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[PMID]:29352477
[Au] Autor:Bergman H; Bhoopathi PS; Soares-Weiser K
[Ad] Endereço:Cochrane Response, Cochrane, St Albans House, 57-59 Haymarket, London, UK, SW1Y 4QX.
[Ti] Título:Benzodiazepines for antipsychotic-induced tardive dyskinesia.
[So] Source:Cochrane Database Syst Rev;1:CD000205, 2018 01 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tardive dyskinesia (TD) is a disfiguring movement disorder, often of the orofacial region, frequently caused by using antipsychotic drugs. A wide range of strategies have been used to help manage TD, and for those who are unable to have their antipsychotic medication stopped or substantially changed, the benzodiazepine group of drugs have been suggested as a useful adjunctive treatment. However, benzodiazepines are very addictive. OBJECTIVES: To determine the effects of benzodiazepines for antipsychotic-induced tardive dyskinesia in people with schizophrenia, schizoaffective disorder, or other chronic mental illnesses. SEARCH METHODS: On 17 July 2015 and 26 April 2017, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (including trial registers), inspected references of all identified studies for further trials and contacted authors of each included trial for additional information. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) focusing on people with schizophrenia (or other chronic mental illnesses) and antipsychotic-induced TD that compared benzodiazepines with placebo, no intervention, or any other intervention for the treatment of TD. DATA COLLECTION AND ANALYSIS: We independently extracted data from the included studies and ensured that they were reliably selected, and quality assessed. For homogenous dichotomous data, we calculated random effects, risk ratio (RR), and 95% confidence intervals (CI). We synthesised continuous data from valid scales using mean differences (MD). For continuous outcomes, we preferred endpoint data to change data. We assumed that people who left early had no improvement. MAIN RESULTS: The review now includes four trials (total 75 people, one additional trial since 2006, 21 people) randomising inpatients and outpatients in China and the USA. Risk of bias was mostly unclear as reporting was poor. We are uncertain about all the effects as all evidence was graded at very low quality. We found no significant difference between benzodiazepines and placebo for the outcome of 'no clinically important improvement in TD' (2 RCTs, 32 people, RR 1.12, 95% CI 0.60 to 2.09, very low quality evidence). Significantly fewer participants allocated to clonazepam compared with phenobarbital (as active placebo) experienced no clinically important improvement (RR 0.44, 95% CI 0.20 to 0.96, 1 RCT, 21 people, very low quality evidence). For the outcome 'deterioration of TD symptoms,' we found no clear difference between benzodiazepines and placebo (2 RCTs, 30 people, RR 1.48, 95% CI 0.22 to 9.82, very low quality evidence). All 10 participants allocated to benzodiazepines experienced any adverse event compared with 7/11 allocated to phenobarbital (RR 1.53, 95% CI 0.97 to 2.41, 1 RCT, 21 people, very low quality evidence). There was no clear difference in the incidence of participants leaving the study early for benzodiazepines compared with placebo (3 RCTs, 56 people, RR 2.73, 95% CI 0.15 to 48.04, very low quality evidence) or compared with phenobarbital (as active placebo) (no events, 1 RCT, 21 people, very low quality evidence). No trials reported on social confidence, social inclusion, social networks, or personalised quality of life, which are outcomes designated important by patients. No trials comparing benzodiazepines with placebo or treatment as usual reported on adverse effects. AUTHORS' CONCLUSIONS: There is only evidence of very low quality from a few small and poorly reported trials on the effect of benzodiazepines as an adjunctive treatment for antipsychotic-induced TD. These inconclusive results mean routine clinical use is not indicated and these treatments remain experimental. New and better trials are indicated in this under-researched area; however, as benzodiazepines are addictive, we feel that other techniques or medications should be adequately evaluated before benzodiazepines are chosen.
[Mh] Termos MeSH primário: Ansiolíticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Discinesia Induzida por Medicamentos/tratamento farmacológico
Moduladores GABAérgicos/uso terapêutico
[Mh] Termos MeSH secundário: Antipsicóticos/efeitos adversos
Clonazepam/uso terapêutico
Discinesia Induzida por Medicamentos/etiologia
Seres Humanos
Fenobarbital/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Anxiety Agents); 0 (Antipsychotic Agents); 0 (GABA Modulators); 12794-10-4 (Benzodiazepines); 5PE9FDE8GB (Clonazepam); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000205.pub3


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[PMID]:29037435
[Au] Autor:Barnes Heller H
[Ad] Endereço:Neurology/Neurosurgery, Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA. Electronic address: Heidi.barnesheller@wisc.edu.
