Important Information for Patients with Brugada Syndrome Or Brugada ECG Pattern 1

Total Page：16

File Type：pdf, Size：1020Kb

Important Information for Patients with Brugada Syndrome Or Brugada ECG Pattern 1

BC INHERITED St. Paul’s Hospital (Vancouver) Royal Jubilee Hospital (Victoria) BC Children’s Hospital ARRHYTHMIA Ph: 604-682-2344 Ext. 66766 Ph: 250-727-4461 Ph: 604-875-2295 PROGRAM Important Information for Patients with Brugada Syndrome or Brugada ECG Pattern 1. Avoid all drugs listed below and appearing on the website: www.brugadadrugs.org 2. Treat a fever with acetaminophen (Tylenol) 3. Avoid big meals and excess alcohol 4. Report fainting/blackout spells/seizures 5. Carry a copy of your ECG in your wallet List of Drugs to be Avoided by Patients with Brugada Syndrome or Brugada ECG Pattern – reviewed November 2014 *This list is not comprehensive. Please consult www.brugadadrugs.org for the most up to date information. Patients with a diagnosis of Brugada syndrome OR who have a type I ECG pattern (appearing spontaneously on ECG or following a procainamide challenge) should review ALL new medications (prescription or over the counter) with their health care provider. Drugs with RELATIVE/THEORETICAL CONTRAINDICATION Drugs with ABSOLUTE CONTRAINDICATION PRESCRIPTION DRUGS PRESCRIPTION DRUGS Amiodarone ( Cordarone ) Ketamine Acetycholine Carbamazepine (Tegretol)** Lidocaine (Zylocaine) *** Ajmaline (Gilurytmal) Cibenzoline (Cipralen) Maprotiline Amitriptyline (Elavil) Cyamemazine (Cianatil) Metoclopramide (Maxeran) Bupivacaine (Marcaine) Disopyramide Paroxetine ( Paxil) Clomipramine (Anafranil) Dosulepine Perphenazine Desipramine (Pentofran) Doxepin Phenytoin ( Dilantin ) Ergonovine Edrophonium (Enlon) Propranolol Lithium Fluoxetine (Prozac) Thioridazine Loxapine (Cloxazepine) Fluvoxamine (Luvox) Tramadol Flecainide (Tambocor) Imipramine Verapamil Nortriptyline (Pamelor) Indapamide Oxcarbazepine (Trileptal) Pilsicainide (Sunrhythm) Procainamide (Pronestyl) Procaine (Novocain) Propafenone (Rythmol) Propofol (Diprivan) Trifluoperazine (Fluoperazine) STREET DRUGS/OTHER SUBSTANCES OVER-THE-COUNTER DRUGS Cocaine (blow, C, coke, crack, rock, snow) Dimenhydrinate (Gravol) Alcohol Diphenhydramine (Benedryl) Terfenadine/Fexofenadine (Allegra) ** Carbamazepine is structurally similar to oxcarbazepine, which is on the contraindicated list. *** Lidocaine use for local anesthesia (i.e. by dentists) does appear to be safe when combined with adrenaline/epinephrine (i.e. xylocaine **** Not a Providence Health Care approved educational material For more information, please consult www.brugadadrugs.org Postema PG, Wolper C, Amin AS, Probst V, Borggrefe M, Roden DM, Priori SG, Tan HL, Hiraoka M, Brugada J, Wilde AA. Drugs and Brugada syndrome patients: review of the literature, recommendations and an up-to-date website ( www.brugadadrugs.org ). Heart Rhyhtm 2009;6(9): 1335-1341. .

