scholarly journals The Pharmacology of Chewable Versus Regular Carbamazepine in Chronically Treated Children With Epilepsy

1992 ◽  
Vol 19 (2) ◽  
pp. 204-207 ◽  
Author(s):  
Peter Camfield ◽  
Paul Hwang ◽  
Carol Camfield ◽  
Albert Fraser ◽  
Steven Soldin ◽  
...  
Keyword(s):  
Side Effects ◽  
Seizure Control ◽  
Peak Level ◽  
Serum Levels ◽  
The Other ◽  
Trough Levels

ABSTRACT:We report the first comparison of Chewable and Regular Carbamazepine (CBZ) tablets in children with epilepsy. Forty-four children receiving chronic monotherapy CBZ participated. In month 1 children received regular CBZ; in month 2, the same dose of Chewable CBZ. Once per week fasting predose CBZ and CBZ epoxide serum levels were determined. In a subset of 15 children, at the end of each month serum levels were obtained every 2 hours for 12 hours beginning pre-dose. Standards for CBZ and CBZ epoxide were tested in each centre. Overall, weekly levels showed no consistent differences between the month on chewable CBZ and regular CBZ. Seizure control and rates of reported side effects were similar. In five patients chewable CBZ produced higher peak CBZ levels while five had higher peaks with regular CBZ. In conclusion, regular and chewable CBZ often have unpredictable differences in peak but not trough levels of CBZ suggesting that peak level side effects with one form of CBZ might be alleviated by changing to the other.

Study of Serum Levels, Venous Irritation and Gastrointestinal Side-effects with Intravenous Erythromycin Lactobionate in Patients with Bronchopulmonary Infection

1983 ◽  
Vol 2 (4) ◽  
pp. 593-605 ◽  
Author(s):  
G.E. Marlin ◽  
P.J. Thompson ◽  
C.R. Jenkins ◽  
K.R. Burgess ◽  
D.A.J. LaFranier
Keyword(s):  
Side Effects ◽  
Serum Levels ◽  
The Other ◽  
Fourth Dose ◽  
Gastrointestinal Side Effects ◽  
Spasmolytic Agents ◽  
Bronchopulmonary Infection ◽  
High Concentrations ◽  
Venous Irritation ◽  
Erythromycin Lactobionate

1 Sixteen patients with bronchopulmonary infection received 500 mg erythromycin lactobionate by intravenous infusion every 8 h for 2 days. The duration of infusion was either 30 (8 patients) or 60 min (8 patients). An inline filterset (0.22 μm) was included in the intravenous administration set in 4 patients of each infusion group. 2 Serum erythromycin levels were obtained before and at various times for 8 h after the first and fourth doses and before and immediately after the other doses. The incidence and severity of venous irritation and gastrointestinal side-effects were assessed. 3 Mean (S.D.) peak erythromycin levels for the 30 min infusion were 26.31 (6.89) μg/ml (first dose) and 26.85 (6.11) μg/ml (fourth dose) and for the 60min infusions, 23.96 (7.91) μg/ml (first dose) and 23.65 (6.55) μg/ml (fourth dose). 4 Venous irritation was experienced by 12 patients, ranging from localized discomfort to thrombophlebitis, but the severity was significantly reduced by inline filtration (P < 0.005). 5 Gastrointestinal side-effects were reported by 8 patients and 1 patient withdrew because of severe abdominal pain and nausea. These symptoms were usually relieved by spasmolytic agents and possibly could be explained by high concentrations reaching the gut wall either by biliary excretion or direct transport from blood and stimulating smooth muscle motility.

scholarly journals Correlating Isavuconazole Serum Levels with Efficacy and Adverse Effects (AE) Among Immunocompromised Patients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S293-S293 ◽  
Author(s):  
Pauline Kim ◽  
Bernard Tegtmeier ◽  
Sanjeet Dadwal ◽  
James Ito ◽  
Jane Kriengkauykiat
Keyword(s):  
Side Effects ◽  
Serum Creatinine ◽  
Total Bilirubin ◽  
Response Rates ◽  
Serum Levels ◽  
Research Support ◽  
Upper Limit ◽  
Serum Trough ◽  
Trough Levels ◽  
Serum Trough Levels