[Ti] Título:Feline Epilepsy.
[So] Source:Vet Clin North Am Small Anim Pract;48(1):31-43, 2018 Jan.
[Is] ISSN:1878-1306
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Seizures occur commonly in cats and can be classified as idiopathic epilepsy, structural epilepsy, or reactive seizures. Pursuit of a diagnosis may include a complete blood count, serum biochemistry, brain MRI, and cerebrospinal fluid analysis as indicated. Antiepileptic drugs should be considered if a cat is having frequent seizures, or any 1 seizure longer than 5 minutes. Phenobarbital is often the drug of choice; however, levetiracetam may be more useful for certain types of epilepsy in cats. Long-term prognosis depends on the underlying diagnosis and response to therapy.
[Mh] Termos MeSH primário: Doenças do Gato
Epilepsia/veterinária
Convulsões/veterinária
[Mh] Termos MeSH secundário: Animais
Anticonvulsivantes/uso terapêutico
Doenças do Gato/diagnóstico por imagem
Doenças do Gato/tratamento farmacológico
Doenças do Gato/etiologia
Gatos
Epilepsia/diagnóstico por imagem
Epilepsia/tratamento farmacológico
Epilepsia/etiologia
Fenobarbital/uso terapêutico
Piracetam/análogos & derivados
Piracetam/uso terapêutico
Prognóstico
Fatores de Risco
Convulsões/diagnóstico por imagem
Convulsões/tratamento farmacológico
Convulsões/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticonvulsants); 230447L0GL (etiracetam); YQE403BP4D (Phenobarbital); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE


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[PMID]:28468518
[Au] Autor:Kraft WK; Adeniyi-Jones SC; Chervoneva I; Greenspan JS; Abatemarco D; Kaltenbach K; Ehrlich ME
[Ad] Endereço:From Sidney Kimmel Medical College, Thomas Jefferson University (W.K.K., S.C.A.-J., I.C., J.S.G., D.A., K.K.), and Nemours duPont Pediatrics, Thomas Jefferson University Hospital (S.C.A.-J., J.S.G.) - both in Philadelphia; and the Departments of Neurology, Pediatrics, and Genetics and Genomic Scienc
[Ti] Título:Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome.
[So] Source:N Engl J Med;376(24):2341-2348, 2017 06 15.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current pharmacologic treatment of the neonatal abstinence syndrome with morphine is associated with a lengthy duration of therapy and hospitalization. Buprenorphine may be more effective than morphine for this indication. METHODS: In this single-site, double-blind, double-dummy clinical trial, we randomly assigned 63 term infants (≥37 weeks of gestation) who had been exposed to opioids in utero and who had signs of the neonatal abstinence syndrome to receive either sublingual buprenorphine or oral morphine. Infants with symptoms that were not controlled with the maximum dose of opioid were treated with adjunctive phenobarbital. The primary end point was the duration of treatment for symptoms of neonatal opioid withdrawal. Secondary clinical end points were the length of hospital stay, the percentage of infants who required supplemental treatment with phenobarbital, and safety. RESULTS: The median duration of treatment was significantly shorter with buprenorphine than with morphine (15 days vs. 28 days), as was the median length of hospital stay (21 days vs. 33 days) (P<0.001 for both comparisons). Adjunctive phenobarbital was administered in 5 of 33 infants (15%) in the buprenorphine group and in 7 of 30 infants (23%) in the morphine group (P=0.36). Rates of adverse events were similar in the two groups. CONCLUSIONS: Among infants with the neonatal abstinence syndrome, treatment with sublingual buprenorphine resulted in a shorter duration of treatment and shorter length of hospital stay than treatment with oral morphine, with similar rates of adverse events. (Funded by the National Institute on Drug Abuse; BBORN ClinicalTrials.gov number, NCT01452789 .).
