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Phenytoine

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https://www.readbyqxmd.com/read/28076384/anti-epileptic-drug-combination-efficacy-in-an-in-vitro-seizure-model-phenytoin-and-valproate-lamotrigine-and-valproate
#1
Kim Det Taing, Terence J O'Brien, David A Williams, Chris R French
In this study, we investigated the relative efficacy of different classes of commonly used anti-epileptic drugs (AEDs) with different mechanisms of action, individually and in combination, to suppress epileptiform discharges in an in vitro model. Extracellular field potential were recorded in 450 μm thick transverse hippocampal slices prepared from juvenile Wistar rats, in which "epileptiform discharges" (ED's) were produced with a high-K+ (8.5 mM) bicarbonate-buffered saline solution. Single and dual recordings in stratum pyramidale of CA1 and CA3 regions were performed with 3-5 MΩ glass microelectrodes...
2017: PloS One
https://www.readbyqxmd.com/read/28067060/update-on-pharmacotherapy-of-myoclonic-seizures
#2
Pasquale Striano, Vincenzo Belcastro
Myoclonic seizures are brief, involuntary muscular jerks arising from the central nervous system that can occur in different epilepsy syndromes, including idiopathic generalized epilepsies or the most severe group of epileptic encephalopathies. Valproate is commonly the first choice alone or in combination with some benzodiazepines or levetiracetam. However, more treatment options exist today as there is emerging evidence to support the efficacy of some newer antiepileptic drugs. In addition, of major importance remains avoidance of medications (e...
January 8, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28063739/development-of-left-atrial-thrombus-after-coadministration-of-dabigatran-etexilate-and-phenytoin
#3
Nicole Hager, Jennifer Bolt, Lori Albers, Wladyslaw Wojcik, Patrick Duffy, William Semchuk
Dabigatran etexilate is a substrate of the P-glycoprotein (adenosine triphosphate-binding cassette subfamily B member 1) transport system and is subject to interactions with medications that induce or inhibit this system. The clinical relevance of the interaction between dabigatran and phenytoin has not been well described. We report a case of left atrial thrombus in a patient receiving concomitant dabigatran etexilate and phenytoin, which is a P-glycoprotein inducer. This case illustrates the potential clinical significance of the interactions of medications that affect P-glycoprotein and dabigatran...
October 28, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28057897/review-and-update-of-the-hong-kong-epilepsy-guideline-on-status-epilepticus
#4
REVIEW
E Lw Fung, B Bh Fung
Convulsive status epilepticus is the most extreme form of seizure. It is a medical and neurological emergency that requires prompt and appropriate treatment. Treatment of convulsive status epilepticus is usually divided into stages/steps. The International League Against Epilepsy has released a new definition of status epilepticus that may help to unify the definition in future studies. Over the last few years new information has become available regarding its management. The Rapid Anticonvulsant Medication Prior to Arrival Trial demonstrated non-inferiority of intramuscular midazolam in early status epilepticus compared with intravenous lorazepam...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28032682/antiepileptic-drugs-impacts-on-human-serum-paraoxonase-1
#5
Şükrü Beydemir, Yeliz Demir
Serum paraoxonase (PON1) is a key enzyme related to high-density lipoprotein (HDL)-cholesterol particle. It can prevent the oxidation of low-density lipoprotein (LDL) and HDL. The present article focuses on the in vitro inhibition role of some antiepileptic drugs (AEDs) such as valproic acid, gabapentin, primidone, phenytoin, and levetiracetam on human paraoxonase (hPON1). Therefore, PON1 was purified from human serum with a specific activity of 3976.36 EU/mg and 13.96% yield by using simple chromatographic methods...
December 29, 2016: Journal of Biochemical and Molecular Toxicology
https://www.readbyqxmd.com/read/28026965/assessing-the-efficacy-of-poly-n-isopropylacrylamide-for-drug-delivery-applications-using-molecular-dynamics-simulations
#6
Soroush Moghadam, Ronald G Larson
All-atom molecular dynamic simulations (AA-MD) are performed for aqueous solutions of hydrophobic drug molecules (phenytoin) with model polymer excipients, namely, (1) N-isopropylacrylamide, (pNIPAAm), (2) pNIPAAm-co-acrylamide (Am), and (3) pNIPAAm-co-dimethylacrylamide (DMA). After validating the force field parameters using the well-known lower critical solution behavior of pNIPAAm, we simulate the polymer-drug complex in water and its behavior at temperatures below (295 K) and above the LCST (310 K). Using radial distribution functions, we find that there is an optimum comonomer molar fraction of around 20-30% DMA at which interaction with phenytoin drug molecules is strongest, consistent with recent experimental findings...