Abstract Background Isavuconazole (ISV) is an antifungal approved for treatment of invasive aspergillosis and mucormycosis. Although data correlating response to serum levels is lacking, we found in a previous report a trend towards increased side effects with elevated serum trough levels. This study expands to a larger population to evaluate ISV trough levels in relation to clinical outcomes and side effects (AE). Methods Patients who received ISV &gt;/ = 7 days with serum trough levels from April 2015 to September 2016 were included in AE analysis. Patients with proven or probable invasive fungal infection (IFI) were evaluated for response. Demographics, ALT, total bilirubin, serum creatinine, QTc, 14-, 30-, and 90-day response (complete, partial or no response) were collected. Results 94 patients were evaluated for response. At baseline, 39% were female, 70% had leukemia, 55% had hematopoietic cell transplant (87% were allogeneic), and 73% had active disease (relapsed, progressing, newly diagnosed). Of the IFIs, 64% were due to Aspergillus species, 12% Mucorales, and 4% Fusariumspecies. Response rates for patients by trough levels &lt;3 vs. 3 to 5 vs. &gt;5 mcg/mL are as follows: 14-day was 32% vs. 32% vs. 25%, 30-day was 48% vs. 52% vs. 44%, and 90-day was 39% vs. 50% vs. 33%, all P = NS. 205 patients were evaluated for AE in relation to trough levels. In comparing patients with trough levels &lt;5 vs. &gt;/ = 5 ug/mL, ALT levels 3 times upper limit was 18% vs. 36% (P = 0.032), total bilirubin 3 times upper limit was 22% vs. 32% (P = 0.79), serum creatinine 3 times upper limit was 7.8% vs. 12% (P = 0.47), and QTc interval was 1% vs. 2% mean decrease from baseline (P = 0.9). Conclusion Higher ISV levels were associated with increased ALT. ISV levels did not show apparent correlation with response rates, but there is a trend towards improved response rates with ISV levels between 3 - 5 ug/mL. Disclosures S. Dadwal, Merck: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Ansun Biopharma: Investigator, Research support. Oxford Immunotec: Investigator, Research support. Gilead Sciences: Investigator, Research support. J. Ito, Astellas: Speaker’s Bureau, Speaker honorarium.

Phenytoin 300 MG Daily — Not a Dose for Everyone

1978 ◽  
Vol 12 (10) ◽  
pp. 584-588 ◽  
Author(s):  
Ronald E. Baars ◽  
Robert P. Rapp ◽  
Byron Young ◽  
Daniel Canafax
Keyword(s):  
Side Effects ◽  
Serum Level ◽  
Crossover Study ◽  
Clinical Response ◽  
Seizure Control ◽  
Serum Levels ◽  
Therapeutic Benefit ◽  
Once Daily ◽  
Drug Serum Level

Phenytoin serum levels were compared in a crossover study of a new 300 mg capsule form and three 100 mg capsules administered once daily. The new 300 mg capsule was equivalent to three 100 mg capsules in efficacy of seizure control and maintenance of phenytoin serum levels. This standard 300 mg dose produced a grand mean drug serum level of 7.63 mcg/ml and was below 10 mcg/ml in 15 to 20 patients. The authors recommend monitoring of phenytoin serum levels and clinical response, to detect needed dosage adjustments for optimum therapeutic benefit from phenytoin and to avoid toxic side effects.

Sleep and epilepsy—chicken or egg?

2018 ◽  
Author(s):  
Dora A. Lozsadi
Keyword(s):  
Side Effects ◽  
Sleep Disorders ◽  
Learning Disability ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Seizure Control ◽  
Subjective Sleep ◽  
Neurological Conditions ◽  
The Uk ◽  
Patients With Epilepsy

Epilepsy is the commonest serious chronic neurological condition, affecting 0.5% of the population in the UK. Subjective sleep disturbance and excessive daytime sleepiness are reported to be 50% more frequent in those with epilepsy than in controls. Causes are multiple. Both poor seizure control and nocturnal attacks are known to contribute to such sleep disorders. Epilepsy also increases the risk of associated sleep disorders, and additional neurological conditions, such as dementia, learning disability, and depression. These all affect sleep hygiene. Prescribed anti-epileptic drugs will further aggravate the problem. Side-effects will include drowsiness. Sedating benzodiazepines and barbiturates are considered worst offenders. Others affect sleep architecture to varying degrees and/or cause insomnia. While hyper-somnolence in patients with epilepsy will raise the possibility of any of the above issues, sleep deprivation is one of the commonest seizure triggers. This chapter will shed more light on the intricate relationship between sleep and epilepsy.

scholarly journals Possible Future Monoclonal Antibody (mAb)-Based Therapy against Arbovirus Infections

2013 ◽  
Vol 2013 ◽  
pp. 1-21 ◽  
Author(s):  
Giuseppe Sautto ◽  
Nicasio Mancini ◽  
Giacomo Gorini ◽  
Massimo Clementi ◽  
Roberto Burioni
Keyword(s):  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Side Effects ◽  
Antiviral Activity ◽  
The Other ◽  
Viral Escape ◽  
Passive Immunotherapy ◽  
Medical Need

