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Phenytoine

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https://www.readbyqxmd.com/read/29445430/seizure-prophylaxis-in-the-immediate-post-hemorrhagic-period-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#1
Thomas V Kodankandath, Salman Farooq, Wled Wazni, John-Andrew Cox, Christopher Southwood, Gregory Rozansky, Vijay Johnson, John R Lynch
Introduction: Seizures are a well-known complication of aneurysmal subarachnoid hemorrhage (aSAH) and occur most commonly in the immediate posthemorrhagic period. Most commonly used antiepileptic drugs (AEDs) for seizure prophylaxis in aSAH include phenytoin and levetiracetam. There is no reliable data available on the safety and efficacy of restricting AED prophylaxis only till the aneurysm is secured. Methods: We retrospectively chart reviewed patients admitted to our neurosciences intensive care unit (NICU) with aSAH during the past two years...
December 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29442362/a-descriptive-systematic-review-of-salivary-tdm-in-neonates-and-infants
#2
Laura Hutchinson, Marlene Sinclair, Bernadette Reid, Kathryn Burnett, Bridgeen Callan
INTRODUCTION: Saliva, as a matrix, offers many benefits over blood in therapeutic drug monitoring (TDM), in particular for infantile TDM. However, the accuracy of salivary TDM in infants remains an area of debate. This review explored the accuracy, applicability and advantages of using saliva TDM in infants and neonates. METHODS: Databases were searched up to and including September 2016. Studies were included based on PICO as follows: P: Infants and neonates being treated with any medication, I: Salivary Therapeutic Drug Monitoring vs C: Traditional methods and O: accuracy, advantages/disadvantages and applicability to practice...
February 14, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29437004/therapeutic-drug-monitoring-of-phenytoin-by-simple-rapid-accurate-highly-sensitive-and-novel-method-and-its-clinical-applications
#3
Abdul Sami Shaikh, Ruichen Guo
BACKGROUND: Phenytoin has very challenging pharmacokinetic properties. To prevent its toxicity and ensure efficacy, continuous therapeutic monitoring is required. It is hard to get a simple, accurate, rapid, easily available, economical and highly sensitive assay in one method for therapeutic monitoring of phenytoin. OBJECTIVE: The present study is directed towards establishing and validating a more simple, rapid, an accurate, highly sensitive, novel and environment friendly liquid chromatography/mass spectrometry (LC/MS) method for offering rapid and reliable TDM results of phenytoin in epileptic patients to physicians and clinicians for making immediate and rational decision...
February 9, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29427835/phenytoin-related-ataxia-in-patients-with-epilepsy-clinical-and-radiological-characteristics
#4
Priya D Shanmugarajah, Nigel Hoggard, Daniel P Aeschlimann, Pascale C Aeschlimann, Gary J Dennis, Stephen J Howell, Markus Reuber, Richard A Grünewald, Marios Hadjivassiliou
PURPOSE: Phenytoin is an effective anticonvulsant for focal epilepsy. Its use can be associated with long-term adverse effects including cerebellar ataxia. Whilst phenytoin is toxic to Purkinje cells in vitro; the clinical and radiological phenotype and mechanism of cerebellar degeneration in vivo remain unclear. We describe the prevalence, clinical and radiological characteristics of phenytoin-related ataxia. METHODS: Patients with epilepsy receiving treatment with phenytoin were recruited from the Epilepsy clinics at Royal Hallamshire Hospital, Sheffield, UK...