[Mh] Termos MeSH primário: Analgésicos Opioides/efeitos adversos
Analgésicos Opioides/uso terapêutico
Buprenorfina/uso terapêutico
Síndrome de Abstinência Neonatal/tratamento farmacológico
Tratamento de Substituição de Opiáceos
[Mh] Termos MeSH secundário: Administração Oral
Administração Sublingual
Buprenorfina/efeitos adversos
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Seres Humanos
Hipnóticos e Sedativos/uso terapêutico
Recém-Nascido
Tempo de Internação
Masculino
Morfina/efeitos adversos
Morfina/uso terapêutico
Fenobarbital/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Hypnotics and Sedatives); 40D3SCR4GZ (Buprenorphine); 76I7G6D29C (Morphine); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1614835


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[PMID]:27778062
[Au] Autor:Tutka P; Kondrat-Wróbel MW; Zaluska K; Zólkowska D; Florek-Luszczki M; Luszczki JJ
[Ad] Endereço:Department of Pharmacology, University of Rzeszów, Al. Rejtana 16c, 35-959, Rzeszów, Poland. tutka@umlub.pl.
[Ti] Título:Cytisine inhibits the protective activity of various classical and novel antiepileptic drugs against 6 Hz-induced psychomotor seizures in mice.
[So] Source:Psychopharmacology (Berl);234(2):281-291, 2017 Jan.
[Is] ISSN:1432-2072
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cytisine (CYT) is a partial agonist of brain α4ß2 nicotinic acetylcholine receptors widely used in Central/Eastern Europe for smoking cessation. OBJECTIVES: This study evaluated the effect of CYT on the ability of classical and novel antiepileptic drugs to prevent seizures evoked by the 6-Hz test, a model of psychomotor seizures in mice thought as a model of drug-resistant seizures. RESULTS: CYT administered intraperitoneally (i.p.) in a dose of 2 mg kg significantly inhibited the anticonvulsant activity of lacosamide, levetiracetam, and pregabalin, increasing their median effective doses 50 (ED ) values from 6.88 to 10.52 mg kg (P < 0.05) for lacosamide, from 22.08 to 38.26 mg kg (P < 0.05) for levetiracetam, and from 40.48 to 64.61 mg kg (P < 0.01) for pregabalin, respectively. There were no significant changes in total brain concentrations of lacosamide, levetiracetam, and pregabalin following CYT i.p. administration. CYT administered in a dose of 2 mg kg failed to change the protective action of clobazam, clonazepam, phenobarbital, tiagabine, and valproate in the 6-Hz test. Neither CYT (2 mg kg ) alone nor its combination with the anticonvulsant drugs (at their ED values from the 6-Hz test) affected motor coordination; skeletal muscular strength and long-term memory, as determined in the chimney; and grip strength and passive avoidance tests, respectively. CONCLUSION: CYT-evoked alterations in the protection provided by some antiepileptic drugs against seizures can be of serious concern for epileptic smokers, who might demonstrate therapeutic failure to lacosamide, levetiracetam, and pregabalin, resulting in possible breakthrough seizure attacks.
[Mh] Termos MeSH primário: Alcaloides/toxicidade
Anticonvulsivantes/uso terapêutico
Eletrochoque/efeitos adversos
Agonistas Nicotínicos/toxicidade
Convulsões/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Anticonvulsivantes/farmacologia
Azocinas/toxicidade
Relação Dose-Resposta a Droga
Masculino
Memória de Longo Prazo/efeitos dos fármacos
Memória de Longo Prazo/fisiologia
Camundongos
Fenobarbital/antagonistas & inibidores
Fenobarbital/farmacologia
Fenobarbital/uso terapêutico
Piracetam/análogos & derivados
Piracetam/antagonistas & inibidores
Piracetam/farmacologia
Piracetam/uso terapêutico
Quinolizinas/toxicidade
Convulsões/etiologia
Convulsões/psicologia
Ácido Valproico/antagonistas & inibidores
Ácido Valproico/farmacologia
Ácido Valproico/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alkaloids); 0 (Anticonvulsants); 0 (Azocines); 0 (Nicotinic Agonists); 0 (Quinolizines); 230447L0GL (etiracetam); 53S5U404NU (cytisine); 614OI1Z5WI (Valproic Acid); YQE403BP4D (Phenobarbital); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171205
[Lr] Data última revisão:
171205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00213-016-4461-0


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[PMID]:28859122
[Au] Autor:Luszczki JJ; Patrzylas P; Zagaja M; Andres-Mach M; Zaluska K; Kondrat-Wrobel MW; Szpringer M; Chmielewski J; Florek-Luszczki M
[Ad] Endereço:Department of Pathophysiology, Medical University of Lublin, Lublin, Poland.
