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Phenytoine

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https://www.readbyqxmd.com/read/29649093/comparison-of-cyp3a4-inducing-capacity-of-enzyme-inducing-antiepileptic-drugs-using-4%C3%AE-hydroxycholesterol-as-biomarker
#1
Kristine Hole, Birgit M Wollmann, Camilla Nguyen, Tore Haslemo, Espen Molden
BACKGROUND: Enzyme-inducing antiepileptic drugs (EIAEDs) are among the clinically most important inducers of cytochrome P450 (CYP) 3A4, but there is limited evidence regarding the comparative potency of each EIAED in raising CYP3A4 activity. The aim of this study was to estimate CYP3A4-inductive potency of EIAEDs by comparing CYP3A4 activity in patients treated with carbamazepine, phenobarbital, or phenytoin. METHODS: Residual serum samples from patients treated with EIAEDs or levetiracetam were collected from a therapeutic drug monitoring service for analysis of 4β-hydroxycholesterol (4βOHC), which is an indicator of CYP3A4 activity...
April 11, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29644157/persistent-bradycardia-with-the-long-term-use-of-phenytoin-and-oxycodone-first-case-report
#2
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/29629324/immunohistochemical-analysis-of-the-role-connective-tissue-growth-factor-in-drug-induced-gingival-overgrowth-in-response-to-phenytoin-cyclosporine-and-nifedipine
#3
A J Anand, Sivaram Gopalakrishnan, R Karthikeyan, Debasish Mishra, Shreeyam Mohapatra
Objective: To evaluate for the presence of connective tissue growth factor (CTGF) in drug (phenytoin, cyclosporine, and nifedipine)-induced gingival overgrowth (DIGO) and to compare it with healthy controls in the absence of overgrowth. Materials and Methods: Thirty-five patients were chosen for the study and segregated into study (25) and control groups (10). The study group consisted of phenytoin-induced (10), cyclosporine-induced (10), and nifedipine-induced (5) gingival overgrowth...
January 2018: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/29628024/the-association-between-cyp2c9-2c19-polymorphisms-and-phenytoin-maintenance-doses-in-asian-epileptic-patients-a-systematic-review-and-meta-analysis
#4
Kai Liao, Yong Liu, Chun-Zhi Ai, Xi Yu, Wei Li
OBJECTIVE: Therapeutic response to phenytoin (PHT), a first-line antiepileptic drug (AED), is highly variable, in part likely due to genetic factors. Genetic polymorphisms in cytochrome P450 (CYP) 2C9 and CYP2C19 are expected to affect the metabolism of PHT and consequently affect its maintenance doses. We aimed to clarify the effects of genetic polymorphisms in both enzymes on daily PHT maintenance dosage in Asian epileptic patients by meta-analysis. MATERIALS AND METHODS: A systematic literature search was conducted in PubMed and EMBASE for relevant studies published prior to April 14, 2017...
April 9, 2018: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29625812/scn2a-mutation-in-an-infant-presenting-with-migrating-focal-seizures-and-infantile-spasm-responsive-to-a-ketogenic-diet
#5
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/29624640/why-we-prefer-levetiracetam-over-phenytoin-for-treatment-of-status-epilepticus
#6
G Zaccara, F S Giorgi, A Amantini, G Giannasi, R Campostrini, F Giovannelli, M Paganini, P Nazerian
Over last fifty years, intravenous (iv) phenytoin (PHT) loading dose has been the treatment of choice for patients with benzodiazepine-resistant convulsive status epilepticus and several guidelines recommended this treatment regimen with simultaneous iv diazepam. Clinical studies have never shown a better efficacy of PHT over other antiepileptic drugs. In addition, iv PHT loading dose is a complex and time-consuming procedure which may expose patients to several risks, such as local cutaneous reactions (purple glove syndrome), severe hypotension and cardiac arrhythmias up to ventricular fibrillation and death, and increased risk of severe allergic reactions...
