Lack of relationship between sodium valproate-induced adverse effects and the plasma concentration of its metabolite 2-propylpenten-4-oic acid

1987 ◽  
Vol 32 (2) ◽  
pp. 219-222 ◽  
Author(s):  
M. Paganini ◽  
G. Zaccara ◽  
F. Moroni ◽  
R. Campostrini ◽  
L. Bendoni ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Adverse Effects ◽  
Sodium Valproate

S

2020 ◽  
pp. 718-772
Author(s):  
Sean Ainsworth
Keyword(s):  
Sodium Chloride ◽  
Adverse Effects ◽  
Sodium Bicarbonate ◽  
Sodium Valproate ◽  
Fusidic Acid ◽  
Sodium Benzoate ◽  
Skin Care ◽  
Maternal Treatment ◽  
Sodium Phenylbutyrate

This chapter presents information on neonatal drugs that begin with S, including use, pharmacology, adverse effects, fetal and infant implications of maternal treatment, treatment, and supply of Salbutamol = Albuterol (USAN), Sildenafil, Skin care and skin sterility, Sodium phenylbutyrate and glycerol phenylbutyrate, Sodium benzoate, Sodium bicarbonate, Sodium chloride, Sodium fusidate (fusidic acid), Sodium valproate, Sotalol, Spiramycin, Spironolactone, Stiripentol, Streptokinase, Sucrose, Sulfadiazine = Sulphadiazine (former BAN), Surfactants, and Suxamethonium = Succinylcholine (USAN)

Cinnarizine and sodium valproate as the preventive agents of pediatric migraine: A randomized double-blind placebo-controlled trial

Cephalalgia ◽  
2019 ◽  
Vol 40 (7) ◽  
pp. 665-674
Author(s):  
Man Amanat ◽  
Mansoureh Togha ◽  
Elmira Agah ◽  
Mahtab Ramezani ◽  
Ali Reza Tavasoli ◽  
...  
Keyword(s):  
Placebo Group ◽  
Adverse Effects ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Sodium Valproate ◽  
Medical Center ◽  
Controlled Trial ◽  
Migraine Prophylaxis ◽  
Double Blind ◽  
Double Blind Placebo

Background Few migraine preventive agents have been assessed in a pediatric population. We evaluated the safety and efficacy of cinnarizine and sodium valproate for migraine prophylaxis in children and adolescents. Methods We carried out a randomized double-blind placebo-controlled trial in the Children’s Medical Center and Sina hospital, Tehran, Iran. Eligible participants were randomly assigned in 1:1:1 ratio via interactive web response system to receive either cinnarizine, sodium valproate, or placebo. The primary endpoints were the mean change in frequency and intensity of migraine attacks from baseline to the last 4 weeks of trial. The secondary endpoint was the efficacy of each drug in the prevention of migraine. The drug was considered effective if it decreased migraine frequency by more than 50% in the double-blind phase compared with the baseline. Safety endpoint was adverse effects that were reported by children or their parents. Results A total of 158 children participated. The frequency of migraine attacks significantly reduced compared to baseline in cinnarizine (difference: −8.0; 95% confidence interval (CI): −9.3 to −6.6), sodium valproate (difference: −8.3; 95% confidence interval: −9.3 to −7.2), and placebo (difference: −4.4; 95% confidence interval: −5.4 to −3.4) arms. The decrease was statistically greater in cinnarizine (difference: −3.6; 95% confidence interval: −5.5 to −1.6) and sodium valproate (difference: −3.9; 95% confidence interval: −5.8 to −1.9) arms, compared to placebo group. Children in all groups had significant reduction in intensity of episodes compared to baseline (cinnarizine: −4.6; 95% confidence interval: −5.2 to −4.0; sodium valproate: −4.0; 95% confidence interval: −4.8 to −3.3; placebo: −2.6; 95% confidence interval: −3.4 to −1.8). The decrease was statistically greater in cinnarizine (difference: −2.0; 95% confidence interval: −3.2 to −0.8) and sodium valproate (difference: −1.5; 95% confidence interval: −2.7 to −0.3) arms, compared to the placebo group. Seventy-one percent of individuals in the cinnarizine group, 66% of cases in the sodium valproate group, and 42% of people in the placebo arm reported more than 50% reduction in episodes at the end of the trial. The odds ratio for >50% responder rate was 3.5 (98.3% confidence interval: 1.3 to 9.3) for cinnarizine versus placebo and 2.7 (98.3% confidence interval: 1.0 to 6.9) for sodium valproate versus placebo. Nine individuals reported adverse effects (three in cinnarizine, five in sodium valproate, and one in the placebo group) and one case in the sodium valproate group discontinued the therapy due to severe sedation. Conclusion Cinnarizine and sodium valproate could be useful in migraine prophylaxis in children and adolescents. Trial registration: IRCT201206306907N4.

scholarly journals Do lamotrigine and levetiracetam solve the problem of using sodium valproate in women with epilepsy?

