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https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#1
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department (ED) treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
September 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28935657/use-of-hybrid-capillary-tube-setup-on-400mhz-nmr-for-quantitation-of-crucial-low-quantity-metabolites-using-asicco-signal
#2
Ranjeet Tiwari, Deepak Ahire, Hemantha Kumar, Sarmistha Sinha, Siddheshwar Kisan Chauthe, Murali Subramanian, Ramaswamy Iyer, Ramakanth Sarabu, Lakshmi Kant Bajpai
Metabolites of new chemical entities can influence safety and efficacy of a molecule and often times need to be quantified in preclinical studies. However, synthetic standards of metabolites are very rarely available in early discovery. Alternate approaches such as bio-synthesis needs to be explored to generate these metabolites. Assessing the quantity and purity of these small amounts of metabolites with a non-destructive analytical procedure becomes crucial. Quantitative nuclear magnetic resonance (qNMR) becomes the method of choice for these samples...
September 21, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28931473/psychiatric-and-behavioral-side-effects-of-antiepileptic-drugs-in-adults-with-epilepsy
#3
Baibing Chen, Hyunmi Choi, Lawrence J Hirsch, Austen Katz, Alexander Legge, Richard Buchsbaum, Kamil Detyniecki
PURPOSE: Psychiatric and behavioral side effects (PBSEs) are common, undesirable effects associated with antiepileptic drug (AED) use. The objective of the study was to compare the PBSE profiles of older and newer AEDs in a large specialty practice-based sample of patients diagnosed with epilepsy. METHODS: As part of the Columbia and Yale AED Database Project, we reviewed patient records including demographics, medical history, AED use, and side effects for 4085 adult patients (age: 18 years) newly started on an AED regimen...
September 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28928441/effects-of-anti-epileptic-drugs-on-spreading-depolarization-induced-epileptiform-activity-in-mouse-hippocampal-slices
#4
Ching-Huei Lin, Shih-Pin Hsu, Ting-Chun Cheng, Chin-Wei Huang, Yao-Chang Chiang, I-Han Hsiao, Ming-Hsueh Lee, Mei-Lin Shen, Dong Chuan Wu, Ning Zhou
Epilepsy and spreading depolarization (SD) are both episodic brain disorders and often exist together in the same individual. In CA1 pyramidal neurons of mouse hippocampal slices, induction of SD evoked epileptiform activities, including the ictal-like bursts, which occurred during the repolarizing phase of SD, and the subsequent generation of paroxysmal depolarization shifts (PDSs), which are characterized by mild depolarization plateau with overriding spikes. The duration of the ictal-like activity was correlated with both the recovery time and the depolarization potential of SD, whereas the parameters of PDSs were not significantly correlated with the parameters of SD...
September 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28927713/risk-factors-of-early-adverse-drug-reactions-with-phenytoin-a-prospective-inpatient-cohort
#5
Reinaldo Uribe-San-Martín, Ethel Ciampi, Wilhelm Uslar, Silvana Villagra, Jaime Godoy, Patricio Mellado
INTRODUCTION: Phenytoin (PHT) is an effective and inexpensive antiepileptic drug (AED). However, its use has been limited for fear of adverse drug reactions (ADRs) and is being replaced by newer AED, increasing the costs and causing major budget problems, particularly for developing countries. OBJECTIVE: The objective of this study was to determine ADR frequency, explore, and establish related risk factors. METHODS: Prospective data were collected from a cohort of inpatients using PHT for the first time...
September 15, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28914189/a-hopeful-prospect-of-riociguat-as-a-soluble-guanylate-cyclase-stimulator-for-management-of-pressure-ulcers
#6
Soha Azadi, Hajar Ashrafi, Amir Azadi
Pressure ulcer remains as a common problem, especially developed in disabled patients and hence, subjected to continuous pressure for prolonged periods of time. Most of the studies investigating the preventive and therapeutic approaches have focused on wound cleansing, dressing and supportive strategies , as well as pharmacological therapy including zinc sulphate, vitamin A or phenytoin. Despite such efforts, pressure ulcer continues to impair the life quality and expectancy. Thus involving in the paradigm shift in biomedical studies, the recent ones focus on biological signaling pathways involving nitric oxide (NO)- soluble guanylatecyclase (sGC)- cyclic guanosine monophosphate (cGMP) contributing in vasodilation, reperfusion and oxygen delivery...