April 6, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29610167/-hla-a-31-01-and-oxcarbazepine-induced-dress-in-a-patient-with-seizures-and-complete-dcx-deletion
#7
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/29602083/antiepileptic-drug-treatment-of-generalized-tonic-clonic-seizures-an-evaluation-of-regulatory-data-and-five-criteria-for-drug-selection
#8
REVIEW
Simon D Shorvon, Pedro E Bermejo, Ayana A Gibbs, Gilles Huberfeld, Reetta Kälviäinen
BACKGROUND: A generalized tonic-clonic seizure (GTCS) is the most severe form of common epileptic seizure and carries the greatest risk of harm. The aim of this review is to provide an evidence-based guide for the selection of antiepileptic drugs (AEDs) for patients with GTCSs. Eight AEDs are approved in Europe and the USA for the treatment of both primarily GTCSs (PGTCSs) and secondarily GTCSs (SGTCSs) and are considered in this paper. METHODS: Each AED is evaluated using five criteria: (1) efficacy, by seizure type (a: PGTCSs and b: SGTCSs); (2) adverse effects; (3) interactions; (4) adherence and dosing; and (5) mechanism of action (MOA)...
March 27, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29593860/potential-drug-drug-interactions-with-direct-oral-anticoagulants-in-elderly-hospitalized-patients
#9
Heather L Forbes, Thomas M Polasek
Background: To determine the prevalence and nature of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in elderly hospitalized patients. Methods: This was a retrospective observational study. Inclusion criteria were: aged over 65 years; taking apixaban, rivaroxaban or dabigatran; and admitted to the Repatriation General Hospital between April 2014 and July 2015. A list of clinically relevant 'perpetrator' drugs was compiled from product information, the Australian Medicines Handbook, the Australian National Prescribing Service resources, and local health network guidelines...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29588963/phenytoin-as-a-last-resort-treatment-in-scn8a-encephalopathy
#10
Hilde M Braakman, Judith S Verhoeven, Corrie E Erasmus, Charlotte A Haaxma, Marjolein H Willemsen, H Jurgen Schelhaas
SCN8A encodes Nav1.6, one of the main voltage-gated sodium channel subunits in the brain, and SCN8A mutations lead to epileptic encephalopathy. Particular mutations render the mutant channel more susceptible to inhibition by phenytoin. Yet, the potentially severe side effects of phenytoin maintenance therapy, especially cognitive impairment, are undesirable in these already cognitively impaired patients. We describe a 5-year-old patient with SCN8A encephalopathy in whom phenytoin proved successful as emergency treatment to prevent clustering of seizures and status epilepticus, thus hospital stays...
September 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29588957/dress-syndrome-a-case-of-cross-reactivity-with-lacosamide
#11
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
#12
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...
March 10, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29570914/voriconazole-concentration-is-inversely-correlated-with-corticosteroid-usage-in-immunocompromized-patients
#13
Osamu Imataki, Kazunori Yamaguchi, Makiko Uemura, Noriyasu Fukuoka
BACKGROUND: Voriconazole (VRCZ) is a broad-spectrum antifungal agent that can be administered both orally and intravenously. A high level of intra- and interindividual variability in serum drug therapeutic concentrations has been reported. We analyzed the influence of corticosteroid use on serum VRCZ concentration by assessing the correlation between corticosteroid dose and VRCZ trough level. METHODS: Immunocompromized patients treated with VRCZ with or without corticosteroid use from June 2010 through March 2017 (6 years and 8 months) were reviewed in our institute...