[Ti] Título:Effects of arachidonyl-2'-chloroethylamide (ACEA) on the protective action of various antiepileptic drugs in the 6-Hz corneal stimulation model in mice.
[So] Source:PLoS One;12(8):e0183873, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Accumulating evidence indicates that cannabinoid CB1 receptor ligands play a pivotal role in seizures, not only in preclinical studies on animals, but also in clinical settings. This study was aimed at characterizing the influence of arachidonyl-2'-chloroethylamide (ACEA-a selective cannabinoid CB1 receptor agonist) co-administered with phenylmethylsulfonyl fluoride (PMSF) on the anticonvulsant potency of various antiepileptic drugs (clobazam, lacosamide, levetiracetam, phenobarbital, tiagabine and valproate) in the 6-Hz corneal stimulation model. Psychomotor seizures in male albino Swiss mice were evoked by a current (32 mA, 6 Hz, 3 s stimulus duration) delivered via corneal electrodes. Potential adverse effects produced by the antiepileptic drugs in combination with ACEA+PMSF were assessed using the chimney test (motor performance), passive avoidance task (remembering and acquisition of learning), and grip-strength test (muscular strength). Brain concentrations of antiepileptic drugs were measured by HPLC to exclude any pharmacokinetic contribution to the observed effect. ACEA (5 mg/kg, i.p.) + PMSF (30 mg/kg, i.p.) significantly potentiated the anticonvulsant potency of levetiracetam (P<0.05), but not that of clobazam, lacosamide, phenobarbital, tiagabine or valproate in the 6-Hz corneal stimulation model. Moreover, ACEA+PMSF did not significantly affect total brain concentrations of levetiracetam in mice. No behavioral side effects were observed in animals receiving combinations of the studied antiepileptic drugs with ACEA+PMSF. In conclusion, the combined administration of ACEA+PMSF with levetiracetam is associated with beneficial anticonvulsant pharmacodynamic interaction in the 6-Hz corneal stimulation model. The selective activation of cannabinoid CB1 receptor-mediated neurotransmission in the brain may enhance levetiracetam-related suppression of seizures in epilepsy patients, contributing to the efficacious treatment of epilepsy in future.
[Mh] Termos MeSH primário: Anticonvulsivantes/farmacologia
Ácidos Araquidônicos/farmacologia
Epilepsia Parcial Complexa/tratamento farmacológico
Fluoreto de Fenilmetilsulfonil/farmacologia
Piracetam/análogos & derivados
Receptor CB1 de Canabinoide/agonistas
[Mh] Termos MeSH secundário: Acetamidas/farmacologia
Animais
Aprendizagem da Esquiva/efeitos dos fármacos
Benzodiazepinas/farmacologia
Córnea
Modelos Animais de Doenças
Sinergismo Farmacológico
Quimioterapia Combinada
Eletrochoque/métodos
Epilepsia Parcial Complexa/metabolismo
Epilepsia Parcial Complexa/fisiopatologia
Masculino
Camundongos
Força Muscular/efeitos dos fármacos
Ácidos Nipecóticos/farmacologia
Fenobarbital/farmacologia
Piracetam/farmacologia
Desempenho Psicomotor/efeitos dos fármacos
Ácido Valproico/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Acetamides); 0 (Anticonvulsants); 0 (Arachidonic Acids); 0 (Nipecotic Acids); 0 (Receptor, Cannabinoid, CB1); 0 (arachidonyl-2-chloroethylamide); 12794-10-4 (Benzodiazepines); 230447L0GL (etiracetam); 2MRO291B4U (clobazam); 563KS2PQY5 (lacosamide); 57KD15003I (Phenylmethylsulfonyl Fluoride); 614OI1Z5WI (Valproic Acid); YQE403BP4D (Phenobarbital); Z80I64HMNP (tiagabine); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183873


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[PMID]:28661008
[Au] Autor:Nevitt SJ; Sudell M; Weston J; Tudur Smith C; Marson AG
[Ad] Endereço:Department of Biostatistics, University of Liverpool, Block F, Waterhouse Building, 1-5 Brownlow Hill, Liverpool, UK, L69 3GL.