September 15, 2017: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/28905718/physiologic-behavioral-and-histologic-responses-to-various-euthanasia-methods-in-c57bl-6ntac-male-mice
#7
Gregory P Boivin, Michael A Bottomley, Patricia A Schiml, Lori Goss, Nadja Grobe
Rodent euthanasia using exposure to increasing concentrations of CO2 has come under scrutiny due to concerns of potential pain during the euthanasia process. Alternatives to CO2, such as isoflurane and barbiturates, have been proposed as more humane methods of euthanasia. In this study, we examined 3 commonly used euthanasia methods in mice: intraperitoneal injection of pentobarbital-phenytoin solution, CO2 inhalation, and isoflurane anesthesia followed by CO2 inhalation. We hypothesized that pentobarbital-phenytoin euthanasia would cause fewer alterations in cardiovascular response, result in less behavioral evidence of pain or stress, and produce lower elevations in ACTH than would the isoflurane and CO2 methods, which we hypothesized would not differ in regard to these parameters...
January 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28884979/effects-of-antiepileptic-drugs-on-the-carotid-artery-intima-media-thickness-in-epileptic-patients
#8
Qilun Lai, Chunhong Shen, Yang Zheng, Yinxi Zhang, Yi Guo, Meiping Ding
BACKGROUND AND PURPOSE: It has been reported that taking antiepileptic drugs (AEDs) may increase the risk of atherosclerosis. We performed a meta-analysis to evaluate the carotid artery intima-media thickness (CA-IMT) as a surrogate factor for atherosclerosis in epileptic patients. METHODS: We searched NCBI (PubMed), ISI Web of Knowledge, EMBASE, and the Cochrane Library databases for studies of the association between AEDs and CA-IMT in epileptic patients. A random-effects meta-analysis was used to pool results across studies...
September 4, 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28877137/a-systematic-review-of-nmda-receptor-antagonists-for-treatment-of-neuropathic-pain-in-clinical-practice
#9
Rohit Aiyer, Neel Mehta, Semih Gungor, Amitabh Gulati
OBJECTIVE: To investigate the efficacy of N-methyl-D-aspartate receptor (NMDA) receptor antagonists for neuropathic pain and review literature to determine if specific pharmacologic agents provide adequate neuropathic pain relief. METHODS: Literature was reviewed on PubMed using a variety of key words for 8 NMDA receptor antagonists. These key words include: "Ketamine and Neuropathy", "Ketamine and Neuropathic Pain", "Methadone and Neuropathy", "Methadone and Neuropathic Pain", "Memantine and Neuropathic pain", "Memantine and Neuropathy", "Amantadine and Neuropathic Pain", "Amantadine and Neuropathy", "Dextromethorphan and Neuropathic Pain", "Dextromethorphan and Neuropathy", "Carbamazepine and Neuropathic Pain", "Carbamazepine and Neuropathy", "Valproic Acid and Neuropathy", "Valproic Acid and Neuropathic Pain", "Phenytoin and Neuropathy" and "Phenytoin and Neuropathic Pain"...