More than 150 arboviruses belonging to different families are known to infect humans, causing endemic infections as well as epidemic outbreaks. Effective vaccines to limit the occurrence of some of these infections have been licensed, while for the others several new immunogens are under development mostly for their improvements concerning safety and effectiveness profiles. On the other hand, specific and effective antiviral drugs are not yet available, posing an urgent medical need in particular for emergency cases. Neutralizing monoclonal antibodies (mAbs) have been demonstrated to be effective in the treatment of several infectious diseases as well as in preliminaryin vitroandin vivomodels of arbovirus-related infections. Given their specific antiviral activity as well-tolerated molecules with limited side effects, mAbs could represent a new therapeutic approach for the development of an effective treatment, as well as useful tools in the study of the host-virus interplay and in the development of more effective immunogens. However, before their use as candidate therapeutics, possible hurdles (e.g., Ab-dependent enhancement of infection, occurrence of viral escape variants) must be carefully evaluated. In this review are described the main arboviruses infecting humans and candidate mAbs to be possibly used in a future passive immunotherapy.

SERUM GONADOTROPHINS, TESTOSTERONE AND SPERMATOGENESIS IN SUBFERTILE MEN

1977 ◽  
Vol 86 (3) ◽  
pp. 651-658 ◽  
Author(s):  
J. H. Aafjes ◽  
J. C. M. van der Vijver ◽  
R. Docter ◽  
P. E. Schenck
Keyword(s):  
Partial Correlation ◽  
Sperm Count ◽  
Correlation Coefficients ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
The Other ◽  
Sperm Production ◽  
Positive Correlation ◽  
Natural Logarithm ◽  
Biopsy Score

ABSTRACT In 210 subfertile men there existed a significant positive correlation between serum FSH and LH (0.41). No correlation was observed between the gonadotrophin levels and testosterone. In contrast to this FSH as well as LH were negatively correlated with the natural logarithm (In) of the sperm count/ml ejaculate (−0.44 and −0.18, respectively). When the positive correlation which existed between FSH and LH was used to calculate partial correlation coefficients, the coefficient between FSH and ln sperm count did hardly change (−0.41) the coefficient between LH and ln sperm count on the other hand became insignificant (−0.05). This suggests that spermatogenesis influences FSH serum levels in subfertile men by a decreased suppression when sperm production is diminished. Testicular biopsies taken from 97 of these patients were used to determine biopsy scores. These scores showed a significant negative correlation with FSH (−0.34) and a positive one with ln sperm count/ml ejaculate (0.45). Interestingly the biopsy score of 16 patients who fertilized their wives, was found to be higher compared with the score of the other patients who did not fertilize. The number of sperm/ml ejaculate and the FSH values of these 2 groups of biopsied patients were, however, not significantly different. This leads to the conclusion that the biopsy score is a better parameter for the evaluation of oligospermic men than either sperm count or FSH serum values.

THE EFFECT OF EXOGENOUS PROGESTAGEN ON THE LEVELS OF FREE OESTROGEN IN THE OVARIAN VEIN PLASMA OF THE EWE

1970 ◽  
Vol 48 (4) ◽  
pp. 485-496 ◽  
Author(s):  
J. F. SMITH ◽  
T. J. ROBINSON
Keyword(s):  
Plasma Levels ◽  
Similar Pattern ◽  
Peak Level ◽  
The Other ◽  
Ovarian Vein ◽  
Active Ovary ◽  
The Mean ◽  
Significant Change

SUMMARY The levels of free oestrogen (oestrone and oestradiol-17β) in plasma in the ovarian vein were determined in three groups, each of 27 ewes, at nine intervals at about the time of oestrus. One group had a normal oestrus while the other two had been treated for 16 days with intravaginal sponges containing either 10 or 30 mg of a synthetic progestagen (Cronolone, Searle). In untreated ewes, the mean level (corrected) of oestradiol-17β in plasma from the active ovary rose from 25·3 ng/100 ml at −48 h to a peak of 91·6 ng/100 ml at 0 h (onset of oestrus) and then fell. There was evidence of biphasic production. The mean level of oestrone was relatively high (13·0 ng/100 ml) at −48 h; it fell to 2·0 ng/100 ml between −36 and −24 h and then rose again to 9·4 ng/100 ml at + 12 h. There was no significant change, with time, in the plasma levels of either oestrogen from the non-active ovary. The total amounts of oestradiol-17β and of oestrone produced from both ovaries at an oestrous period were estimated to average 9·7 and 2·4 μg. In treated ewes, a similar pattern of production of oestradiol-17β was shown by the ewes treated with 30 mg Cronolone. That of ewes treated with 10 mg differed (P < 0·01). Peak level was reached at an earlier stage, relative to the onset of oestrus, and it declined more rapidly, the total amount of oestrogen produced (oestrone + oestradiol-17β) was less (10 mg Cronolone, 8·6 μg; 30 mg Cronolone, 12·1 μg; normal oestrus, 12·1 μg), and there was no biphasic production.

