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.

Serum levels of aripiprazole and dehydroaripiprazole, clinical response and side effects

2008 ◽  
Vol 9 (3) ◽  
pp. 212-218 ◽  
Author(s):  
Katrin M. Kirschbaum ◽  
Matthias J. Müller ◽  
Jaroslav Malevani ◽  
Arian Mobascher ◽  
Carsten Burchardt ◽  
...  
Keyword(s):  
Side Effects ◽  
Clinical Response ◽  
Serum Levels

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.

scholarly journals Comparison of Tolerability and Impact on Metabolic Profiles of Antiretroviral Regimens Containing Darunavir/Ritonavir or Darunavir/Cobicistat in Romanian HIV Infected Patients

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 987
Author(s):  
Ruxandra-Cristina Marin ◽  
Delia Mirela Tiț ◽  
Oana Săndulescu ◽  
Adrian Streinu-Cercel ◽  
Simona Gabriela Bungău
Keyword(s):  
Side Effects ◽  
Metabolic Profile ◽  
Laboratory Data ◽  
Serum Levels ◽  
Serum Markers ◽  
Antiretroviral Drugs ◽  
Metabolic Profiles ◽  
Once Daily ◽  
Hiv 1 ◽  
Metabolic Impairments

The management of the side effects caused by the antiretroviral therapy is one of the main problems facing clinicians. The patient’s tolerability and safety influence the success of the therapy. This retrospective study assesses the tolerability and impact on metabolic profiles of antiretroviral regimens containing darunavir/ritonavir (DRV/r) versus those containing darunavir/cobicistat (DRV/c), in routine clinical practice. The database of Prof. Dr Matei Bals of the National Institute of Infectious Diseases (INBI MB) was studied for the period 2017–2020, allowing the inclusion in the study of 462 HIV-infected patients who received the current regimen at least three months before evaluation. The following parameters were collected and analyzed: significant medical history, associated diseases, serum levels for profile evaluation: carbohydrate, lipidic, serum level of liver and pancreatic enzymes, serum markers of cardiac function, coagulation, and renal function. DRV/c (800 mg/150 mg, once daily) administrated in combination with other antiretroviral (ARV) in HIV-1 infected subjects proved to be better tolerated and with a lower impact on metabolic profile than DRV/r (600 mg/100 mg, twice daily). Patients in DRV/r group are significantly more at risk of developing, over time, side effects and metabolic impairments than those in DRV/c group, in all body functions studied, with statistically significant differences (p < 0.05) between the two groups. Laboratory data were correlated with patient’s demographic and clinical characteristics and statistically significant outcomes have been found, proving that a personalized regimen is needed to minimize the ART side effects and to maximize the success of therapy. The results of the study showed that DRV/c, associated with other antiretroviral drugs in the regimens of Romanian HIV infected subjects, have a more favorable metabolic profile than those containing DRV/r.

Genetic Variation in TNF-α, its Relation with Inflammatory Biomarkers and Susceptibility to Rheumatoid Arthritis

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Khadiga Ahmed Ismail
Keyword(s):  
Rheumatoid Arthritis ◽  
Serum Level ◽  
Functional Disability ◽  
Serum Levels ◽  
Amplification Refractory Mutation System ◽  
Reactive Protein ◽  
Tnf Α ◽  
Mutation System ◽  
Potential Factor ◽  
Factor Α

Background: Tumor necrosis Factor-α (TNF-α) is encoded and controlled by TNF-α gene, which is involved in rheumatoid arthritis (RA) susceptibility. This research aimed to identify genetic variations of TNF-α (G308A) and to establish its association with inflammatory markers in Rheumatoid Arthritis predisposition. Methods: In the present study, fifty RA patients and fifty volunteers were involved and evaluated for the C-reactive protein, rheumatoid factor, and TNF-α were estimated by ELISA, Erythrocyte Sedimentation Rate (ESR) by Wintergreen method and for TNF-α-308 G>A polymorphism by polymerase chain reaction with amplification refractory mutation system (PCR-ARMS). Results: The CRP, RF, ESR and TNF-α were significantly elevated in RA patients relative to controls. The serum level TNF-α was also significantly elevated in female patients and in patients ≥50 years. Analysis of TNF-308 gene polymorphism revealed that GG genotypes were more prevalent in RA patients than in the healthy individuals and that GG genotype may be a potential factor to RA. The G allele was more common in RA than in the control. Elevated TNF-α serum levels were significantly associated the GG genotype and functional disability in RA patients. Conclusion: TNF-α promoter 308polymorphism GG genotype may be considered as a risk factor for RA and the TNF-α serum level was significantly related to the functional disability in the disease.