January 11, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28025639/evaluation-of-bone-metabolism-in-critically-ill-patients-using-ctx-and-pinp
#7
Alexandra Gavala, Konstantinos Makris, Anna Korompeli, Pavlos Myrianthefs
Background. Prolonged immobilization, nutritional and vitamin D deficiency, and specific drug administration may lead to significant bone resorption. Methods and Patients. We prospectively evaluated critically ill patients admitted to the ICU for at least 10 days. Demographics, APACHE II, SOFA scores, length of stay (LOS), and drug administration were recorded. Blood collections were performed at baseline and on a weekly basis for five consecutive weeks. Serum levels of PINP, β-CTx, iPTH, and 25(OH)vitamin D were measured at each time-point...
2016: BioMed Research International
https://www.readbyqxmd.com/read/28018756/incidence-of-potential-drug-drug-interactions-in-a-limited-and-stereotyped-prescription-setting-comparison-of-two-free-online-pharmacopoeias
#8
Bhaskar Kannan, Amrutha Bindu Nagella, A Sathia Prabhu, Gopalakrishnan M Sasidharan, A S Ramesh, Venkatesh Madhugiri
BACKGROUND: Drug-drug interactions (DDIs) are very common adverse events in health care delivery settings. The use of electronic pharmacopeias can potentially reduce the incidence of DDIs, but they are often thought to be cumbersome to use. This study is aimed at studying the incidence of potential DDIs in a surgical department, where a limited number of drugs are used in stereotyped combinations. We also compared two popular drug compendia in detecting potential DDIs. METHODS: The prescriptions of selected patients were entered into Epocrates® and Medscape® for Android smartphones...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28017579/seizures-caused-by-brain-tumors-in-children
#9
Iván Sánchez Fernández, Tobias Loddenkemper
PURPOSE: To review the epidemiology, clinical features, and treatment of seizures secondary to pediatric brain tumors. METHOD: Literature review. RESULTS: Pediatric brain tumors are the most common solid pediatric tumor and the most common cause of death in pediatric cancer. Seizures are one of the most common symptoms of pediatric brain tumors. Factors associated with increased risk of seizures include supratentorial location, gray matter involvement, low-grade, and certain histological features-especially dysembryoplastic neuroepithelial tumor, ganglioglioma, and oligodendroglioma...
December 7, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28007722/physical-compatibility-of-isavuconazonium-sulfate-with-select-i-v-drugs-during-simulated-y-site-administration
#10
Wonhee So, Liz Kim, Abrar K Thabit, David P Nicolau, Joseph L Kuti
PURPOSE: The physical compatibility of isavuconazonium sulfate with 95 i.v. drugs during simulated Y-site administration was studied. METHODS: Isavuconazonium sulfate for injection and all other drugs were reconstituted according to the manufacturer's recommendation and further diluted with 0.9% sodium chloride injection or 5% dextrose injection to a final concentration (1.5 mg/mL for isavuconazonium sulfate and standard concentrations used clinically for other drugs)...
January 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28007721/physical-compatibility-of-ceftolozane-tazobactam-with-selected-i-v-drugs-during-simulated-y-site-administration
#11
Abrar K Thabit, Yukihiro Hamada, David P Nicolau
PURPOSE: Results of a study to examine the physical compatibility of ceftolozane-tazobactam with common i.v. medications during simulated Y-site administration are presented. METHODS: Ceftolozane-tazobactam was reconstituted according to manufacturer recommendations and diluted with 0.9% sodium chloride or 5% dextrose to solutions containing 15 mg (10 mg of ceftolozane and 5 mg of tazobactam)/mL. All other i.v. drugs were prepared according to manufacturer recommendations and diluted with 0...
January 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27995212/is-this-a-simple-drug-eruption-to-be-discharged
#12
Mucahit Emet, Ilker Akbas, Esra Senturk, Omer Faruk Elmas, Sahin Aslan
'Erythema Multiforme associated with Phenytoin And Cranial radiation Therapy' (EMPACT) is a very rare clinic situation and classified in EM-like drug reactions. It can be easily misdiagnosed as acute urticaria or drug eruption in ED. Initial symptoms may resemble a simple skin problem, but diagnosing and early hospitalization of the patients can be lifesaving. Here, we present a man with renal cell cancer and brain metastases who admitted to ED due to fever and generalized rash. His skin lesions beginning from his head and spreading through the torso appeared four days after the end of radiotherapy (11 days after the initial dose of both radiation and oral phenytoin)...
December 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27991432/the-effect-of-proton-pump-inhibitors-on-the-cyp2c19-enzyme-activity-evaluated-by-the-pantoprazole-13-c-breath-test-in-gerd-patients-clinical-relevance-for-personalized-medicine
#13
Anil S Modak, Iryna Klyarytska, Valerij Kriviy, Tatjana Tsapyak, Yliya Rabotyagova
Patients with gastroesophageal reflux disease (GERD) are routinely prescribed one of the six FDA approved proton pump inhibitors (PPI). All of these PPI are inhibitors of CYP2C19 enzyme to varying degrees. The phenotype pantoprazole-(13)C breath test (Ptz-BT) was used to identify patients who are poor metabolizers (PM) and the extent of phenoconversion of CYP2C19 enzyme activity caused by four PPI (omeprazole, esomprazole pantoprazole and rabeprazole) in 54 newly diagnosed GERD patients prior to initiating randomly selected PPI therapy and 30 d after PPI therapy...