February 2, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29417081/pharmacokinetic-behavior-of-phenytoin-in-head-trauma-and-cerebrovascular-accident-patients-in-an-iranian-population
#5
Shahnaz Alimardani, Sima Sadrai, Hamidreza Taghvaye Masoumi, Pooneh Salari, Atabak Najafi, Behzad Eftekhar, Mojtaba Mojtahedzadeh
Objective: Acute brain injury is one of the leading causes of morbidity and mortality worldwide. Phenytoin has been commonly used as an anticonvulsant agent for the treatment or prophylaxis of seizures following acute brain injury. After a severe head injury, several pharmacokinetic changes occur. The aim of this study is the comparative evaluation of phenytoin serum concentration in patients with traumatic and nontraumatic brain injury (TBI). Methods: This prospective observational study was performed on twenty adult brain injury patients who were admitted to an Intensive Care Unit and required phenytoin for the treatment or prophylaxis of postinjury seizures...
October 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29414565/current-state-of-the-union-of-epilepsy-care-in-the-united-states-antiepileptic-drugs-an-introduction-to-the-connectors-project
#6
Joseph I Sirven, Patricia O Shafer, Linda Kalilani, Imane Wild, Jesse Fishman, Steve Owens
PURPOSE: How antiepileptic drugs (AEDs) are used in the United States (US) is one proxy public health indicator for the current state of epilepsy management. The use of phenytoin, other older AEDs, and newer AEDs may act as an indicator for the quality of epilepsy practice in addition to the current American Academy of Neurology quality measures. Data on AED used by states and populations can help identify which public health interventions are necessary to improve the status of epilepsy care...
February 1, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29412538/avoiding-errors-when-administering-injectable-phenytoin-to-a-child-in-status-epilepticus
#7
Callum Douglass
Errors often occur in the prescribing, preparing, administering and monitoring of intravenous phenytoin ( NHS Improvement 2016 ). Following two fatal incidents involving injectable phenytoin, with contributing factors such as wrong weight estimation, a disregard for existing phenytoin prescriptions and confusion about the final concentration, an alert was issued by NHS Improvement in 2016. This article explores research into the use of injectable phenytoin and why adverse events occur when it is used. The article will inform nurses and doctors who work with children in acute settings about the risks associated with using injectable phenytoin and implications for practice on how to negate these risks...
February 7, 2018: Nursing Children and Young People
https://www.readbyqxmd.com/read/29402349/evaluation-of-a-commercially-available-euthanasia-solution-as-a-voluntarily-ingested-euthanasia-agent-in-laboratory-mice
#8
Emily S Dudley, Gregory P Boivin
All currently accepted methods of euthanasia for laboratory mice involve some degree of stress, fear, anxiety, or pain. We evaluated the voluntary oral administration of a euthanasia drug in 99 male and 81 female mice of various strains. We first explored the palatability of sugar-cookie dough with various flavorings added. We placed the cookie dough in the cage with an adult mouse and recorded the amount ingested after 1 h. Mice readily ingested all flavors of sugar-cookie dough. We then added a euthanasia solution containing pentobarbital and phenytoin to all flavors of cookie dough and placed a small bolus in the cage of each mouse or mouse pair...
January 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29391074/seizures-and-choice-of-antiepileptic-drugs-following-subarachnoid-hemorrhage-a-review
#9
Sherif Hanafy Mahmoud, Jenna Buxton
Seizures are important complications following a subarachnoid hemorrhage (SAH). The evidence for the use of antiepileptic drugs (AEDs) in treatment and prevention of those seizures is conflicting. The purpose of this review is to provide an up-to-date evidence summary of the incidence and outcomes of seizures following an SAH as well as the use of different AEDs post-SAH in order to evaluate the need for seizure prophylaxis, the choice of AEDs, and their dosing considerations in SAH patients. A literature search of PubMed, Medline, Embase, and the Cochrane Library was performed...
November 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29389596/flavonoid-compounds-as-reversing-agents-of-the-p-glycoprotein-mediated-multidrug-resistance-an-in-vitro-evaluation-with-focus-on-antiepileptic-drugs
#10
Ana Ferreira, Márcio Rodrigues, Ana Fortuna, Amílcar Falcão, Gilberto Alves
The pharmacoresistance to antiepileptic drugs (AEDs) remains a major unsolved therapeutic need. The overexpression of multidrug transporters, as the P-glycoprotein (P-gp), at the level of the blood-brain barrier of epileptic patients has been suggested as a key mechanism underlying the refractory epilepsy. Thus, efforts have been made to search for therapeutically useful P-gp inhibitors. Herein, the strategy of flavonoid/AED combined therapy was exploited as a possible approach to overcome the P-gp-mediated pharmacoresistance...