Cardiovascular Risk Assessement in Osteoporotic Patients Using Osteoprotegerin as a Reliable Predictive Biochemical Marker

2018 ◽  
pp. 253
Author(s):  
Noora Wael Rasheed ◽  
Ooroba Jameel Taresh
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Serum Level ◽  
Biochemical Markers ◽  
Hdl Cholesterol ◽  
Predictive Marker ◽  
Serum Levels ◽  
Arterial Calcification ◽  
The Metabolic Syndrome

       Some studies indicated a relationship between increased serum levels of osteoprotegerin with arterial calcification and as a result, it leads to the risk of cardiovascular disease. In our study group we selected patients with osteoporosis, with similar age and body mass index for the assessment of the relationship between cardiovascular disease and osteoprotegerin serum level. We took into account the analysis of correlation and association between the presence of distinct patterns of atherosclerosis and associated diseases like high blood pressure,  diabetes mellitus, low HDL cholesterol, increased LDL cholesterol, increased triglycerides and was the case of presence of any type of dyslipidemia, in case of pre-existent treatment. Objective of study was the assessment of osteoprotegerin value as predictive marker for cardiovascular and metabolic risk in osteoporotic patients. Our results showed significant correlations of parathyroid hormone, osteocalcin and biochemical markers of bone with glucose metabolism and lipid were found in our research, maintaining crosstalk between calcium and biochemical markers of bone and cardiovascular risk. The serum level of Osteoprotegerin has been shown to have a large predictive value for the metabolic syndrome as a cardiovascular risk standard in patients with osteoporosis. The osteoprotegerin serum levels were increased in the patients with metabolic syndrome as a protective response facing the atherosclerotic lesions.

Study Upon the Serum Level of Uric Acid and the Metabolic Syndrome Components

2019 ◽  
Vol 70 (3) ◽  
pp. 1062-1066
Author(s):  
Maria Rada ◽  
Delia Berceanu-Vaduva ◽  
Milan Velimirovici ◽  
Simona Dragan ◽  
Daniel Duda-Seiman ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Serum Level ◽  
Abdominal Obesity ◽  
Cardiometabolic Risk ◽  
Serum Levels ◽  
Mean Value ◽  
The Metabolic Syndrome ◽  
Direct Association ◽  
Metabolic Syndrome Components

The serum level of uric acid (UA) appears to be associated with a variety of cardiometabolic risk factors; however, direct association with the metabolic syndrome (MetS) remains controversial. The aim of this study is to investigate the association between serum levels of UA and the components that define MetS, differentiated by gender. 262 patients were enrolled (132 women and 130 men); mean value of the age: 58.7�16 year. Hyperuricemia was considered when the level of serum UA �7mg/dL in men, and � 6mg/dL in women; MetS was defined according to the IDF criteria. The prevalence of MetS in the studied group was 35.11% and the prevalence of hyperuricemia was 16.79%. Men with hyperuricemia had the highest prevalence of abdominal obesity (87.5% vs. 66.32%, p [0.001) and hypertriglyceridemia (65.62% vs. 45.91%, p [ 0.001) versus men with normal level of serum UA. Women with hyperuricemia also had a significantly higher incidence of abdominal obesity (75% vs. 57.51%, p [0.001), hypertriglyceridemia (58.33% vs. 38.33%, p [0.001), decreased HDL (50% vs. 33.33%, p [0.001) and hyperglycemia (66.66% versus 50%, p [0.001) compared to those with normal levels of serum UA. The majority of men with hyperuricemia have more than 4 of the MetS components. Hyperuricemia had a higher prevalence in patients with MetS, it may be considered as a causal factor of MetS. Elevated levels of serum uric acid were significantly more associated with the increasing number of MetS components. Early detection and treatment of hyperuricemia is essential for preventing the metabolic syndrome and its complications.

