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phenytoin with epilepsi

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https://www.readbyqxmd.com/read/29906700/patient-characteristics-and-treatment-patterns-in-patients-with-newly-diagnosed-epilepsy-a-us-database-analysis
#1
Edward Faught, Sandra Helmers, David Thurman, Hyunmi Kim, Linda Kalilani
OBJECTIVE: The objective of this study was to determine patient characteristics and antiepileptic drug (AED) treatment patterns in patients with newly diagnosed epilepsy in a United States (US) population followed for ≥180 days. METHODS: In this retrospective cohort study, Commercial, Supplemental Medicare, and Medicaid insurance claims from US-based Truven Health MarketScan® claims database were analyzed for incident epilepsy cases (index date: January 2010-June 2013; prior baseline of 2 years [1 year for ages 1 to <2 years; none for those <1 year])...
June 12, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29897632/effect-of-valproic-acid-on-perampanel-pharmacokinetics-in-patients-with-epilepsy
#2
Manuela Contin, Francesca Bisulli, Margherita Santucci, Roberto Riva, Francesca Tonon, Susan Mohamed, Lorenzo Ferri, Carlotta Stipa, Paolo Tinuper
We prospectively examined the effect of antiepileptic (AED) cotherapy on steady state plasma concentrations of perampanel (PMP) in epileptic patients. We classified AEDs as strong enzyme inducers (carbamazepine, phenobarbital, phenytoin, oxcarbazepine), not strong enzyme inducers/not inhibitors (levetiracetam, lamotrigine, topiramate, rufinamide, lacosamide, zonisamide, clobazam), and enzyme inhibitors (valproic acid [VPA]). The main outcome was the comparison of PMP plasma concentration to weight-adjusted dose ratio (C/D; [μg/mL]/mg kg-1  d-1 ) among comedication subgroups...
June 13, 2018: Epilepsia
https://www.readbyqxmd.com/read/29893991/quality-of-antiepileptic-drugs-in-sub-saharan-africa-a-study-in-gabon-kenya-and-madagascar
#3
Jeremy Jost, Voa Ratsimbazafy, Thu Trang Nguyen, Thuy Linh Nguyen, Hanh Dufat, Annabelle Dugay, Alassane Ba, Guilhem Sivadier, Yattussia Mafilaza, Cyril Jousse, Mounir Traïkia, Martin Leremboure, Emilie Auditeau, Adeline Raharivelo, Edgard Ngoungou, Symon M Kariuki, Charles R Newton, Pierre-Marie Preux
OBJECTIVE: Epilepsy is a major public health issue in low- and middle-income countries, where the availability and accessibility of quality treatment remain important issues, the severity of which may be aggravated by poor quality antiepileptic drugs (AEDs). The primary objective of this study was to measure the quality of AEDs in rural and urban areas in 3 African countries. METHODS: This cross-sectional study was carried out in Gabon, Kenya, and Madagascar. Both official and unofficial supply chains in urban and rural areas were investigated...
June 12, 2018: Epilepsia
https://www.readbyqxmd.com/read/29872630/hypoxic-respiratory-failure-due-to-hyperammonemic-encephalopathy-induced-by-concurrent-use-of-valproic-acid-and-topiramate-a-case-report-and-review-of-the-literature
#4
Yonas Raru, Fuad Zeid
Valproic acid (VPA) is widely used for the treatment of epilepsy, migraine, and a variety of psychiatric symptoms, including bipolar disorder, borderline personality disorder, and alcohol withdrawal. Valproate is associated with severe idiosyncratic adverse effects, the most notable being valproate-induced hyperammonemic encephalopathy (VHE). Topiramate is also a broad-spectrum anticonvulsant that is also extensively used for migraine prophylaxis, as a mood stabilizer, and for alcohol dependency. There is increased occurrence of VHE when valproate is used with other medications like phenytoin, phenobarbital, and topiramate...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29867462/effects-of-antiepileptic-drugs-on-spontaneous-recurrent-seizures-in-a-novel-model-of-extended-hippocampal-kindling-in-mice
#5
Hongmei Song, Uilki Tufa, Jonathan Chow, Nila Sivanenthiran, Chloe Cheng, Stellar Lim, Chiping Wu, Jiachun Feng, James H Eubanks, Liang Zhang
Epilepsy is a common neurological disorder characterized by naturally-occurring spontaneous recurrent seizures and comorbidities. Kindling has long been used to model epileptogenic mechanisms and to assess antiepileptic drugs. In particular, extended kindling can induce spontaneous recurrent seizures without gross brain lesions, as seen clinically. To date, the development of spontaneous recurrent seizures following extended kindling, and the effect of the antiepileptic drugs on these seizures are not well understood...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29861526/levetiracetam-use-during-pregnancy-in-women-with-epilepsy-preliminary-observations-from-a-tertiary-care-center-in-northern-india
#6
Ramandeep Bansal, Vanita Suri, Seema Chopra, Neelam Aggarwal, Pooja Sikka, Subhas Chandra Saha, Manoj Kumar Goyal, Praveen Kumar
INTRODUCTION: Data on efficacy and safety of levetiracetam (LEV) during pregnancy is still limited. We analyzed efficacy and safety of LEV during pregnancy in North Indian women with epilepsy (WWE) which is being presented here. PATIENTS AND METHODS: This retrospective study included 99 WWE (on treatment with a single antiepileptic drug [AED]) who were evaluated in medical-surgical disorder antenatal clinic of the department of obstetrics and gynecology at a tertiary care teaching hospital and referral center in North India...