January 2018: Food Research International
https://www.readbyqxmd.com/read/29380527/the-sphingosine-1-phosphate-analogue-fty720-alleviates-seizure-induced-over-expression-of-p-glycoprotein-in-rat-hippocampus
#11
Fei Gao, Ying Gao, Fangling Meng, Chunmei Yang, Jiangfeng Fu, Yajun Li
Over-expression of P-glycoprotein (P-gp) in the brain is an important factor leading to drug-resistant epilepsy. Clinical use of P-gp inhibitors is limited by their systemic toxicity. In the present study, we tested the hypothesis that FTY720, a sphingosine 1-phosphate (S1P) analogue used for treating multiple sclerosis, modulates the up-regulation of P-gp and improves brain delivery of phenytoin (PHT) through S1P receptor 1 in the hippocampus of a pilocarpine-induced rat model of status epilepticus (SE). We administered vehicle, FTY720 or FTY720 + W146 (an S1P receptor 1 antagonist) to SE rats...
January 30, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29368126/pharmacotherapy-for-refractory-and-super-refractory-status-epilepticus-in-adults
#12
Martin Holtkamp
Patients with prolonged seizures that do not respond to intravenous benzodiazepines and a second-line anticonvulsant suffer from refractory status epilepticus and those with seizures that do not respond to continuous intravenous anesthetic anticonvulsants suffer from super-refractory status epilepticus. Both conditions are associated with significant morbidity and mortality. A strict pharmacological treatment regimen is urgently required, but the level of evidence for the available drugs is very low. Refractory complex focal status epilepticus generally does not require anesthetics, but all intravenous non-anesthetizing anticonvulsants may be used...
January 24, 2018: Drugs
https://www.readbyqxmd.com/read/29367180/fosphenytoin-pre-medication-for-pediatric-extra-operative-electrical-stimulation-brain-mapping
#13
Ravindra Arya, Gewalin Aungaroon, Alonso Zea Vera, Paul S Horn, Anna W Byars, Hansel M Greiner, Francesco T Mangano, Katherine D Holland
PURPOSE: We studied the effect of fosphenytoin (FOS) pre-medication on the incidence and thresholds of after-discharges (ADs), seizures, and functional responses during electrical stimulation mapping (ESM). METHODS: As individualized by the attending epileptologist, FOS was given intravenously at 2 mg-phenytoin-equivalents (PE)/kg/min or 150 mg-PE/min (whichever slower). Patients who received and did not receive FOS were compared for the incidence and thresholds of ADs, seizures, and functional responses...
January 20, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29366689/in-vivo-study-of-teratogenic-and-anticonvulsant-effects-of-antiepileptics-drugs-in-zebrafish-embryo-and-larvae
#14
C S Martinez, D A Feas, M Siri, D E Igartúa, N S Chiaramoni, SdV Alonso, M J Prieto
Epilepsy is a neurological disorder treated with antiepileptic drugs (AEDs). Since AEDs are administered in women in childbearing age, it is critical to study if drugs are capable of inducing developmental toxicity. Along the bibliography available, there is no research comparing teratogenicity and anticonvulsant effect within the same study. In the present study, we evaluated the teratogenic and anticonvulsant effects of six different AEDs: carbamazepine, levetiracetam, lamotrigine, phenobarbital, phenytoin and valproic acid...