[Ti] Título:Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data.
[So] Source:Cochrane Database Syst Rev;6:CD011412, 2017 06 29.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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. OBJECTIVES: To compare the time to withdrawal of allocated treatment, remission and first seizure of 10 AEDs (carbamazepine, phenytoin, sodium valproate, phenobarbitone, oxcarbazepine, lamotrigine, gabapentin, topiramate, levetiracetam, zonisamide) currently used as monotherapy in children and adults with partial onset seizures (simple partial, complex partial or secondary generalised) or generalised tonic-clonic seizures with or without other generalised seizure types (absence, myoclonus). SEARCH METHODS: We searched the following databases: Cochrane Epilepsy's Specialised Register, CENTRAL, MEDLINE and SCOPUS, and two clinical trials registers. We handsearched relevant journals and contacted pharmaceutical companies, original trial investigators, and experts in the field. The date of the most recent search was 27 July 2016. SELECTION CRITERIA: We included randomised controlled trials of a monotherapy design in adults or children with partial onset seizures or generalised onset tonic-clonic seizures (with or without other generalised seizure types). DATA COLLECTION AND ANALYSIS: This was an individual participant data (IPD) review and network meta-analysis. Our primary outcome was 'time to withdrawal of allocated treatment', and our secondary outcomes were 'time to achieve 12-month remission', 'time to achieve six-month remission', 'time to first seizure post-randomisation', and 'occurrence of adverse events'. We presented all time-to-event outcomes as Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs). We performed pairwise meta-analysis of head-to-head comparisons between drugs within trials to obtain 'direct' treatment effect estimates and we performed frequentist network meta-analysis to combine direct evidence with indirect evidence across the treatment network of 10 drugs. We investigated inconsistency between direct estimates and network meta-analysis via node splitting. Due to variability in methods and detail of reporting adverse events, we have not performed an analysis. We have provided a narrative summary of the most commonly reported adverse events. MAIN RESULTS: IPD was provided for at least one outcome of this review for 12,391 out of a total of 17,961 eligible participants (69% of total data) from 36 out of the 77 eligible trials (47% of total trials). We could not include IPD from the remaining 41 trials in analysis for a variety of reasons, such as being unable to contact an author or sponsor to request data, data being lost or no longer available, cost and resources required to prepare data being prohibitive, or local authority or country-specific restrictions.We were able to calculate direct treatment effect estimates for between half and two thirds of comparisons across the outcomes of the review, however for many of the comparisons, data were contributed by only a single trial or by a small number of participants, so confidence intervals of estimates were wide.Network meta-analysis showed that for the primary outcome 'Time to withdrawal of allocated treatment,' for individuals with partial seizures; levetiracetam performed (statistically) significantly better than both current first-line treatments carbamazepine and lamotrigine; lamotrigine performed better than all other treatments (aside from levetiracetam), and carbamazepine performed significantly better than gabapentin and phenobarbitone (high-quality evidence). For individuals with generalised onset seizures, first-line treatment sodium valproate performed significantly better than carbamazepine, topiramate and phenobarbitone (moderate- to high-quality evidence). Furthermore, for both partial and generalised onset seizures, the earliest licenced treatment, phenobarbitone seems to perform worse than all other treatments (moderate- to high-quality evidence).Network meta-analysis also showed that for secondary outcomes 'Time to 12-month remission of seizures' and 'Time to six-month remission of seizures,' few notable differences were shown for either partial or generalised seizure types (moderate- to high-quality evidence). For secondary outcome 'Time to first seizure,' for individuals with partial seizures; phenobarbitone performed significantly better than both current first-line treatments carbamazepine and lamotrigine; carbamazepine performed significantly better than sodium valproate, gabapentin and lamotrigine. Phenytoin also