2012 ◽  
Vol 5 (1) ◽  
pp. 6-13
Author(s):  
John J Craig
Keyword(s):  
Adverse Effects ◽  
Antiepileptic Drug ◽  
Sodium Valproate ◽  
Broad Spectrum ◽  
Current Information ◽  
Drug Of Choice ◽  
Child Bearing ◽  
Seizure Syndrome

Women with epilepsy, especially those of child-bearing age, are faced with difficult choices when it comes to choosing the most suitable antiepileptic drug (AED). This is particularly so for those with idiopathic generalized epilepsies, or those for whom seizure syndrome is not immediately apparent, where sodium valproate is still considered the drug of choice. While with treatment most might expect to become seizure free, without any adverse effects, other considerations for women mean that valproate is usually initially avoided, with other AEDs such as lamotrigine or levetiracetam being chosen in preference. Based on current information, this article attempts to provide an overview on whether or not the availability of these and other broad-spectrum AEDs have solved the difficulties of using valproate in women of child-bearing age.

scholarly journals High-Trough Plasma Concentration of Afatinib Is Associated with Dose Reduction

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3425
Author(s):  
Takayuki Takahashi ◽  
Hideyuki Terazono ◽  
Takayuki Suetsugu ◽  
Hideki Sugawara ◽  
Junko Arima ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Adverse Effects ◽  
Dose Reduction ◽  
Roc Curve ◽  
High Performance ◽  
Kinase Inhibitor ◽  
Plasma Concentrations ◽  
Laboratory Data ◽  
Trough Plasma Concentration ◽  
Trough Plasma

Afatinib is used to treat non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation as a second-generation EGFR-tyrosine kinase inhibitor (TKI). Early prediction of adverse effects based on the pharmacokinetics of afatinib enables support for quality of life (QOL) in patients with no change in efficacy. We examined the pharmacokinetic relationship between trough plasma concentration and adverse effects and evaluated the utility of measuring the trough plasma concentration of afatinib as the first EGFR-TKI treatment for NSCLC in a prospective multicenter study. Twenty-four patients treated with afatinib were enrolled in this study. All blood samples were collected at the trough point, and plasma concentrations were measured using high-performance liquid chromatography–tandem mass spectrometry. Logistic regression analysis for the dose reduction of afatinib was performed, and the receiver operating characteristic (ROC) curve was plotted. Although all patients started afatinib at 40 mg/day, plasma concentrations were variable, and mean and median trough plasma concentrations were 32.9 ng/mL and 32.5 ng/mL in this study, respectively. Minimum and maximum trough plasma concentrations were 10.4 ng/mL and 72.7 ng/mL, respectively. This variability was speculated to involve personal parameters such as laboratory data. However, no patient characteristics or laboratory data examined correlated with the trough plasma concentration of afatinib, except albumin. Albumin showed a weak correlation with plasma concentration (r = 0.60, p = 0.009). The trough plasma concentration of afatinib was significantly associated with the dose reduction of afatinib (p = 0.047). The area under the ROC curve (AUC) for the trough plasma concentration of afatinib was 0.81. The cut-off value was 21.4 ng/mL. The sensitivity and specificity of the cut-off as a risk factor were 0.80 and 0.75. In summary, the trough plasma concentration of afatinib was associated with continued or reduced dosage because of the onset of several adverse effects, and a threshold was seen. Adverse effects not only lower QOL but also hinder continued treatment. Measuring plasma concentrations of afatinib appears valuable to predict adverse effects and continue effective therapy.

scholarly journals Hemodynamics and bispectral index (BIS) of dogs anesthetized with midazolam and ketamine associated with medetomidine or dexmedetomidine and submitted to ovariohysterectomy

2010 ◽  
Vol 25 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Fernando do Carmo Silva ◽  
Eduardo Hatschbach ◽  
Yuri Karaccas de Carvalho ◽  
Bruno Watanabe Minto ◽  
Flávio Massone ◽  
...  
Keyword(s):  
Heart Rate ◽  
Plasma Concentration ◽  
Adverse Effects ◽  
Bispectral Index ◽  
Recovery Period ◽  
Hemodynamic Parameters ◽  
Hemodynamic Stability ◽  
Continuous Administration ◽  
End Tidal ◽  
End Tidal Co2

PURPOSE: To evaluate hemodynamics and bispectral index (BIS) in bitches anesthetized with ketamine and midazolam in combination with dexmedetomidine or medetomidine and submitted to ovariohysterectomy. METHODS: Twenty bitches pretreated with levomedetomidine and buprenorphine were anesthetized with 5 mg.kg-1 ketamine and 0.2 mg.kg-1 midazolam i.v. Continuous infusion of 0.4 mg.kg-1.h-1 midazolam and 20 mg.kg-1.h-1 ketamine was initiated in combination with DEX (n=10): 20 µg.kg-1.h-1 dexmedetomidine or MED (n=10): 30 µg.kg-1.h-1 medetomidine over 30 minutes. A pharmacokinetic study provided dexmedetomidine plasma concentration, set to be 3.0 ng.mL-1. RESULTS: BIS decreased in both groups (P<0.05), but it was lower in DEX (P<0.05) as compared to MED. No differences were found in hemodynamic parameters (heart rate, systolic, diastolic and mean arterial pressure) between groups (P>0.05), but heart rate decreased in both groups, as compared to control values (P<0.05). Respiratory rate decreased (P<0.05) and expired end tidal CO2 increased progressively (P<0.05) and similarly in both groups. Anesthetic recovery period was similar between groups (P<0.05) with no adverse effects. CONCLUSION: Continuous administration of dexmedetomidine with calculated plasma concentration equal to 3 ng.mL-1 in combination with midazolam and ketamine provides suitable anesthesia for spay surgery in bitches, hemodynamic stability and calm awakening with no adverse effects.

Sign in / Sign up

Export Citation Format

Share Document