September 1, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28875044/decreased-rivaroxaban-levels-in-a-patient-with-cerebral-vein-thrombosis-receiving-phenytoin
#10
Ana F Becerra, Tomas Amuchastegui, Aldo H Tabares
Combined use of antiepileptic drugs and anticoagulants is common. We describe the first case documenting laboratory interaction between rivaroxaban and phenytoin. A 48-year-old woman was admitted to our hospital due to cerebral venous thrombosis, bilateral pulmonary embolism, and deep vein thrombosis. She came from a small town with difficult access to warfarin monitoring. She was receiving phenytoin 100 mg three times daily (t.i.d.) and started enoxaparin 60 mg twice daily (b.i.d.). An abdominal mass was diagnosed and removed by laparoscopy (gastrointestinal stromal tumor)...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28873066/preliminary-study-of-the-association-between-the-elimination-parameters-of-phenytoin-and-phenobarbital
#11
Janthima Methaneethorn, Duangchit Panomvana, Thaveechai Vachirayonstien
BACKGROUND: Therapeutic drug monitoring is essential for both phenytoin and phenobarbital therapy given their narrow therapeutic indexes. Nevertheless, the measurement of either phenytoin or phenobarbital concentrations might not be available in some rural hospitals. Information assisting individualized phenytoin and phenobarbital combination therapy is important. This study's objective was to determine the relationship between the maximum rate of metabolism of phenytoin (Vmax) and phenobarbital clearance (CLPB), which can serve as a guide to individualized drug therapy...
September 5, 2017: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/28866335/predictors-of-outcomes-and-refractoriness-in-status-epilepticus-a-prospective-study
#12
Murat Mert Atmaca, Nerses Bebek, Betül Baykan, Ayşen Gökyiğit, Candan Gürses
OBJECTIVE: The objective of this study was to determine the predictors of outcomes and refractoriness in status epilepticus (SE). METHODS: This is a prospective study of 59 adult patients with SE who were admitted to the Emergency Department between February 2012 and December 2013. The effects of clinical, demographic, and electrophysiologic features of patients with SE were evaluated. To evaluate outcome in SE, STESS, mSTESS, and EMSE scales were used. RESULTS: Logistic regression analysis showed that being aged ≥65years (p=0...
August 31, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28857712/a-novel-drug-interaction-between-busulfan-and-blinatumomab
#13
Karen Sweiss, John G Quigley, Annie Oh, Jonathan Lee, Rosa Ye, Damiano Rondelli, Pritesh Patel
Busulfan is an alkylating agent used in pre-transplant conditioning for patients undergoing hematopoietic stem cell transplantation. Several factors contribute to variations in busulfan drug disposition including bioavailability, age, liver function, genetic polymorphisms, and concurrent administration of other drugs. Busulfan is metabolized by hepatic oxidation via the cytochrome P450 3A4 system as well as through conjugation with glutathione. Interactions with drugs such as phenytoin, itraconazole, and metronidazole have been reported to alter busulfan clearance and result in sub- or supra-therapeutic concentrations...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28856745/using-known-drug-interactions-to-manage-supratherapeutic-calcineurin-inhibitor-concentrations
#14
REVIEW
Nicholas W Lange, David M Salerno, Karen Berger, Demetra S Tsapepas
OBJECTIVES: To summarize the available body of evidence guiding the management of supratherapeutic concentrations of calcineurin inhibitors (CNI) using cytochrome P450 (CYP450) enzyme inducers. METHODS: A non-date restricted literature search within MEDLINE, Embase, and Scopus was performed using the terms "cyclosporine", "tacrolimus", "calcineurin inhibitor", "toxicity", "pharmacokinetics", "carbamazepine", "rifampin", "phenytoin", and "phenobarbital." Additional references were identified from a review of all included citations...
August 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28843182/propylparaben-suppresses-epileptiform-activity-in-hippocampal-ca1-pyramidal-cells-in-vitro
#15
Leonardo Lara-Valderrábano, Emilio J Galván, Luisa Rocha
Epilepsy is a highly prevalent neurological disorder. Additionally, a percentage of patients do not respond to conventional antiepileptic drugs. Therefore, drugs for epilepsy control are still being developed. In the present study, the effect of propylparaben (PPB) in the epileptiform activity induced by 4-aminopyridine in hippocampal CA1 pyramidal neurons was evaluated using individual recordings in current-clamp mode. Results indicated that PPB suppressed the epileptiform activity in registered neurons. This effect disappeared when PPB was removed from the solution of incubation...