performed significantly better than lamotrigine (high-quality evidence). In general, the earliest licenced treatments (phenytoin and phenobarbitone) performed better than the other treatments for both seizure types (moderate- to high-quality evidence).Generally, direct evidence and network meta-analysis estimates (direct plus indirect evidence) were numerically similar and consistent with confidence intervals of effect sizes overlapping.The most commonly reported adverse events across all drugs were drowsiness/fatigue, headache or migraine, gastrointestinal disturbances, dizziness/faintness and rash or skin disorders. AUTHORS' CONCLUSIONS: Overall, the high-quality evidence provided by this review supports current guidance (e.g. NICE) that carbamazepine and lamotrigine are suitable first-line treatments for individuals with partial onset seizures and also demonstrates that levetiracetam may be a suitable alternative. High-quality evidence from this review also supports the use of sodium valproate as the first-line treatment for individuals with generalised tonic-clonic seizures (with or without other generalised seizure types) and also demonstrates that lamotrigine and levetiracetam would be suitable alternatives to either of these first-line treatments, particularly for those of childbearing potential, for whom sodium valproate may not be an appropriate treatment option due to teratogenicity.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Epilepsia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Aminas/uso terapêutico
Carbamazepina/análogos & derivados
Carbamazepina/uso terapêutico
Criança
Ácidos Cicloexanocarboxílicos/uso terapêutico
Epilepsias Parciais/tratamento farmacológico
Epilepsia Generalizada/tratamento farmacológico
Frutose/análogos & derivados
Seres Humanos
Isoxazóis/uso terapêutico
Metanálise em Rede
Fenobarbital/uso terapêutico
Fenitoína/uso terapêutico
Piracetam/análogos & derivados
Piracetam/uso terapêutico
Indução de Remissão
Triazinas
Ácido Valproico/uso terapêutico
Ácido gama-Aminobutírico/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Amines); 0 (Anticonvulsants); 0 (Cyclohexanecarboxylic Acids); 0 (Isoxazoles); 0 (Triazines); 0H73WJJ391 (topiramate); 230447L0GL (etiracetam); 30237-26-4 (Fructose); 33CM23913M (Carbamazepine); 459384H98V (zonisamide); 56-12-2 (gamma-Aminobutyric Acid); 614OI1Z5WI (Valproic Acid); 6158TKW0C5 (Phenytoin); 6CW7F3G59X (gabapentin); U3H27498KS (lamotrigine); VZI5B1W380 (oxcarbazepine); YQE403BP4D (Phenobarbital); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011412.pub2


  7 / 16651 MEDLINE  
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[PMID]:28556259
[Au] Autor:Torolira D; Suchomelova L; Wasterlain CG; Niquet J
[Ad] Endereço:Epilepsy Research Laboratory (151), Veterans Affairs Greater Los Angeles Healthcare System.
[Ti] Título:Phenobarbital and midazolam increase neonatal seizure-associated neuronal injury.
[So] Source:Ann Neurol;82(1):115-120, 2017 Jul.
[Is] ISSN:1531-8249
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Status epilepticus is common in neonates and infants, and is associated with neuronal injury and adverse developmental outcomes. γ-Aminobutyric acidergic (GABAergic) drugs, the standard treatment for neonatal seizures, can have excitatory effects in the neonatal brain, which may worsen the seizures and their effects. Using a recently developed model of status epilepticus in postnatal day 7 rat pups that results in widespread neuronal injury, we found that the GABA agonists phenobarbital and midazolam significantly increased status epilepticus-associated neuronal injury in various brain regions. Our results suggest that more research is needed into the possible deleterious effects of GABAergic drugs on neonatal seizures and on excitotoxic neuronal injury in the immature brain. Ann Neurol 2017;82:115-120.
[Mh] Termos MeSH primário: Midazolam/efeitos adversos
Neurônios/patologia
Fenobarbital/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Apoptose/efeitos dos fármacos
Encéfalo/efeitos dos fármacos
Contagem de Células
Feminino
Masculino
Ratos
Estado Epiléptico/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
R60L0SM5BC (Midazolam); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.1002/ana.24967


  8 / 16651 MEDLINE  
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[PMID]:28445845
[Au] Autor:Mináriková M; Fojtikova V; Vyskocilová E; Sedlácek J; Sikut M; Borek-Dohalska L; Stiborová M; Martinkova M
[Ad] Endereço:Department of Biochemistry, Faculty of Science, Charles University, Hlavova (Albertov) 2030-8, Prague 2, Czech Republic.