Copy Link

Recommended publications

Appendix A: Potentially Inappropriate Prescriptions (Pips) for Older People (Modified from ‘STOPP/START 2’ O’Mahony Et Al 2014)
Appendix A: Potentially Inappropriate Prescriptions (PIPs) for older people (modified from ‘STOPP/START 2’ O’Mahony et al 2014) Consider holding (or deprescribing - consult with patient): 1. Any drug prescribed without an evidence-based clinical indication 2. Any drug prescribed beyond the recommended duration, where well-defined 3. Any duplicate drug class (optimise monotherapy) Avoid hazardous combinations e.g.: 1. The Triple Whammy: NSAID + ACE/ARB + diuretic in all ≥ 65 year olds (NHS Scotland 2015) 2. Sick Day Rules drugs: Metformin or ACEi/ARB or a diuretic or NSAID in ≥ 65 year olds presenting with dehydration and/or acute kidney injury (AKI) (NHS Scotland 2015) 3. Anticholinergic Burden (ACB): Any additional medicine with anticholinergic properties when already on an Anticholinergic/antimuscarinic (listed overleaf) in > 65 year olds (risk of falls, increased anticholinergic toxicity: confusion, agitation, acute glaucoma, urinary retention, constipation). The following are known to contribute to the ACB: Amantadine Antidepressants, tricyclic: Amitriptyline, Clomipramine, Dosulepin, Doxepin, Imipramine, Nortriptyline, Trimipramine and SSRIs: Fluoxetine, Paroxetine Antihistamines, first generation (sedating): Clemastine, Chlorphenamine, Cyproheptadine, Diphenhydramine/-hydrinate, Hydroxyzine, Promethazine; also Cetirizine, Loratidine Antipsychotics: especially Clozapine, Fluphenazine, Haloperidol, Olanzepine, and phenothiazines e.g. Prochlorperazine, Trifluoperazine Baclofen Carbamazepine Disopyramide Loperamide Oxcarbazepine Pethidine
[Show full text]
Inhibitory Effect of Eslicarbazepine Acetate and S-Licarbazepine on 2 Nav1.5 Channels
bioRxiv preprint doi: https://doi.org/10.1101/2020.04.24.059188; this version posted August 14, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. 1 Inhibitory effect of eslicarbazepine acetate and S-licarbazepine on 2 Nav1.5 channels 3 Theresa K. Leslie1, Lotte Brückner 1, Sangeeta Chawla1,2, William J. Brackenbury1,2* 4 1Department of Biology, University of York, Heslington, York, YO10 5DD, UK 5 2York Biomedical Research Institute, University of York, Heslington, York, YO10 5DD, UK 6 * Correspondence: Dr William J. Brackenbury, Department of Biology and York Biomedical 7 Research Institute, University of York, Wentworth Way, Heslington, York YO10 5DD, UK. Email: 8 [email protected]. Tel: +44 1904 328284. 9 Keywords: Anticonvulsant, cancer, epilepsy, eslicarbazepine acetate, Nav1.5, S-licarbazepine, 10 voltage-gated Na+ channel. 11 Abstract 12 Eslicarbazepine acetate (ESL) is a dibenzazepine anticonvulsant approved as adjunctive treatment for 13 partial-onset epileptic seizures. Following first pass hydrolysis of ESL, S-licarbazepine (S-Lic) 14 represents around 95 % of circulating active metabolites. S-Lic is the main enantiomer responsible 15 for anticonvulsant activity and this is proposed to be through the blockade of voltage-gated Na+ 16 channels (VGSCs). ESL and S-Lic both have a voltage-dependent inhibitory effect on the Na+ current 17 in N1E-115 neuroblastoma cells expressing neuronal VGSC subtypes including Nav1.1, Nav1.2, 18 Nav1.3, Nav1.6 and Nav1.7.
[Show full text]
2D6 Substrates 2D6 Inhibitors 2D6 Inducers
