• Korean Journal of Clinical Pharmacy
• /
• v.23 no.4
• /
• pp.344-364
• /
• 2013

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

• CELLMED
• /
• v.3 no.4
• /
• pp.27.1-27.13
• /
• 2013

Epilepsy has now become the most serious brain disorder. A number of synthetic antiepileptic drugs are available in practice, however their effectiveness does not grip true with the entire population suffering from epilepsy. Traditional systems of medicine are popular in developing countries and most of the population relies on traditional medicines for their primary health care need. Medicinal plants to be an important source of traditional medicines. Various plants are used for the treatment of epilepsy in traditional system of medicines and various plants are yet to be scientifically investigated. Phytoconstituents have been the basis of treatment of human diseases including epilepsy. Herbal products are extensively used for the treatment of many diseases worldwide and where allopathic fails or has severe side effects. Psycho neural drugs are also have very serious side effects like physical dependence, tolerance, deterioration of cognitive function and effect on respiratory, digestive and immune system. So the treatments through herbal medicines are widely used across the world due to their wide applicability and therapeutic efficacy with least side effects, which in turn has accelerated the research regarding natural therapy. In this review we have summarized some herbal antiepileptics.

• Archives of Pharmacal Research
• /
• v.27 no.7
• /
• pp.693-712
• /
• 2004

The rats with protein-calorie malnutrition (PCM, 5％ casein diet for a period of 4-week) were reported to exhibit 60 and 80％ suppression in the hepatic microsomal cytochrome P450 (CYP) 1 A2 and CYP2C11 levels, respectively, and 40-50％ decreases in CYP2E1 and CYP3A 1/2 levels compared to control (23％ casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1 A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance ($CL_{NR}$) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows： diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

• Clinical and Experimental Pediatrics
• /
• v.51 no.4
• /
• pp.409-414
• /
• 2008

Purpose : To assess the prevalence of hyponatremia in epileptic children receiving carbamazepine or oxcarbazpine, we investigate serum sodium changes according to age, serum carbamazepine level, and daily oxcarbazepine dosage, and the prevalence of symptoms of hyponatremia. Methods : We reviewed the clinical data of the 197 children receiving carbamazepine and/or oxcarbazepine with or without antiepileptic therapy. And these were classified into the carbamazepine treated patients (group I), oxcarbazepine treated patients (group II), and carbamzepine or oxcarbazepine with other antiepileptics treated patients (group III). Potentially predictive values for development of hyponatremia were examined in each group: age, plasma level of carbamazepine and daily dosage of oxcarbazepine. We assessed the symptoms of hyponatremia. Results : The overall prevalence of hyponatremia was 20.8% (group I, II and III : 17.9%, 22.6%, and 21.8%, respectively), and the prevalence in groups II and III compared with controls (P<0.03) was significantly lower. The changes of serum sodium levels relation to age were not significantly different. The changes of serum sodium levels by increasing of serum levels of carbamazepine and dosage of oxcarbazepine were statistically significant (P<0.01). Among the 41 patients who had biochemical hyponatremia, the prevalence of hyponatremic symptoms was 17.1%. Conclusion : Hyponatremia may occur relatively more frequently with oxcarbazepine or combined other antiepileptics than carbamzepine therapy only. Age of children receiving carbamazepine or oxcarbazepine was no predictive value for occurrence of hyponatremia. The patients whose serum level were less than 125 mEq/L showed more severe clinical symptoms than any other study groups.

• Journal of Acupuncture Research
• /
• v.31 no.1
• /
• pp.177-186
• /
• 2014

Objectives : The aim of this study is to report a case of a 51-year-old patient with Herpes zoster, whose symptoms were relieved within five weeks after the East-west medical combined treatment. Methods : A Herpes zoster patient with extreme pain around the right lower ribs and lower back was admitted into the Korean medicine hospital. Bee venom acupuncture was applied directly onto the site of pain and electroacupuncture was applied on $GV_6-BL_{20}$, inferior site of spinous process of the 12th thoracic vertebra-$BL_{21}$, $GV_5-BL_{22}$, $GV_4-BL_{23}$ six times a week. Moxibustion was applied on $BL_{49}$, $BL_{50}$, $BL_{51}$, $BL_{52}$, $GB_{25}$, $LR_{13}$ six times a week, and the patient took daily doses of herbal medicine and western medicines such as anticonvulsants, analgesics, antiepileptics. The patient's symptoms were evaluated with numeric rating scale(NRS) and neuropathic pain scale(NPS). Results : The results were as follows: 1. After the East-west medical combined treatment, the NRS grade decreased from 8 to 1. 2. On the neuropathic pain scale, the patient's symptoms changed from deep sharp pain and burning sensation to superficial dull pain and coldness. Sensitivity to touch, discomfort, and itchiness also decreased. Sudden attacks of pain appeared 14 to 21 days after onset, but disappeared after final treatment. Conclusions : The results of the above patient suggests that the East-west medical combined treatment may be effective for total remission of herpes zoster. Further research is needed to confirm such effects.

• Journal of Yeungnam Medical Science
• /
• v.2 no.1
• /
• pp.71-75
• /
• 1985

The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache sases with more than moderately abnormal EEG Visited the Neurology clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study is only analysis of clinical treatment of 162 cases Without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial Improvement and partial progression. Case 1. In 4 weeks of antiepileptic the ray (AR), spikes disappeared but in 2 months developed bursts. Case 2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case 3. In 1 week of AR, bursts disappeared but spikes developed. Case 4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandmal seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study With more patients is to be expected.