January 20, 2018: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/29363050/effect-of-age-related-factors-on-the-pharmacokinetics-of-lamotrigine-and-potential-implications-for-dose-optimisation-in-epilepsy-patients
#15
Sven C van Dijkman, Nico C B de Jager, Willem M Rauwé, Meindert Danhof, Oscar Della Pasqua
BACKGROUND AND AIMS: In this study, we evaluate the performance of allometric concepts to predict the implications of age and size on the pharmacokinetics of lamotrigine, and assess the dose rationale across different age groups from 0.2 to 91 years. METHODS: An allometrically scaled pharmacokinetic model was developed using adolescent and adult data, taking into account the effect of comedications. Model parameters were then used to extrapolate lamotrigine pharmacokinetics to older adults (> 65 years), children (4-12 years) and infants and toddlers (0...
January 23, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29362853/volumetric-absorptive-microsampling-as-an-alternative-tool-for-therapeutic-drug-monitoring-of-first-generation-anti-epileptic-drugs
#16
Sofie Velghe, Christophe P Stove
Dosage adjustment of anti-epileptic drugs by therapeutic drug monitoring (TDM) is very useful, especially for the first-generation anti-epileptic drugs (AEDs). Microsampling-the collection of small volumes of blood-is increasingly considered a valuable alternative to conventional venous sampling for TDM. Volumetric absorptive microsampling (VAMS) allows accurate and precise collection of a fixed volume of blood, eliminating the volumetric blood hematocrit bias coupled to conventional dried blood spot collection...
January 23, 2018: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29356648/case-250-alpers-huttenlocher-syndrome
#17
Judy Wu, Carina Yang, John Collins, Daniel Thomas Ginat
History A 10-year-old girl with global developmental delay and attention deficit hyperactivity disorder was transferred from an outside hospital because of confusion and multiple episodes of left face and arm jerking. Physical examination revealed normal muscle bulk, strength, and tone in the bilateral upper and lower extremities but insuppressible left arm and jaw twitching Lumbar puncture revealed no white or red blood cells, a normal glucose level of 55 mg/dL (3.0 mmol/L) (normal range, 50-80 mg/dL [2.8-4...
February 2018: Radiology
https://www.readbyqxmd.com/read/29352387/current-perspectives-on-erythema-multiforme
#18
REVIEW
Marianne Lerch, Carlo Mainetti, Benedetta Terziroli Beretta-Piccoli, Thomas Harr
Recognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings...
January 19, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29343610/cyp2j2-expression-in-adult-ventricular-myocytes-protects-against-external-and-drug-induced-ros-toxicity
#19
Eric A Evangelista, Rozenn Lemaitre, Nona Sotoodehnia, Sina Gharib, Rheem A Totah
CYP2J2 is a drug metabolizing enzyme that is highly expressed in adult ventricular myocytes. It is responsible for the bioactivation of arachidonic acid (AA) into epoxyeicosatrienoic acids (EETs). EETs are biologically active signaling compounds that protect against disease progression, particularly in cardiovascular diseases. As a drug-metabolizing enzyme, CYP2J2 is susceptible to drug interactions that could lead to cardiotoxicity. Previously, CYP2J2 has been shown to be resistant to induction by canonical CYP inducers such as phenytoin and rifampin...
January 17, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29342085/development-of-a-region-specific-physiologically-based-pharmacokinetic-brain-model-to-assess-hippocampus-and-frontal-cortex-pharmacokinetics
#20
Zaril Zakaria, Raj Badhan
Central nervous system drug discovery and development is hindered by the impermeable nature of the blood-brain barrier. Pharmacokinetic modeling can provide a novel approach to estimate CNS drug exposure; however, existing models do not predict temporal drug concentrations in distinct brain regions. A rat CNS physiologically based pharmacokinetic (PBPK) model was developed, incorporating brain compartments for the frontal cortex (FC), hippocampus (HC), "rest-of-brain" (ROB), and cerebrospinal fluid (CSF). Model predictions of FC and HC Cmax, tmax and AUC were within 2-fold of that reported for carbamazepine and phenytoin...
January 17, 2018: Pharmaceutics
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