status of drug therapy and patients' understanding of Parkinson disease (PD) and therapy. A total of 4,278 and 101 patients respectively participated in primary mail survey and secondary interview surveys. Measures of PD severity, activity level, and level of assistance required in daily life were improved compared with those in the 2008 survey. Average daily dose of levodopa was increased across all disease durations...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Roberto Michelucci, Elena Pasini, Patrizia Riguzzi, Eva Andermann, Reetta Kälviäinen, Pierre Genton
Generalized motor seizures, usually tonic-clonic, tonic-vibratory, myoclonic or clonic, and stimulus-sensitive/action myoclonus are typical features of progressive myoclonus epilepsies (PMEs). Despite the introduction of many anticonvulsants, the treatment of these symptoms, particularly myoclonus, remains challenging, due to the incomplete and often transitory effects of most drugs. Moreover, treatment is only symptomatic, since therapy targeting the underlying aetiology for these genetic conditions is in its infancy...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Josef Finsterer
Some of the side and beneficial effects of antiepileptic drugs (AEDs) are mediated via the influence on mitochondria. This is of particular importance in patients requiring AED treatment for mitochondrial epilepsy. AED treatment in patients with mitochondrial disorders should rely on the known influences of AEDs on these organelles. AEDs may influence various mitochondrial functions or structures in a beneficial or detrimental way. There are AEDs in which the toxic effect outweighs the beneficial effect, such as valproic acid (VPA), carbamazepine (CBZ), phenytoin (PHT), or phenobarbital (PB)...
September 3, 2016: Handbook of Experimental Pharmacology
Hazel Hummels, Daphne Bertholee, Douwe van der Meer, Jan Pieter Smit, Bob Wilffert, Peter Ter Horst
THE AIM OF THE STUDY: The aim of this study is to determine the quality of lactation studies that investigated antipsychotics in breast milk according to the Food and Drug Administration (FDA) and International Lactation Consultant Association (ILCA) draft guidelines. MATERIALS AND METHODS: We used the draft FDA and ILCA guidelines to review the quality of articles including antipsychotic use during breastfeeding. We used PubMed and Lactmed for the literature search...
December 2016: European Journal of Clinical Pharmacology
Anand Iyer, Richard Appleton
Infantile spasms, and specifically within the context of West syndrome , is one of the most common epileptic encephalopathies to occur in early infancy. Early recognition and treatment can improve neurodevelopmental outcome in some cases, although the underlying aetiology is probably the most important prognostic factor in both spasm suppression and developmental outcome. Corticosteroids, either adrenocorticotrophic hormone (ACTH) or prednisolone, and vigabatrin are currently the preferred first-line treatment options...
October 2016: Paediatric Drugs
Annika Hilgers, Marion Schaefer
BACKGROUND: Based on data of clinical trials, new agents are receiving approval to the pharmaceutical market, for which information concerning safety issues under real-life conditions is not yet available. OBJECTIVES: The aim was to evaluate the tolerability of newer antiepileptic drugs (AEDs), such as topiramate, levetiracetam, zonisamide, pregabalin, extended-release oxcarbazepine, lacosamide and eslicarbazepine, under real-life conditions by means of an assessment of routine clinical data of inpatients...
June 2016: Drugs—Real World Outcomes
Josta de Jong, Ester Garne, Lolkje T W de Jong-van den Berg, Hao Wang
BACKGROUND: More information is needed about possible associations between the newer anti-epileptic drugs (AEDs) in the first trimester of pregnancy and specific congenital anomalies of the fetus. OBJECTIVES: We performed a literature review to find signals for potential associations between newer AEDs (lamotrigine, topiramate, levetiracetam, gabapentin, oxcarbazepine, eslicarbazepine, felbamate, lacosamide, pregabalin, retigabine, rufinamide, stiripentol, tiagabine, vigabatrin, and zonisamide) and specific congenital anomalies...
June 2016: Drugs—Real World Outcomes
Milap C Nahata
The lack of commercially available liquid dosage forms for pediatric patients prompted this study. The objectives of our study were to determine the stability of zonisamide, amitriptyline, and glycopyrrolate in extemporaneously prepared oral suspensions in plastic prescription bottles. One group of suspensions was prepared in OraPlus:OraSweet (1:1) for each drug and stored either under refrigeration (4°C) or at room temperature (25°C). A second group of suspensions were compounded in 1% methylcellulose:simple syrup at a 1:10 proportion for zonisamide, amitriptyline, and glycopyrrolate; these suspensions were stored at either under refrigeration (4°C) or at room temperature (25°C)...
March 2016: International Journal of Pharmaceutical Compounding
Rajsekar R Rajaraman, Johnson Lay, Amethyst Alayari, Kirsten Anderson, Raman Sankar, Shaun A Hussain
OBJECTIVE: There is scant evidence to guide the management of infantile spasms after successful response to initial therapies. There is significant risk of relapse, largely because effective pharmacologic treatments cannot be continued long term because of concern for significant adverse events. Zonisamide (ZNS) and topiramate (TPM) are commonly used to prevent relapse, and the purpose of this study was to specifically evaluate the efficacy of ZNS and TPM as agents for secondary prevention of infantile spasms...
August 2016: Epilepsia
Kinji Ohno, Hideki Yagi, Bisei Ohkawara
No abstract text is available yet for this article.
April 2016: Neural Regeneration Research
Heather M Byers, Christopher W Beatty, Si Houn Hahn, Sidney M Gospe
BACKGROUND: Channelopathies are a group of monogenic disorders that affect a single ion channel and can result in neurological disease. While a rare cause of epilepsy, channelopathies offer unique insight to the molecular basis of epilepsy and treatment opportunities. Calcium homeostasis is tightly regulated by a series of interacting subunits. CACNA1A encodes the principal pore-forming subunit of the voltage-gated P/Q-type calcium channel, alpha1. Patients with epileptic encephalopathy due to pathogenic variants in CACNA1A have been previously described and are challenging to treat...
July 2016: Pediatric Neurology
Albert Aldenkamp, Frank Besag, Giuseppe Gobbi, Rochelle Caplan, David W Dunn, Matti Sillanpää
The literature was evaluated for cognitive and more general behavioural effects. We distinguished the older antiepileptic drugs (AEDs), from the newer and newest AEDs. The striking finding was the lack of information on children. From the available evidence it would appear that there may be negative cognitive effects with phenobarbital, phenytoin, topiramate and zonisamide, and adverse behavioural effects with phenobarbital, valproate, gabapentin, topiramate, levetiracetam and zonisamide. There is inconclusive data on ethosuximide, clobazam, vigabatrin, felbamate, pregabalin, stiripentol, rufinamide, lacosamide and retigabine...
May 16, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
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