March 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29565514/correlation-between-nurr1-expression-and-drug-resistance-in-the-brain-of-rats-with-epilepsy
#14
H-Y Li, F Liu, H-R Wang
OBJECTIVE: To investigate the correlation between nuclear receptor related 1 (Nurr1) expression and drug resistance in the brain of rats with epilepsy. MATERIALS AND METHODS: A total of 60 adult male Sprague-Dawley rats were selected, and the animal model of epilepsy was established by electrical stimulation. These rats were randomly divided into the control group and the drug-resistant group. The model of drug-resistant epilepsy was screened with phenytoin (PHT) and phenobarbital (PB); the hippocampus and temporal lobe cortex tissues were isolated from rats; the messenger ribonucleic acid (mRNA) and protein levels of Nurr1 in the hippocampus and cortex tissues of the two groups of rats were detected by reverse transcription polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry, respectively...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29547827/pharmacological-characterization-of-the-cannabinoid-receptor-2-agonist-%C3%AE-caryophyllene-on-seizure-models-in-mice
#15
Jana Tchekalarova, Keylla da Conceição Machado, Antonio Luiz Gomes Júnior, Ana Amélia de Carvalho Melo Cavalcante, Albena Momchilova, Rumyana Tzoneva
PURPOSE: Activation of CB1 receptors, produces anticonvulsant effect accompanied by memory disturbance both in animal seizure tests and in patients with epilepsy. Few reports considered the role of CB2 receptor on seizure susceptibility and cognitive functions. The aim of the present study was to explore the effect of a selective CB2 receptor agonist β-caryophyllene (BCP) in models of seizures and cognition in mice. METHODS: Dose-dependent effects of BCP was studied in maximal electroshock seizure (MES) test, subcutaneous pentylenetetrazole (scPTZ) test and Morris water maze test...
March 12, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29545765/clinical-characteristics-and-etiology-of-bilateral-vestibular-loss-in-a-cohort-from-central-illinois
#16
Jorge C Kattah
Background: Previous series of bilateral vestibular loss (BVL) identified numerous etiologies, but surprisingly, a cause in a significant number of cases remains unknown. In an effort to understand possible etiology and management strategies, a global effort is currently in progress. Here, I contribute my 10-year experience with both acute and chronic BVL during the 2007-2017 decade. Methods: This is a retrospective review of the charts and EMR of patients diagnosed with BVL in the last 10 years...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29537409/calvarial-thickening-due-to-anticonvulsants-other-than-phenytoin
#17
Z Siddiqui, K Singh
No abstract text is available yet for this article.
December 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29527023/drug-reaction-with-eosinophilia-and-systemic-symptoms-an-update-and-review-of-recent-literature
#18
Abhishek De, Murlidhar Rajagopalan, Aarti Sarda, Sudip Das, Projna Biswas
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, is also known as drug induced hypersensitivity syndrome and by various other names. It is now recognised as one of the severe cutaneous adverse reaction (SCAR) and can be potentially life-threatening. Historically, it was most frequently linked with phenytoin and was initially described as phenytoin hypersensitivity syndrome. However, it was later found to be caused by various other medications. Anticonvulsants and sulfonamides are the most common offender...
January 2018: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/29526461/a-circadian-clock-in-the-blood-brain-barrier-regulates-xenobiotic-efflux
#19
Shirley L Zhang, Zhifeng Yue, Denice M Arnold, Gregory Artiushin, Amita Sehgal
Endogenous circadian rhythms are thought to modulate responses to external factors, but mechanisms that confer time-of-day differences in organismal responses to environmental insults/therapeutic treatments are poorly understood. Using a xenobiotic, we find that permeability of the Drosophila "blood"-brain barrier (BBB) is higher at night. The permeability rhythm is driven by circadian regulation of efflux and depends on a molecular clock in the perineurial glia of the BBB, although efflux transporters are restricted to subperineurial glia (SPG)...
March 22, 2018: Cell
https://www.readbyqxmd.com/read/29522172/does-common-prescription-medication-affect-the-rate-of-orthodontic-tooth-movement-a-systematic-review
#20
Militiadis A Makrygiannakis, Eleftherios G Kaklamanos, Athanasios E Athanasiou
Background: As the taking of any medication may theoretically affect the complex pathways responsible for periodontal tissue homeostasis and the events leading to orthodontic tooth movement, it is considered important for the orthodontist to be able to identify prospective patients' history and patterns of pharmaceutical consumption. Objective: To systematically investigate and appraise the quality of the available evidence regarding the effect of commonly prescribed medications on the rate of orthodontic tooth movement...
March 6, 2018: European Journal of Orthodontics
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