scholarly journals Assessment of Live Candidate Vaccines for Paratuberculosis in Animal Models and Macrophages

2009 ◽  
Vol 78 (3) ◽  
pp. 1383-1389 ◽  
Author(s):  
Gabriella M. Scandurra ◽  
Geoffrey W. de Lisle ◽  
Sonia M. Cavaignac ◽  
May Young ◽  
R. Pamela Kawakami ◽  
...  
Keyword(s):  
Side Effects ◽  
Bacterial Load ◽  
Economic Effect ◽  
Cost Effective ◽  
The Other ◽  
Murine Models ◽  
Initial Screening ◽  
Vaccine Candidates ◽  
Allelic Exchange ◽  
Potential Vaccine

ABSTRACT Mycobacterium avium subsp. paratuberculosis (basonym M. paratuberculosis) is the causative agent of paratuberculosis, a chronic enteritis of ruminants. To control the considerable economic effect that paratuberculosis has on the livestock industry, a vaccine that induces protection with minimal side effects is required. We employed transposon mutagenesis and allelic exchange to develop three potential vaccine candidates, which were then tested for virulence with macrophages, mice, and goats. All three models identified the WAg906 mutant as being the most attenuated, but some differences in the levels of attenuation were evident among the models when testing the other strains. In a preliminary mouse vaccine experiment, limited protection was induced by WAg915, as evidenced by a reduced bacterial load in spleens and livers 12 weeks following intraperitoneal challenge with M. paratuberculosis K10. While we found macrophages and murine models to be rapid and cost-effective alternatives for the initial screening of M. paratuberculosis mutants for attenuation, it appears necessary to do the definitive assessment of attenuation with a ruminant model.

Beta-Blocker Attenuates Cardiotoxicity Related Anthracycline Usage

2021 ◽  
Vol 104 (8) ◽  
pp. 1389-1392
Keyword(s):  
Side Effects ◽  
Cancer Therapy ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Beta Blocker ◽  
The Other ◽  
Large Numbers ◽  
Therapy Effectiveness ◽  
Chemotherapy Agents

To summarize the recent trials and studies of the role of beta-blocker on the treatment for cancer patients treated with anthracycline to decrease morbidity and mortality rate. Good management of cancer will result in large numbers of cancer survivors. On the other hand, cancer therapy also has side effects, one of which is cardiotoxicity. Cardiotoxicity could reduce therapy effectiveness, hence, increase disease progression and mortality rate. Anthracyclines is one of the chemotherapy agents with cardiotoxicity as a side effect. Beta-blocker has the ability to reduce cardiotoxicity due to anthracyclines usage. Keywords: Beta-blocker; Cardiotoxicity; Anthracyclines

A trial construction of high durability railway viaducts with local aggregates

2019 ◽  
Author(s):  
Kotaro Kawamura ◽  
Joe Takemura ◽  
Shigenobu Iguchi ◽  
Tsutomu Yoshida ◽  
Masashi Kobayashi
Keyword(s):  
Fly Ash ◽  
Side Effects ◽  
Portland Cement ◽  
Ordinary Portland Cement ◽  
The Other ◽  
Strength Concrete ◽  
High Durability ◽  
Sound Barrier ◽  
Early Strength ◽  
Structural Measure

<p>We are carrying out a construction project of new railroad viaducts. These new railroad viaducts are constructing using about 110,000 m<span>3</span> volume concrete. In this construction place, it is difficult for us to get low ASR-reactive aggregates and it is expected to be supplied with snowmelt water on the viaducts in winter. Then we tested ASR-reactive these local aggregates and found an effective mixed ratio of fly-ash is 20% of cement. On the other hand, various side effects were also expected by using fly-ash. For example, initial cracking due to contraction, early strength concrete, bleeding, etc. Therefore, we repeated various tests and examined and carried out a method that could ensure the same construction method and quality as when using ordinary Portland cement, even with fly-ash. Also, we adopted a structure that is unlikely to be affected by rainwater as a structural measure. For example, the entire adoption of a ramen type viaduct that has eliminated bearings, adoption of FRP sound barrier, etc. Then we made it possible to build highly durable railway viaducts by these various measures of materials and structures.</p>

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