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Phenytoine

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https://www.readbyqxmd.com/read/28208879/carbamazepine-induced-life-threatening-stevens-johnson-syndrome-and-agranulocytosis-the-maiden-case
#1
A Avinash, V Mohanbabu Amberkar, Sushil Kiran Kunder, Sharath Madhyastha, K Meenakumari
Stevens-Johnson syndrome is one of the few dermatological emergencies in clinical practice. The syndrome is often secondary to the usage of drugs, of which allopurinol, penicillins, sulfa drugs, ibuprofen, sodium valproate, phenytoin, lamotrigine and carbamazepine are commonly implicated. Agranulocytosis is the existence of a clinically significant reduction in neutrophil count. This condition is a serious threat to the patient, as he/she is at a greater risk of contracting bacterial or fungal infections, which may prove to be fatal...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205474/utility-of-magnetic-resonance-imaging-in-the-surgical-management-of-drug-extravasation-a-case-report
#2
Yet Yen Yan, Tein Jin Tan
We report a case of phenytoin extravasation complicated by eschar formation. Pre-operative MRI study showed a large non-enhancing area over the dorsum of the imaged right wrist and hand corresponding with the site of phenytoin extravasation and raising the suspicion of subcutaneous tissue necrosis. The MRI findings correlated well with the intra-operative findings. We believe that pre-operative MRI in drug extravasation cases can characterise the type of soft tissue injury and define the extent of injury. This helps the surgeon in the surgical approach and treatment options...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28202425/levetiracetam-induced-thrombocytopenia-in-a-patient-with-status-epilepticus
#3
Jonguk Kim, Jung-Won Shin
Levetiracetam has broad-spectrum activity in epilepsy. In contrast to phenytoin, levetiracetam has an ideal pharmacokinetic profile without any severe haemodynamic side effects and therefore intravenous loading of levetiracetam is commonly used in adult patients with status epilepticus, especially those who have medical problems. However, levetiracetam-induced serious adverse effects, such as thrombocytopenia and pancytopenia, have been reported in the literature. Here, we describe a case of status epilepticus after cardiac arrest treated with levetiracetam in which severe thrombocytopenia developed and was successfully managed by discontinuation of levetiracetam...
February 15, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28181622/a-framework-for-multi-scale-simulation-of-crystal-growth-in-the-presence-of-polymers
#4
Taraknath Mandal, Wenjun Huang, Jodi M Mecca, Ashley Getchell, William W Porter, Ronald G Larson
We present a multi-scale simulation method for modeling crystal growth in the presence of polymer excipients. The method includes a coarse-grained (CG) model for small molecules of known crystal structure whose force field is obtained using structural properties from atomistic simulations. This CG model is capable of stabilizing the molecular crystal structure and capturing the crystal growth from the melt for a wide range of small organic molecules, as demonstrated by application of our method to the molecules isoniazid, urea, sulfamethoxazole, prilocaine, oxcarbazepine, and phenytoin...
February 9, 2017: Soft Matter
https://www.readbyqxmd.com/read/28179720/using-team-based-learning-to-teach-a-hybrid-pharmacokinetics-course-online-and-in-class
#5
Ann Snyder Franklin, Susan Markowsky, Justin De Leo, Sven Normann, Erik Black
Objective. To compare the effectiveness of face-to-face and online team-based learning (TBL) to teach phenytoin pharmacokinetics. Design. A TBL format was used to teach an online cohort of 222 pharmacy students and two face-to-face cohorts (Tampa and Las Vegas) of pharmacy students. Students in all cohorts completed individual and team readiness tests (iRATs and tRATs), and a self-assessment survey to determine teamwork and content understanding. Knowledge retention questions also were added to the final examination...
December 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28177134/the-influence-of-combination-use-of-cyp450-inducers-on-the-pharmacokinetics-of-voriconazole-a-systematic-review
#6
REVIEW
T-Y Li, W Liu, K Chen, S-Y Liang, F Liu
WHAT IS KNOWN AND OBJECTIVES: Voriconazole is a triazole antifungal agent and is extensively metabolized via cytochrome P450 (CYP450); therefore, special precautions need to be taken when co-administered with a known CYP450 inducer, which may lead to treatment failure. The influence of some CYP450 inducers on the pharmacokinetics of voriconazole has been described in previous studies, but a systematic review was lacking. In this study, we carried out a systematic review to assess the influence of CYP450 inducers on the pharmacokinetic (PK) parameters of voriconazole...
February 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28176298/what-does-the-u-s-medicare-administrative-claims-database-tell-us-about-initial-antiepileptic-drug-treatment-for-older-adults-with-new-onset-epilepsy
#7
Roy C Martin, Edward Faught, Jerzy P Szaflarski, Joshua Richman, Ellen Funkhouser, Kendra Piper, Lucia Juarez, Chen Dai, Maria Pisu
OBJECTIVE: Disparities in epilepsy treatment are not uncommon; therefore, we examined population-based estimates of initial antiepileptic drugs (AEDs) in new-onset epilepsy among racial/ethnic minority groups of older US Medicare beneficiaries. METHODS: We conducted retrospective analyses of 2008-2010 Medicare administrative claims for a 5% random sample of beneficiaries augmented for minority representation. New-onset epilepsy cases in 2009 had ≥1 International Classification of Diseases, Ninth Revision (ICD-9) 345...
February 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28166164/phenytoin-induced-chorea-a-case-report
#8
Dalvir Gill, Mitchell Lyons, Fatme Allam
No abstract text is available yet for this article.
