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https://www.readbyqxmd.com/read/29352387/current-perspectives-on-erythema-multiforme
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/29341912/quantitative-estimation-of-phenytoin-sodium-disproportionation-in-the-formulations-using-vibration-spectroscopies-and-multivariate-methodologies
#4
Sathish Dharani, Ziyaur Rahman, Sogra F Barakh Ali, Hamideh Afrooz, Mansoor A Khan
Phenytoin sodium (PS) has tendency to convert to its base form; phenytoin base (PHT) during manufacturing, packaging, shelf life and in-use conditions that can influence its clinical performance. The objective of the present work was to develop a non-destructive, quick and easy analytical method for quantification of PHT in the drug product. A formulation was prepared containing the excipients present in the commercial capsule formulation of PS. Formulation containing either 100% PHT or PS was prepared and these formulations were mixed in different proportion to achieve 0-100% PHT matrices...
January 13, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29341907/molecular-level-elucidation-of-saccharin-assisted-rapid-dissolution-and-high-supersaturation-level-of-drug-from-eudragit%C3%A2-e-solid-dispersion
#5
Keisuke Ueda, Harunobu Kanaya, Kenjirou Higashi, Keiji Yamamoto, Kunikazu Moribe
In this work, the effect of saccharin (SAC) addition on the dissolution and supersaturation level of phenytoin (PHT)/Eudragit® E (EUD-E) solid dispersion (SD) at neutral pH was examined. The PHT/EUD-E SD showed a much slower dissolution of PHT compared to the PHT/EUD-E/SAC SD. EUD-E formed a gel layer after the dispersion of the PHT/EUD-E SD into an aqueous medium, resulting in a slow dissolution of PHT. Pre-dissolving SAC in the aqueous medium significantly improved the dissolution of the PHT/EUD-E SD. Solid-state 13C NMR measurements showed an ionic interaction between the tertiary amino group of EUD-E and the amide group of SAC in the EUD-E gel layer...
January 13, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29339038/curcumin-inhibits-tgf-%C3%AE-1-induced-connective-tissue-growth-factor-expression-through-the-interruption-of-smad2-signaling-in-human-gingival-fibroblasts
#6
Jung-Tsu Chen, Chen-Ying Wang, Min-Huey Chen
BACKGROUND/PURPOSE: Many fibrotic processes are associated with an increased level of transforming growth factor-β1 (TGF-β1). TGF-β1 can increase synthesis of matrix proteins and enhance secretion of protease inhibitors, resulting in matrix accumulation. Connective tissue growth factor (CTGF) is a downstream profibrotic effector of TGF-β1 and is associated with the fibrosis in several human organs. Curcumin has been applied to reduce matrix accumulation in fibrotic diseases. This study was aimed to evaluate whether curcumin could suppress TGF-β1-induced CTGF expression and its related signaling pathway involving in this inhibitory action in primary human gingival fibroblasts...
January 13, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29338667/docosahexaenoic-acid-prevents-resistance-to-antiepileptic-drugs-in-two-animal-models-of-drug-resistant-epilepsy
#7
Melika Moezifar, Mohammad Sayyah, Morteza Zendehdel, Hakimeh Gavzan
OBJECTIVES: One-third of epileptic patients are resistant to antiepileptic drugs. Few clinical studies with small sample size indicate that polyunsaturated fatty acids could control drug-resistant epilepsy. We examined the efficacy of acute and chronic administration of docosahexaenoic acid (DHA) in two animal models of drug-resistant epilepsies, i.e. 6-Hz psychomotor seizures in mice and lamotrigine (LTG)-resistant kindled rats. METHODS: Mice received a single injection of DHA (300 µM, i...
January 16, 2018: Nutritional Neuroscience
https://www.readbyqxmd.com/read/29329017/amiodarone-a-multi-channel-blocker-enhances-anticonvulsive-effect-of-carbamazepine-in-the-mouse-maximal-electroshock-model
#8
Monika Banach, Monika Popławska, Kinga K Borowicz-Reutt
Cardiac arrhythmia may occur in the course of epilepsy. Simultaneous therapy of the two diseases might be complicated by drug interactions since antiarrhythmic and antiepileptic agents share some molecular targets. The aim of this study was to evaluate the influence of amiodarone, an antiarrhythmic drug working as a multi-channel blocker, on the protective activity of four classical antiepileptic drugs in the maximal electroshock test in mice. Amiodarone at doses up to 75 mg/kg did not affect the electroconvulsive threshold in mice...