January 2018: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29791030/antiepileptic-drugs-as-prophylaxis-for-postcraniotomy-seizures
#7
REVIEW
Janette Greenhalgh, Jennifer Weston, Yenal Dundar, Sarah J Nevitt, Anthony G Marson
BACKGROUND: This is an updated version of the Cochrane Review previously published in Issue 3, 2015.The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs)...
May 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29766538/chronic-exposure-to-cannabidiol-induces-reproductive-toxicity-in-male-swiss-mice
#8
Renata K Carvalho, Monaliza L Santos, Maingredy R Souza, Thiago L Rocha, Francisco S Guimarães, Janete A Anselmo-Franci, Renata Mazaro-Costa
Children and adults with frequent and severe episodes of epilepsy that do not respond to standard treatments (such as carbamazepine, phenytoin and valproate) have long been prescribed cannabidiol (CBD) as an anticonvulsant drug. However, the safety of its chronic use in relation to reproduction has not been fully examined. This study aimed to assess the effects of chronic CBD exposure on the male reproductive system. CBD was orally administered to 21-day-old male Swiss mice at doses of 15 and 30 mg kg-1 daily (CBD 15 and 30 groups, respectively), with a control group receiving sunflower oil, for 34 consecutive days...
May 16, 2018: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/29754109/improving-effect-of-mild-foot-electrical-stimulation-on-pentylenetetrazole-induced-impairment-of-learning-and-memory
#9
Monir Abasi-Moghadam, Arefe Ghasemi-Dehno, Mehdi Sadegh, Mohammad Reza Palizvan
Epilepsy is a common neurological disorder that affects learning and memory. Recently it has been shown that mild foot electrical stimulation (MFES) can increase learning and memory in normal rats. Pentylenetetrazole (PTZ) kindling is a model of human epilepsy. As with human epilepsy, PTZ kindling impairs learning and memory in rats. The purpose of this study was to investigate the effect MFES on kindling-induced learning and memory deficits in rats. Forty-nine male Wistar rats weighting 200 to 250 g were divided into the following seven groups: PTZ only, phenytoin only, MFES only, PTZ plus phenytoin, PTZ plus MFES, phenytoin plus MFES, and saline (control), with the treatments administered for 26 days...
May 10, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29750337/lamotrigine-resistant-corneal-kindled-mice-a-model-of-pharmacoresistant-partial-epilepsy-for-moderate-throughput-drug-discovery
#10
Zachery Koneval, Kevin M Knox, H Steve White, Melissa Barker-Haliski
OBJECTIVE: Despite numerous treatments for epilepsy, over 30% of patients remain resistant to available antiseizure drugs (ASDs). Thus, there is a strong need for more effective ASDs for these individuals. Early ASD discovery has historically relied on acute in vivo seizure models (maximal electroshock, subcutaneous pentylenetetrazol, 6 Hz), which lack the pathophysiology that defines chronic epilepsy. Etiologically relevant rodent models of pharmacoresistant epilepsy exist (eg, phenytoin (PHT)- and lamotrigine (LTG)-resistant amygdala-kindled rat and focal kainic acid mouse), but these models are resource- and labor-intensive and thus unsuitable for frontline ASD discovery...