[Ti] Título:The capacity and effectiveness of diosmectite and charcoal in trapping the compounds causing the most frequent intoxications in acute medicine: A comparative study.
[So] Source:Environ Toxicol Pharmacol;52:214-220, 2017 Jun.
[Is] ISSN:1872-7077
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to compare the adsorption ability of two adsorbent materials, namely diosmectite and activated charcoal towards selected model compounds that are most commonly involved in acute intoxication. Eleven model compounds were selected: acetylsalicylic acid, α-amanitin, amlodipine, digoxin, phenobarbital, ibuprofen, imipramine, carbamazepine, oxazepam, promethazine, and theophylline. Of the tested compounds, promethazine and imipramine were the most effectively adsorbed to diosmectite. Their adsorption to diosmectite (0.356±0.029mg promethazine/mg diosmectite and 0.354±0.019mg imipramine/mg diosmectite, respectively) was significantly higher than their adsorption to activated charcoal. The effect of temperature and pH on the adsorption efficiencies was also evaluated. In the case of experiments with mixture of both adsorbents, they mostly behaved in a solution independently or in a slightly antagonistic way. Using various methods such as N adsorption and thermogravimetric analysis, the structure and texture of diosmectite and activated charcoal were attained.
[Mh] Termos MeSH primário: Antídotos/química
Carvão Vegetal/química
Envenenamento/prevenção & controle
Silicatos/química
[Mh] Termos MeSH secundário: Adsorção
Alfa-Amanitina/química
Anlodipino/química
Aspirina/química
Carbamazepina/química
Digoxina/química
Ibuprofeno/química
Imipramina/química
Oxazepam/química
Fenobarbital/química
Prometazina/química
Teofilina/química
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alpha-Amanitin); 0 (Antidotes); 0 (Silicates); 16291-96-6 (Charcoal); 1J444QC288 (Amlodipine); 33CM23913M (Carbamazepine); 6GOW6DWN2A (Oxazepam); 73K4184T59 (Digoxin); A3N5ZCN45C (Smectite); C137DTR5RG (Theophylline); FF28EJQ494 (Promethazine); OGG85SX4E4 (Imipramine); R16CO5Y76E (Aspirin); WK2XYI10QM (Ibuprofen); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE


  9 / 16651 MEDLINE  
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[PMID]:28419925
[Au] Autor:Dos Santos RC; Kakazu AK; Santos MG; Belinelli Silva FA; Figueiredo EC
[Ad] Endereço:Toxicant and Drug Analysis Laboratory - LATF, Faculty of Pharmaceutical Sciences, Gabriel Monteiro da Silva St. 700, Federal University of Alfenas - UNIFAL-MG, 37130-000 Alfenas, MG, Brazil.
[Ti] Título:Characterization and application of restricted access carbon nanotubes in online extraction of anticonvulsant drugs from plasma samples followed by liquid chromatography analysis.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1054:50-56, 2017 Jun 01.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Anticonvulsant drugs are often used in the treatment of epilepsy. However, their therapeutic monitoring is often necessary in order to obtain an appropriate dose adjustment, due to the proximity between their therapeutic and toxic ranges. The aim of this study was to carry out the synthesis, characterization and use of restricted access carbon nanotubes (RACNTs) in an online method for the analyses of phenobarbital and carbamazepine and primidone from untreated human blood plasma by column switching liquid chromatography. Therefore, the synthesis of RACNTs was carried out through coating commercial Carbon nanotubes with bovine serum albumin (BSA) to subsequently use them as adsorbents in a column switching system operating in the backflush mode. This material was evaluated through the construction of the kinetic and isotherm curves. The experimental data for the interaction of primidone with RACNTs were adequately adjusted to the chemisorption and Sips models for the kinetic and adsorption studies, respectively. The analytical curves ranged from 2.0 to 40.0mgL , with correlation coefficients higher than 0.99, for all the analytes. The LODs of 0.1, 0.1 and 0.01µgmL were defined for PHB, PRM and CBZ, respectively. The relative standard deviation values ranged from 1.0% to 8.4% for the intra assay precision and from 2.7% to 7.6% for inter assay precision. The relative error values ranged from -13.4% to 7.7% for the intra assay accuracy and from -8.6% to 2.5% for the inter assay accuracy. The method was adequately used in the therapeutic monitoring of anticonvulsant drugs in human plasma samples.