January 5, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29320603/drug-management-for-acute-tonic-clonic-convulsions-including-convulsive-status-epilepticus-in-children
#9
REVIEW
Amy McTague, Timothy Martland, Richard Appleton
BACKGROUND: Tonic-clonic convulsions and convulsive status epilepticus (currently defined as a tonic-clonic convulsion lasting at least 30 minutes) are medical emergencies and require urgent and appropriate anticonvulsant treatment. International consensus is that an anticonvulsant drug should be administered for any tonic-clonic convulsion that has been continuing for at least five minutes. Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29315987/compatibility-of-common-iv-drugs-with-6-hydroxyethyl-starch-130-0-42-and-4-gelatin
#10
Sebastian Heiderich, Anna Auf der Springe, Jonas Jürgens, Wolfgang Koppert, Andreas Leffler, Robert Sümpelmann, Nils Dennhardt
BACKGROUND: Acetate-containing colloid infusion solutions are recommended to recover normovolemia during pediatric anesthesia. Until now, no studies investigating the compatibility with common anesthetic drugs were available. AIMS: This in vitro study was conducted to reveal possible incompatibilities between common anesthetic drugs and the acetate-containing colloid infusion solutions 6% hydroxyethyl starch and 4% gelatin with normal saline as control. METHODS: The colloid infusion solutions were mixed 1:1 with 29 common intravenous drugs in concentrations used in daily clinical practice...
January 9, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29304487/phenytoin-bovine-serum-albumin-interactions-modeling-plasma-protein-drug-binding-a-multi-spectroscopy-and-in-silico-based-correlation
#11
P K Suresh, Naik Divya, Shah Nidhi, R Rajasekaran
The study focused on the analysis of the nature and site of binding of Phenytoin (PHT) -(a model hydrophobic drug) with Bovine Serum Albumin (BSA) (a model protein used as a surrogate for HSA). Interactions with defined amounts of Phenytoin and BSA demonstrated a blue shift (hypsochromic -change in the microenvironment of the tryptophan residue with decrease in the polar environment and more of hydrophobicity) with respect to the albumin protein and a red shift (bathochromic -hydrophobicity and polarity related changes) in the case of the model hydrophobic drug...
December 27, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/29290374/physical-compatibility-of-meropenem-and-vaborbactam-with-select-intravenous-drugs-during-simulated-y-site-administration
#12
James M Kidd, Lindsay M Avery, Tomefa E Asempa, David P Nicolau, Joseph L Kuti
PURPOSE: Meropenem/vaborbactam is a novel intravenous antibiotic combining the carbapenem, meropenem, with a novel β-lactamase inhibitor, vaborbactam. Meropenem/vaborbactam is administered as a 3-hour infusion given every 8 hours, thereby potentially restricting an intravenous line for 9 h/d. Intravenous medications may be given concurrently via Y-site when compatibility data are available. Herein, physical compatibility was determined for the identification which medications can be coadministered with meropenem/vaborbactam via Y-site...
December 28, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29288520/a-critical-appraisal-of-randomized-controlled-trials-on-intravenous-phenytoin-in-convulsive-status-epilepticus
#13
Francesco Brigo, Nicola Luigi Bragazzi, Simona Lattanzi, Raffaele Nardone, Eugen Trinka
OBJECTIVE: Since the 1970s, intravenous (IV) phenytoin (PHT) has been traditionally used as second-stage treatment for convulsive status epilepticus (SE) after failure of benzodiazepines. The aim of this review was to critically assess the evidence supporting the use of IV PHT as treatment of convulsive SE in patients of any age. In particular, we critically appraised the results of randomized controlled trials (RCTs) evaluating IV PHT as treatment of convulsive SE. METHODS: Systematic search of the literature to identify RCTs evaluating IV PHT as treatment of convulsive SE in patients of any age...
December 30, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29288229/genetic-variation-in-cfh-predicts-phenytoin-induced-maculopapular-exanthema-in-european-descent-patients
#14
Mark McCormack, Hongsheng Gui, Andrés Ingason, Doug Speed, Galen E B Wright, Eunice J Zhang, Rodrigo Secolin, Clarissa Yasuda, Maxwell Kwok, Stefan Wolking, Felicitas Becker, Sarah Rau, Andreja Avbersek, Kristin Heggeli, Costin Leu, Chantal Depondt, Graeme J Sills, Anthony G Marson, Pauls Auce, Martin J Brodie, Ben Francis, Michael R Johnson, Bobby P C Koeleman, Pasquale Striano, Antonietta Coppola, Federico Zara, Wolfram S Kunz, Josemir W Sander, Holger Lerche, Karl Martin Klein, Sarah Weckhuysen, Martin Krenn, Lárus J Gudmundsson, Kári Stefánsson, Roland Krause, Neil Shear, Colin J D Ross, Norman Delanty, Munir Pirmohamed, Bruce C Carleton, Fernando Cendes, Iscia Lopes-Cendes, Wei-Ping Liao, Terence J O'Brien, Sanjay M Sisodiya, Stacey Cherny, Patrick Kwan, Larry Baum, Gianpiero L Cavalleri
OBJECTIVE: To characterize, among European and Han Chinese populations, the genetic predictors of maculopapular exanthema (MPE), a cutaneous adverse drug reaction common to antiepileptic drugs. METHODS: We conducted a case-control genome-wide association study of autosomal genotypes, including Class I and II human leukocyte antigen (HLA) alleles, in 323 cases and 1,321 drug-tolerant controls from epilepsy cohorts of northern European and Han Chinese descent. Results from each cohort were meta-analyzed...