December 17, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/27979020/antiepilepsy-drugs-and-the-immune-system
#14
REVIEW
Neetu Godhwani, Sami L Bahna
OBJECTIVE: To alert physicians about the peculiar adverse effects of antiepilepsy drugs (AEDs) on the immune system. DATA SOURCES: PubMed literature during the past 25 years. STUDY SELECTIONS: Reports and review articles on the hypersensitivities of AEDs and their effect on immunity. RESULTS: AEDs have significant effects on the immune system in the form of hypersensitivity or immune suppression. IgE-mediated reactions can be urticaria, angioedema, bronchospasm, or anaphylaxis...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27969087/forced-normalization-an-overlooked-entity-in-epileptic-patients
#15
Andac Topkan, Sule Bilen, Ayse Pinar Titiz, Esra Eruyar, Fikri Ak
The "forced normalization" phenomenon is characterized by acute/subacute onset of psychotic symptoms in the early post-ictal period with dramatic improvement of electrophysiological epileptiform activity. A 56 years old female with going on personality changes, maladaptive behaviours and a mild cognitive impairment since last seizure which was forty-five days ago has been admitted. An evident increase was observed in her maladaptive behaviours with the use of levetiracetam. She began describing visual hallucinations and déjàvu...
October 2016: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/27957468/hashimoto-encephalopathy-with-an-unusual-presentation-of-status-epilepticus-seizures-a-case-report
#16
Masoume Nazeri, Amin Abolhasani Foroughi, Hora Heidari, Sarvin Sajadianfard, Tannaz Eghbali, Peyman Arasteh
A 33 yr old man, previously diagnosed with hypothyroidism, presented with decreased level of consciousness and generalized tonic-clonic (GTC) seizure to Namazi hospital, Shiraz, Iran, during April 2015. The patient later referred with another episode of seizure like attack for which he received phenytoin, carbamazepine and levothyroxine and was discharged. During his last admission, the patient was admitted with chief complaints of decreased consciousness and four GTC attacks. On admission, the patients had aphasia, ataxia, loss of verbal communication, eye contact and complete loss of obedience...
September 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/27957377/rare-case-of-posterior-reversible-leukoencephalopathy-syndrome-secondary-to-acute-chest-syndrome
#17
Rohit Aiyer, Daniel Klein, Yasir El-Sherif
We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient's usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES)...
2016: Case Reports in Radiology
https://www.readbyqxmd.com/read/27941476/effect-of-cyp-inducers-inhibitors-on-topiramate-concentration-clinical-value-of-therapeutic-drug-monitoring
#18
Yoshiaki Yamamoto, Yukitoshi Takahashi, Katsumi Imai, Yoshiyuki Kagawa, Yushi Inoue
BACKGROUND: This study investigated the pharmacokinetic interactions between topiramate and concomitant antiepileptic drugs and evaluated the therapeutic concentration range of topiramate and the effect of the achieved plasma concentration on the retention rate of topiramate therapy. METHODS: A total of 1,217 plasma samples obtained from 610 patients were retrospectively investigated, and the concentration-to-dose ratio (CD ratio) of topiramate was compared among patients on various antiepileptic drug regimens...
December 7, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27940083/statistical-investigation-of-simulated-fed-intestinal-media-composition-on-the-equilibrium-solubility-of-oral-drugs
#19
Zhou Zhou, Claire Dunn, Ibrahim Khadra, Clive G Wilson, Gavin W Halbert
Gastrointestinal fluid is a complex milieu and it is recognised that gut drug solubility is different to that observed in simple aqueous buffers. Simulated gastrointestinal media have been developed covering fasted and fed states to facilitate in vitro prediction of gut solubility and product dissolution. However, the combination of bile salts, phospholipids, fatty acids and proteins in an aqueous buffered system creates multiple phases and drug solubility is therefore a complex interaction between these components, which may create unique environments for each API...
December 7, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27939634/prior-knowledge-based-approach-for-associating-contaminants-with-biological-effects-a-case-study-in-the-st-croix-river-basin-mn-wi-usa
#20
Anthony L Schroeder, Dalma Martinović-Weigelt, Gerald T Ankley, Kathy E Lee, Natalia Garcia-Reyero, Edward J Perkins, Heiko L Schoenfuss, Daniel L Villeneuve
Evaluating potential adverse effects of complex chemical mixtures in the environment is challenging. One way to address that challenge is through more integrated analysis of chemical monitoring and biological effects data. In the present study, water samples from five locations near two municipal wastewater treatment plants in the St. Croix River basin, on the border of MN and WI, USA, were analyzed for 127 organic contaminants. Known chemical-gene interactions were used to develop site-specific knowledge assembly models (KAMs) and formulate hypotheses concerning possible biological effects associated with chemicals detected in water samples from each location...
February 2017: Environmental Pollution
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