May 11, 2018: Epilepsia
https://www.readbyqxmd.com/read/29746397/impact-of-drug-interactions-on-clobazam-and-n-desmethylclobazam-concentrations-in-pediatric-patients-with-epilepsy
#11
Gabrielle R Russell, Stephanie J Phelps, Chasity M Shelton, James W Wheless
BACKGROUND: Clobazam (CLB) is approved as adjunctive treatment for seizures associated with Lennox-Gastaut syndrome in patients ≥2 years of age. It is converted to an active metabolite N-desmethylclobazam (NCLB) by CYP3A4, which is then broken down to an inactive metabolite by CYP2C19. This study characterizes the impact of CYP3A4 and CYP2C19 drug interactions on CLB and NCLB serum concentrations (Cp) and concentration/dose (Cp/D) ratios in pediatric patients with epilepsy. METHODS: This was a retrospective chart review including patients >1 month of age, who received CLB between April 2012 and March 2017...
May 4, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29744790/comparative-efficacy-of-antiepileptic-drugs-for-patients-with-generalized-epileptic-seizures-systematic-review-and-network-meta-analyses
#12
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques Carizio, Leonardo Régis Leira Pereira
Background Valproate is a widely prescribed antiepileptic drug for generalized epilepsies, due to the extensive knowledge on its efficacy since it is on the market for many decades. However, a large number of new antiepileptic medicines was introduced into clinical practice and may be better options for treatment, considering that these medicines differ in terms of efficacy spectrum. Despite extensive research, questions regarding which medicine would constitute the first option for the monotherapy treatment of generalized epilepsy remain...
May 9, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29737274/antiepileptic-drug-monitoring-in-pregnancy-empire-a-double-blind-randomised-trial-on-effectiveness-and-acceptability-of-monitoring-strategies
#13
Shakila Thangaratinam, Nadine Marlin, Sian Newton, Annalise Weckesser, Manny Bagary, Lynette Greenhill, Rachel Rikunenko, Maria D'Amico, Ewelina Rogozińska, Andrew Kelso, Kelly Hard, Jamie Coleman, Ngawai Moss, Tracy Roberts, Lee Middleton, Julie Dodds, Angela Pullen, Sandra Eldridge, Alexander Pirie, Elaine Denny, Doug McCorry, Khalid S Khan
BACKGROUND: Pregnant women with epilepsy on antiepileptic drugs (AEDs) may experience a reduction in serum AED levels. This has the potential to worsen seizure control. OBJECTIVE: To determine if, in pregnant women with epilepsy on AEDs, additional therapeutic drug monitoring reduces seizure deterioration compared with clinical features monitoring after a reduction in serum AED levels. DESIGN: A double-blind, randomised trial nested within a cohort study was conducted and a qualitative study of acceptability of the two strategies was undertaken...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29699863/two-japanese-cases-of-epileptic-encephalopathy-associated-with-an-fgf12-mutation
#14
Ryo Takeguchi, Kazuhiro Haginoya, Yuri Uchiyama, Atsushi Fujita, Michiaki Nagura, Eri Takeshita, Takehiko Inui, Yukimune Okubo, Ryo Sato, Takuya Miyabayashi, Noriko Togashi, Takashi Saito, Eiji Nakagawa, Kenji Sugai, Mitsuko Nakashima, Hirotomo Saitsu, Naomichi Matsumoto, Masayuki Sasaki
A heterozygous mutation in the fibroblast growth factor 12 (FGF12) gene, which elevates the voltage dependence of neuronal sodium channel fast inactivation, was recently identified in some patients with epileptic encephalopathy. Here we report 1 Japanese patient diagnosed with early infantile epileptic encephalopathy (EIEE) and another diagnosed with epilepsy of infancy with migrating focal seizures (EIMFS). These 2 patients had an identical heterozygous missense mutation [c.341G>A:p.(Arg114His)] in FGF12 , which was identified with whole-exome sequencing...