December 29, 2017: Neurology
https://www.readbyqxmd.com/read/29283003/a-particular-case-of-accidental-asphyxiation
#15
Cristian D'Ovidio, Enrica Rosato, Martina Bonelli, Aldo Carnevale, Luigi T Marsella
The case reported involved a 60-year-old man with psychiatric illness who was found dead at his home. He was almost naked and showed signs of death by violent asphyxiation, which led to the suspicion of homicide. Autopsy findings showed foreign material in the trachea and larynx. However, the partially digested content in his stomach, the study of the gastric content and the microscopic analysis the airways made it possible to define this as accidental death due to inhalation of material from a diaper. Toxicological analysis detected the presence of phenytoin, valproic acid, and phenobarbital in his blood, with values within the therapeutic ranges...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29274302/association-of-cyp2c9-3-with-phenytoin-induced-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-systematic-review-and-meta-analysis
#16
X Wu, W Liu, W Zhou
WHAT IS KNOWN AND OBJECTIVE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions that can be induced by phenytoin (PHT). CYP2C9*3 is the key enzyme in PHT metabolism. The aim of this meta-analysis was to evaluate the association between CYP2C9*3 and PHT-induced SJS/TEN. METHODS: An extensive search was performed in multiple databases, including the Cochrane Library, EMBASE, PubMed, OVID and EBSCO. Studies exploring the relationship between CYP2C9*3 and PHT-induced SJS and TEN were included...
December 23, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29248452/protective-effect-of-terminalia-chebula-against-seizures-seizure-induced-cognitive-impairment-and-oxidative-stress-in-experimental-models-of-seizures-in-rats
#17
Ritesh Kumar, Renu Arora, Amit Agarwal, Y K Gupta
ETHNOPHARMACOLOGICAL RELEVANCE: Teminalia chebula (TC) has been traditionally used in the Ayurvedic system of medicine primarily for gastrointestinal disorders. Its fruit extract has also been used to treat epilepsy and other CNS disorders. AIM OF THE STUDY: To evaluate the effect of hydroalcoholic fruit extract of Terminalia chebula (HETC) on experimental models of seizures, seizure-induced cognitive impairment and oxidative stress in rats. MATERIALS AND METHODS: In vitro antioxidant activity of HETC was evaluated by using ABTS, NO and DPPH radical scavenging assay...
December 14, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29246152/linking-physiologically-based-pharmacokinetic-and-genome-scale-metabolic-networks-to-understand-estradiol-biology
#18
Joanna H Sier, Alfred E Thumser, Nick J Plant
BACKGROUND: Estrogen is a vital hormone that regulates many biological functions within the body. These include roles in the development of the secondary sexual organs in both sexes, plus uterine angiogenesis and proliferation during the menstrual cycle and pregnancy in women. The varied biological roles of estrogens in human health also make them a therapeutic target for contraception, mitigation of the adverse effects of the menopause, and treatment of estrogen-responsive tumours. In addition, endogenous (e...
December 15, 2017: BMC Systems Biology
https://www.readbyqxmd.com/read/29243813/antiepileptic-drug-monotherapy-for-epilepsy-a-network-meta-analysis-of-individual-participant-data
#19
REVIEW
Sarah J Nevitt, Maria Sudell, Jennifer Weston, Catrin Tudur Smith, Anthony G Marson
BACKGROUND: Epilepsy is a common neurological condition with a worldwide prevalence of around 1%. Approximately 60% to 70% of people with epilepsy will achieve a longer-term remission from seizures, and most achieve that remission shortly after starting antiepileptic drug treatment. Most people with epilepsy are treated with a single antiepileptic drug (monotherapy) and current guidelines from the National Institute for Health and Care Excellence (NICE) in the United Kingdom for adults and children recommend carbamazepine or lamotrigine as first-line treatment for partial onset seizures and sodium valproate for generalised onset seizures; however a range of other antiepileptic drug (AED) treatments are available, and evidence is needed regarding their comparative effectiveness in order to inform treatment choices...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29242650/infusion-dose-requirement-of-rocuronium-in-patients-on-phenytoin-therapy-a-prospective-comparative-study
#20
Veena Sheshadri, Arathi Radhakrishnan, Kusuma Halemani, Venkatesh H Keshavan
Background and Aims: Patients with intracranial tumour are usually on anticonvulsants. Patients on phenytoin therapy demonstrate rapid metabolism of nondepolarising muscle relaxants secondary to enzyme induction. Infusion dose requirement of rocuronium in such patients has been sparingly studied. We studied the continuous infusion dose requirement of rocuronium bromide in patients on phenytoin therapy and its correlation with serum levels of phenytoin. Methods: Seventy-five patients scheduled for supratentorial tumour surgery were included in the study...
October 2017: Indian Journal of Anaesthesia
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