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.

Serum otolin-1 as a biomarker for benign paroxysmal positional vertigo: a case-control study

2021 ◽  
pp. 1-4
Author(s):  
D V K Irugu ◽  
A Singh ◽  
H Yadav ◽  
H Verma ◽  
R Kumar ◽  
...  
Keyword(s):  
Serum Level ◽  
Benign Paroxysmal Positional Vertigo ◽  
Case Control Study ◽  
Serum Levels ◽  
Case Control ◽  
Control Group ◽  
Positional Vertigo ◽  
The Difference ◽  
Control Study ◽  
Paroxysmal Positional Vertigo

Abstract Objectives This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals. Method This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18–75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant. Results A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259–981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189–370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000). Conclusion The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.

scholarly journals Comparison of non-myeloablative lymphodepleting preconditioning regimens in patients undergoing adoptive T cell therapy

2021 ◽  
Vol 9 (5) ◽  
pp. e001743
Author(s):  
Abraham Nissani ◽  
Shaked Lev-Ari ◽  
Tomer Meirson ◽  
Elad Jacoby ◽  
Nethanel Asher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
T Cell ◽  
Adverse Events ◽  
Cell Therapy ◽  
Clinical Response ◽  
Serum Levels ◽  
Bone Marrow Suppression ◽  
Maximum Effect ◽  
Operating Characteristics ◽  
Lymphocyte Ratio

BackgroundAdoptive cell therapy with T cells genetically engineered to express a chimeric antigen receptor (CAR-T) or tumor-infiltrating T lymphocytes (TIL) demonstrates impressive clinical results in patients with cancer. Lymphodepleting preconditioning prior to cell infusion is an integral part of all adoptive T cell therapies. However, to date, there is no standardization and no data comparing different non-myeloablative (NMA) regimens.MethodsIn this study, we compared NMA therapies with different doses of cyclophosphamide or total body irradiation (TBI) in combination with fludarabine and evaluated bone marrow suppression and recovery, cytokine serum levels, clinical response and adverse events.ResultsWe demonstrate that a cumulative dose of 120 mg/kg cyclophosphamide and 125 mg/m2 fludarabine (120Cy/125Flu) and 60Cy/125Flu preconditioning were equally efficient in achieving deep lymphopenia and neutropenia in patients with metastatic melanoma, whereas absolute lymphocyte counts (ALCs) and absolute neutrophil counts were significantly higher following 200 cGyTBI/75Flu-induced NMA. Thrombocytopenia was most profound in 120Cy/125Flu patients. 30Cy/75Flu-induced preconditioning in patients with acute lymphoblastic leukemia resulted in a minor ALC decrease, had no impact on platelet counts and did not yield deep neutropenia. Following cell infusion, 120Cy/125Flu patients with objective tumor response had significantly higher ALC and significant lower inflammatory indexes, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Receiver-operating characteristics curve analysis 7 days after cell infusion was performed to determine the cut-offs, which distinguish between responding and non-responding patients in the 120Cy/125Flu cohort. NLR≤1.79 and PLR≤32.7 were associated with clinical response and overall survival. Cytokine serum levels did not associate with clinical response in patients with TIL. Patients in the 120Cy/125Flu cohort developed significantly more acute NMA-related adverse events, including thrombocytopenia, febrile neutropenia and cardiotoxicity, and stayed significantly longer in hospital compared with the 60Cy/125Flu and TBI/75Flu cohorts.ConclusionsBone marrow depletion and recovery were equally affected by 120Cy/125Flu and 60Cy/125Flu preconditioning; however, toxicity and consequently duration of hospitalization were significantly lower in the 60Cy/125Flu cohort. Patients in the 30Cy/75Flu and TBI/75Flu groups rarely developed NMA-induced adverse events; however, both regimens were not efficient in achieving deep bone marrow suppression. Among the regimens, 60Cy/125Flu preconditioning seems to achieve maximum effect with minimum toxicity.

Sign in / Sign up

Export Citation Format

Share Document