[Mh] Termos MeSH primário: Anticonvulsivantes/sangue
Carbamazepina/sangue
Cromatografia Líquida de Alta Pressão/instrumentação
Nanotubos de Carbono/química
Fenobarbital/sangue
Primidona/sangue
[Mh] Termos MeSH secundário: Adsorção
Animais
Anticonvulsivantes/isolamento & purificação
Carbamazepina/isolamento & purificação
Bovinos
Desenho de Equipamento
Seres Humanos
Cinética
Limite de Detecção
Fenobarbital/isolamento & purificação
Primidona/isolamento & purificação
Soroalbumina Bovina/química
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Nanotubes, Carbon); 13AFD7670Q (Primidone); 27432CM55Q (Serum Albumin, Bovine); 33CM23913M (Carbamazepine); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE


  10 / 16651 MEDLINE  
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[PMID]:28414157
[Au] Autor:Mahmoud AM; Zaki AR; Hassan ME; Mostafa-Hedeab G
[Ad] Endereço:Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Egypt. Electronic address: ayman.mahmoud@science.bsu.edu.eg.
[Ti] Título:Commiphora molmol resin attenuates diethylnitrosamine/phenobarbital-induced hepatocarcinogenesis by modulating oxidative stress, inflammation, angiogenesis and Nrf2/ARE/HO-1 signaling.
[So] Source:Chem Biol Interact;270:41-50, 2017 May 25.
[Is] ISSN:1872-7786
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:The objective of the current study was to investigate the possible chemopreventive activity of Commiphora molmol resin (myrrh) extract using a rat model of diethylnitrosamine (DEN)/phenobarbital (PB)-induced early stage hepatocarcinogenesis. Here, we pointed to the modulatory effect of myrrh on oxidative stress, angiogenesis, inflammation and nuclear factor (erythroid-derived 2)-like 2 (Nrf2). Hepatocarcinogenesis was induced in Wistar rats using DEN for initiation and PB as a promoting agent. The rats received 125 or 250 mg/kg C. molmol resin extract throughout the experiment. Both doses of myrrh improved liver function marker enzymes and prevented oval cells proliferation and the distortion of hepatic architecture. The pro-inflammatory cytokine interleukin-6, tumor markers, angiogenesis markers, lipid peroxidation and nitric oxide (NO) were significantly increased in DEN/PB-induced rats. In addition, the antioxidant defenses showed marked reduction in the liver of DEN/PB-induced rats. Oral administration of C. molmol extract to DEN/PB-induced rats significantly decreased circulating markers of inflammation, tumor proliferation and angiogenesis, and liver lipid peroxidation and NO. In addition, C. molmol markedly ameliorated the antioxidant defenses and up-regulated Nrf2 and hemeoxygenase (HO)-1 in the liver of DEN/PB-induced rats. In conclusion, these results provide evidence that C. molmol resin has a potent chemopreventive activity, possibly by up-regulating the Nrf2/HO-1 signaling and attenuation of inflammation, angiogenesis and oxidative stress.
[Mh] Termos MeSH primário: Neoplasias Hepáticas Experimentais/tratamento farmacológico
Estresse Oxidativo/efeitos dos fármacos
Transdução de Sinais/efeitos dos fármacos
Terpenos/farmacologia
Terpenos/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Proliferação Celular/efeitos dos fármacos
Dietilnitrosamina/toxicidade
Modelos Animais de Doenças
Heme Oxigenase-1/metabolismo
Inflamação/tratamento farmacológico
Fígado/citologia
Fígado/efeitos dos fármacos
Neoplasias Hepáticas Experimentais/induzido quimicamente
Neoplasias Hepáticas Experimentais/patologia
Masculino
Fator 2 Relacionado a NF-E2/metabolismo
Neovascularização Patológica/tratamento farmacológico
Fenobarbital/toxicidade
Ratos
Ratos Wistar
Proteínas de Transporte Vesicular/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (NF-E2-Related Factor 2); 0 (Terpenes); 0 (Vesicular Transport Proteins); 3IQ78TTX1A (Diethylnitrosamine); EC 1.14.14.18 (Heme Oxygenase-1); H74221J5J4 (myrrh oil); YQE403BP4D (Phenobarbital)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE



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