October 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28838247/the-auditory-and-vestibular-toxicities-induced-by-antiepileptic-drugs
#16
Sherifa A Hamed
Epilepsy is a chronic medical disease in one third of patients and is associated with comorbid adverse somatic conditions due to epilepsy itself or its long-term treatment with antiepileptic drugs (AEDs). Data from experimental, cross-sectional and prospective studies have evidence for the deleterious effect of some AEDs on the auditory and vestibular systems. These abnormalities may be reversible or irreversible. Areas covered: This article review the evidence that long-term treatment with some antiepileptic drugs (AEDs) [e...
August 29, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28830901/drug-rash-with-eosinophilia-and-systemic-symptoms-dress-caused-by-phenytoin
#17
Muhammad Riaz, Bruce D Ragsdale, Zia Ur Rahman, Gaurav Nigam
Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare but potentially life-threatening condition with high mortality. Diagnosis is challenging due to variable clinical presentation and a protracted latency period following initiation of the offending drug. DRESS is a complex interplay that starts by introduction of the offending drug, reactivation of viruses and activation of the immune system. Herpes virus reactivation is considered a diagnostic marker and indicator of illness severity. Prompt recognition and the removal of offending agent remain the key to successful treatment...
August 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28829134/multiscale-computational-modeling-of-the-nanostructure-of-solid-dispersions-of-hydroxypropyl-methylcellulose-acetate-succinate-hpmcas-and-phenytoin
#18
Wenjun Huang, Taraknath Mandal, Ronald G Larson
We recently developed coarse-grained (CG) force fields for hydroxypropyl methylcellulose acetate succinate (HPMCAS) polymers and the model drug molecule phenytoin, and a continuum transport model to study the polymer-drug nanostructures presented during a dissolution test after solvation of solid dispersion particles. We model the polymer-drug interactions that contribute to suppression of drug aggregation, release, and crystal growth during the dissolution process, and we take these as indicators of polymer effectiveness...
September 5, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28820457/role-of-cyp2c9-cyp2c19-and-ephx-polymorphism-in-the-pharmacokinetic-of-phenytoin-a-study-on-uruguayan-caucasian-subjects
#19
Natalia Guevara, Cecilia Maldonado, Manuel Uría, Raquel González, Manuel Ibarra, Silvana Alvariza, Antonella Carozzi, Carlos Azambuja, Pietro Fagiolino, Marta Vázquez
Phenytoin (PHT) oxidative route leads to its main metabolite p-hydroxyphenytoin (p-HPPH), by means of CYP2C9 and CYP2C19. Formation of p-HPPH proceeds via a reactive arene-oxide intermediate. This intermediate can also be converted into PHT dihydrodiol by microsomal epoxide hydrolase (EPHX). The three enzymes are polymorphically expressed and the genetic variants are responsible for changes in the enzyme activity. In order to evaluate the effect that these polymorphisms have on PHT metabolism, PHT and p-HPPH plasma concentrations were measured and the genotype for the three enzymes was assessed in 50 Uruguayan epileptic patients...
August 18, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28815754/pharmacokinetic-interactions-and-dosing-rationale-for-antiepileptic-drugs-in-adults-and-children
#20
S C van Dijkman, W M Rauwé, M Danhof, O Della Pasqua
AIM: Population pharmacokinetic modelling has been widely used across many therapeutic areas to identify sources of variability, which are incorporated into models as covariate factors. Despite numerous publications on pharmacokinetic (PK) drug-drug interactions (DDIs) between antiepileptic drugs (AEDs), such data are not used to support the dose rationale for polytherapy in the treatment of epileptic seizures. Here we assess the impact of DDIs on plasma concentrations and evaluate the need for AED dose adjustment...
August 16, 2017: British Journal of Clinical Pharmacology
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