April 23, 2018: Brain & Development
https://www.readbyqxmd.com/read/29680205/comparative-risk-of-major-congenital-malformations-with-eight-different-antiepileptic-drugs-a-prospective-cohort-study-of-the-eurap-registry
#15
Torbjörn Tomson, Dina Battino, Erminio Bonizzoni, John Craig, Dick Lindhout, Emilio Perucca, Anne Sabers, Sanjeev V Thomas, Frank Vajda
BACKGROUND: Evidence for the comparative teratogenic risk of antiepileptic drugs is insufficient, particularly in relation to the dosage used. Therefore, we aimed to compare the occurrence of major congenital malformations following prenatal exposure to the eight most commonly used antiepileptic drugs in monotherapy. METHODS: We did a longitudinal, prospective cohort study based on the EURAP international registry. We included data from pregnancies in women who were exposed to antiepileptic drug monotherapy at conception, prospectively identified from 42 countries contributing to EURAP...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29644157/persistent-bradycardia-with-the-long-term-use-of-phenytoin-and-oxycodone-first-case-report
#16
Intekhab Askari Syed, Aaron R Kuzel, Muhammad Uzair Lodhi, Waliul Chowdhury, Umar Rahim, Mustafa Rahim
Phenytoin is a medication that is used primarily in the treatment of epilepsy as well as generalized tonic-clonic seizures and status epilepticus. Phenytoin is also considered a class IB antiarrhythmic medication by shortening the duration of the action potential and increasing myocardial conduction. The neurologic adverse effects of phenytoin are well-documented and include altered mental status, ataxia, and nystagmus. Some adverse cardiac manifestations have also been reported, including arrhythmias, hypotension, and respiratory arrest...
February 8, 2018: Curēus
https://www.readbyqxmd.com/read/29625812/scn2a-mutation-in-an-infant-presenting-with-migrating-focal-seizures-and-infantile-spasm-responsive-to-a-ketogenic-diet
#17
Da-Jyun Su, Jyh-Feng Lu, Li-Ju Lin, Jao-Shwann Liang, Kun-Long Hung
SCN2A mutations have been identified in various encephalopathy phenotypes, ranging from benign familial neonatal-infantile seizure (BFNIS) to more severe forms of epileptic encephalopathy such as Ohtahara syndrome or epilepsy of infancy with migrating focal seizure (EIMFS). Thus far, no particularly effective treatment is available for severe epileptic encephalopathy caused by SCN2A mutations in children. We present the case of a boy who developed seizures on the third day of life and received a diagnosis of EIMFS based on his clinical presentations and electroencephalography reports...
April 3, 2018: Brain & Development
https://www.readbyqxmd.com/read/29610167/-hla-a-31-01-and-oxcarbazepine-induced-dress-in-a-patient-with-seizures-and-complete-dcx-deletion
#18
Hyun Kim, Laura Chadwick, Yasir Alzaidi, Jonathan Picker, Annapurna Poduri, Shannon Manzi
Oxcarbazepine is an antiepileptic drug (AED) commonly used as a first-line treatment option for focal epilepsy. Several AEDs, including carbamazepine, oxcarbazepine, and phenytoin are associated with various delayed-hypersensitivity reactions such as drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, or toxic epidermal necrolysis. The Food and Drug Administration-approved label for oxcarbazepine currently presents information regarding a pharmacogenomic association with the HLA antigen allele HLA-B*15:02 and hypersensitivity reactions in certain ancestry groups with a high incidence of this allele...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29588957/dress-syndrome-a-case-of-cross-reactivity-with-lacosamide
#19
Man Kei Fong, Bun Sheng
A 42-year-old patient with epilepsy was admitted to the hospital for fever and generalized skin rash. He has known allergy to phenytoin. Valproate was started in 2012, but failed to control his seizure despite gradual increase in dosage. Phenobarbitone was added 16 days before admission and was stopped on admission. He was treated with beta-lactam antibiotics. The rash subsided gradually after the cessation of phenobarbitone. Lacosamide was subsequently added for seizure control. Unfortunately, he developed drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome soon after introduction of lacosamide that required the use of systemic steroid for acute hepatitis...
June 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29571152/comparative-efficacy-of-unique-antiepileptic-drug-regimens-in-focal-epilepsy-an-exploratory-study
#20
Alexander W Legge, Kamil Detyniecki, Asif Javed, Lawrence J Hirsch, Kenneth Kato, Richard Buchsbaum, Baibing Chen, Hyunmi Choi
OBJECTIVE: To compare efficacy of unique antiepileptic drug (AED) polytherapy regimens among patients with focal epilepsy. METHODS: From a longitudinal study of AED treatment, we identified patients with active focal epilepsy who had attempted at least two unique AED regimens (mono-, duo-, or tri-therapy). Efficacy was defined as the presence of at least one six-month period of continuous seizure freedom during exposure to a regimen. To control for individual variations in response and epilepsy severity, we used within-patient comparison approaches, in which we: 1) compared head-to-head unique regimens tried within the same patients; 2) compared one regimen versus aggregate of other regimens attempted in that patient; and 3) compared aggregated monotherapy versus polytherapy regimens...
May 2018: Epilepsy Research
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