January 27, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28166108/short-term-vision-loss-following-whipple-surgery-a-case-report
#9
Lakshman Gollapalli, Aashish J Kumar, Kunal Sood, Rudram Muppuri
Occipital seizures may result in visual deficits and may be an ictal or postictal phenomenon. A 71-year-old woman underwent pancreatoduodenectomy (Whipple procedure). During recovery in the postanesthesia care unit, the patient complained of blindness. Upon transfer to the intensive care unit, an electroencephalogram indicated bilateral occipital and hemispheric seizure activity. The patient was treated with antiseizure medication, and vision normalized within 3 days. Subtherapeutic concentration of free phenytoin was confirmed...
February 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28160766/phenytoin-induced-gingival-overgrowth-caused-by-death-receptor-pathway-malfunction
#10
Reiri Takeuchi, Hiroko Matsumoto, Kazumune Arikawa, Chieko Taguchi, Ryuji Nakayama, Ikuo Nasu, Koichi Hiratsuka
OBJECTIVE: In this study, we investigated the role of phenytoin (PHT) in death receptor-induced apoptosis of gingival fibroblasts to clarify the mechanism of PHT-induced gingival overgrowth. METHODS: Human gingival fibroblasts were cultured to semi-confluence and treated with PHT (0.025, 0.1, 0.25, and 1.0 μM) for 48 h, and then the apoptotic cell numbers were relatively determined by absorptiometry. After 24 h of 0.25 μM PHT treatment, caspase activity was measured by absorptiometry, apoptotic and cell cycle phase distribution was analyzed by flow cytometry, expression levels of apoptotic genes were quantified by real-time qPCR, and expression of apoptotic proteins was detected by western blot analysis...
February 4, 2017: Oral Diseases
https://www.readbyqxmd.com/read/28144627/phenytoin-responsive-epileptic-encephalopathy-with-a-tandem-duplication-involving-fgf12
#11
Rui-Ming Shi, Tomoko Kobayashi, Atsuo Kikuchi, Ryo Sato, Mitsugu Uematsu, Kumiko An, Shigeo Kure
No abstract text is available yet for this article.
February 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28142242/computational-modeling-of-hydroxypropyl-methylcellulose-acetate-succinate-hpmcas-and-phenytoin-interactions-a-systematic-coarse-graining-approach
#12
Wenjun Huang, Taraknath Mandal, Ronald G Larson
We present coarse-grained (CG) force fields for Hydroxypropyl-Methylcellulose Acetate Succinate (HPMCAS) polymers and the drug molecule phenytoin using a bead/stiff spring model, with each bead representing a HPMCAS monomer or monomer side group (hydroxypropyl acetate, acetate, or succinate), or a single phenytoin ring. We obtain the bonded and non-bonded interaction parameters in our CG model using the RDFs from atomistic simulations of short HPMCAS model oligomers (20-mer) and atomistic simulations of phenytoin molecules...
January 31, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28119481/lacosamide-inhibition-of-nav1-7-voltage-gated-sodium-channels-slow-binding-to-fast-inactivated-states
#13
Sooyeon Jo, Bruce P Bean
Lacosamide is an antiseizure agent targeting voltage-dependent sodium channels. Previous experiments have suggested that lacosamide is unusual in binding selectively to the slow-inactivated state of sodium channels, in contrast to drugs like carbamazepine and phenytoin that bind tightly to fast-inactivated states. We examined the state-dependent effects of lacosamide, using heterologously-expressed human Nav1.7 sodium channels. Lacosamide induced a reversible shift in the voltage-dependence of fast inactivation studied with 100 ms prepulses, suggesting binding to fast-inactivated states...
January 24, 2017: Molecular Pharmacology
https://www.readbyqxmd.com/read/28118749/warfarin-interaction-with-hepatic-cytochrome-p-450-enzyme-inducing-anticonvulsants
#14
Nathan P Clark, Kim Hoang, Thomas Delate, John R Horn, Daniel M Witt
BACKGROUND: Initiation of cytochrome P-450 (CYP)-inducing anticonvulsant medications during warfarin therapy may decrease anticoagulant effect and necessitate frequent warfarin dose adjustments to maintain therapeutic response measured by the international normalized ratio (INR). Clinical information regarding interactions between warfarin and these medications is limited. This study investigated warfarin dose and INR response following CYP-inducing anticonvulsant initiation among chronic warfarin users...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28104975/antiepileptic-drugs-induced-stevens-johnson-syndrome-a-case-series
#15
Bhavi S Trivedi, Nishita H Darji, Supriya D Malhotra, Pankaj R Patel
Stevens-Johnson syndrome (SJS) is an acute life-threatening mucocutaneous reaction, characterized by extensive necrosis and detachment of the epidermis from the skin. The overall incidence of SJS is seen in five cases per million people per year. SJS is typically caused by drugs and is a kind of idiosyncratic reaction. Adverse drug reactions such an SJS have a remarkable effect on patient's safety issues. We encountered nine cases of antiepileptic drug (AED)-induced SJS, specifically with carbamazepine, oxcarbazepine, and phenytoin...
December 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/28100272/bibliometric-analysis-of-literature-on-toxic-epidermal-necrolysis-and-stevens-johnson-syndrome-1940-2015
#16
Waleed M Sweileh
BACKGROUND: Stevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but fatal adverse skin reactions that affect all age groups. In order to better understand literature on this topic, we conducted a bibliometric study using Scopus database to shed light on number and growth of publications, most active countries, institutions, journals and authors involved in publishing articles in this field, citation analysis, top cited articles, international collaboration, role of medications and genetic association...
January 18, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28076384/anti-epileptic-drug-combination-efficacy-in-an-in-vitro-seizure-model-phenytoin-and-valproate-lamotrigine-and-valproate
#17
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
#18
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...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28063739/development-of-left-atrial-thrombus-after-coadministration-of-dabigatran-etexilate-and-phenytoin
#19
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
#20
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
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