Physician Guidelines: Drugs Metabolized by Cytochrome P450’s 1 2D6 Substrates Acetaminophen Captopril Dextroamphetamine Fluphenazine Methoxyphenamine Paroxetine Tacrine Ajmaline Carteolol Dextromethorphan Fluvoxamine Metoclopramide Perhexiline Tamoxifen Alprenolol Carvedilol Diazinon Galantamine Metoprolol Perphenazine Tamsulosin Amiflamine Cevimeline Dihydrocodeine Guanoxan Mexiletine Phenacetin Thioridazine Amitriptyline Chloropromazine Diltiazem Haloperidol Mianserin Phenformin Timolol Amphetamine Chlorpheniramine Diprafenone Hydrocodone Minaprine Procainamide Tolterodine Amprenavir Chlorpyrifos Dolasetron Ibogaine Mirtazapine Promethazine Tradodone Aprindine Cinnarizine Donepezil Iloperidone Nefazodone Propafenone Tramadol Aripiprazole Citalopram Doxepin Imipramine Nifedipine Propranolol Trimipramine Atomoxetine Clomipramine Encainide Indoramin Nisoldipine Quanoxan Tropisetron Benztropine Clozapine Ethylmorphine Lidocaine Norcodeine Quetiapine Venlafaxine Bisoprolol Codeine Ezlopitant Loratidine Nortriptyline Ranitidine Verapamil Brofaramine Debrisoquine Flecainide Maprotline olanzapine Remoxipride Zotepine Bufuralol Delavirdine Flunarizine Mequitazine Ondansetron Risperidone Zuclopenthixol Bunitrolol Desipramine Fluoxetine Methadone Oxycodone Sertraline Butylamphetamine Dexfenfluramine Fluperlapine Methamphetamine Parathion Sparteine 2D6 Inhibitors Ajmaline Chlorpromazine Diphenhydramine Indinavir Mibefradil Pimozide Terfenadine Amiodarone Cimetidine Doxorubicin Lasoprazole Moclobemide Quinidine Thioridazine Amitriptyline Cisapride
[Show full text]
Eslicarbazepine Acetate: a New Improvement on a Classic Drug Family for the Treatment of Partial-Onset Seizures
Drugs R D DOI 10.1007/s40268-017-0197-5 REVIEW ARTICLE Eslicarbazepine Acetate: A New Improvement on a Classic Drug Family for the Treatment of Partial-Onset Seizures 1 1 1 Graciana L. Galiana • Angela C. Gauthier • Richard H. Mattson Ó The Author(s) 2017. This article is an open access publication Abstract Eslicarbazepine acetate is a new anti-epileptic drug belonging to the dibenzazepine carboxamide family Key Points that is currently approved as adjunctive therapy and monotherapy for partial-onset (focal) seizures. The drug Eslicarbazepine acetate is an effective and safe enhances slow inactivation of voltage-gated sodium chan- treatment option for partial-onset seizures as nels and subsequently reduces the activity of rapidly ﬁring adjunctive therapy and monotherapy. neurons. Eslicarbazepine acetate has few, but some, drug– drug interactions. It is a weak enzyme inducer and it Eslicarbazepine acetate improves upon its inhibits cytochrome P450 2C19, but it affects a smaller predecessors, carbamazepine and oxcarbazepine, by assortment of enzymes than carbamazepine. Clinical being available in a once-daily regimen, interacting studies using eslicarbazepine acetate as adjunctive treat- with a smaller range of drugs, and causing less side ment or monotherapy have demonstrated its efﬁcacy in effects. patients with refractory or newly diagnosed focal seizures. The drug is generally well tolerated, and the most common side effects include dizziness, headache, and diplopia. One of the greatest strengths of eslicarbazepine acetate is its ability to be administered only once per day. Eslicar- 1 Introduction bazepine acetate has many advantages over older anti- epileptic drugs, and it should be strongly considered when Epilepsy is a common neurological disorder affecting over treating patients with partial-onset epilepsy.
[Show full text]
Systematic Review of the Effect of Intravenous Lipid Emulsion Therapy for Non-Local Anesthetics Toxicity
Clinical Toxicology ISSN: 1556-3650 (Print) 1556-9519 (Online) Journal homepage: http://www.tandfonline.com/loi/ictx20 Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity Michael Levine, Robert S. Hoffman, Valéry Lavergne, Christine M. Stork, Andis Graudins, Ryan Chuang, Samuel J. Stellpflug, Martin Morris, Andrea Miller-Nesbitt, Sophie Gosselin & for the Lipid Emulsion Workgroup* To cite this article: Michael Levine, Robert S. Hoffman, Valéry Lavergne, Christine M. Stork, Andis Graudins, Ryan Chuang, Samuel J. Stellpflug, Martin Morris, Andrea Miller-Nesbitt, Sophie Gosselin & for the Lipid Emulsion Workgroup* (2016) Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity, Clinical Toxicology, 54:3, 194-221, DOI: 10.3109/15563650.2015.1126286 To link to this article: http://dx.doi.org/10.3109/15563650.2015.1126286 Published online: 06 Feb 2016. Submit your article to this journal Article views: 692 View related articles View Crossmark data Citing articles: 2 View citing articles Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ictx20 Download by: [UPSTATE Medical University Health Sciences Library] Date: 03 August 2016, At: 08:19 CLINICAL TOXICOLOGY, 2016 VOL. 54, NO. 3, 194–221 http://dx.doi.org/10.3109/15563650.2015.1126286 REVIEW Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity Michael Levinea, Robert S. Hoffmanb, Vale´ry Lavergnec, Christine M. Storkd, Andis Graudinse, Ryan Chuangf, Samuel J. Stellpflugg, Martin Morrish, Andrea Miller-Nesbitth, Sophie Gosselini and for the Lipid Emulsion Workgroup* aDepartment of Emergency Medicine, Section of Medical Toxicology, University of Southern California, Los Angeles, CA, USA; bDivision of Medical Toxicology, Ronald O.
[Show full text]
Chapter 25 Mechanisms of Action of Antiepileptic Drugs
Chapter 25 Mechanisms of action of antiepileptic drugs GRAEME J. SILLS Department of Molecular and Clinical Pharmacology, University of Liverpool _________________________________________________________________________ Introduction The serendipitous discovery of the anticonvulsant properties of phenobarbital in 1912 marked the foundation of the modern pharmacotherapy of epilepsy. The subsequent 70 years saw the introduction of phenytoin, ethosuximide, carbamazepine, sodium valproate and a range of benzodiazepines. Collectively, these compounds have come to be regarded as the ‘established’ antiepileptic drugs (AEDs). A concerted period of development of drugs for epilepsy throughout the 1980s and 1990s has resulted (to date) in 16 new agents being licensed as add-on treatment for difficult-to-control adult and/or paediatric epilepsy, with some becoming available as monotherapy for newly diagnosed patients. Together, these have become known as the ‘modern’ AEDs. Throughout this period of unprecedented drug development, there have also been considerable advances in our understanding of how antiepileptic agents exert their effects at the cellular level. AEDs are neither preventive nor curative and are employed solely as a means of controlling symptoms (i.e. suppression of seizures). Recurrent seizure activity is the manifestation of an intermittent and excessive hyperexcitability of the nervous system and, while the pharmacological minutiae of currently marketed AEDs remain to be completely unravelled, these agents essentially redress the balance between neuronal excitation and inhibition. Three major classes of mechanism are recognised: modulation of voltage-gated ion channels; enhancement of gamma-aminobutyric acid (GABA)-mediated inhibitory neurotransmission; and attenuation of glutamate-mediated excitatory neurotransmission. The principal pharmacological targets of currently available AEDs are highlighted in Table 1 and discussed further below.
[Show full text]
Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Seizures with Or Without Secondary Generalisation in Patients Over 18 Years of Age
Effective Shared Care Agreement (ESCA) Eslicarbazepine acetate For the adjunctive treatment of partial-onset seizures with or without secondary generalisation in patients over 18 years of age. AREAS OF RESPONSIBILITY FOR THE SHARING OF CARE This shared care agreement outlines suggested ways in which the responsibilities for managing the prescribing of eslicarbazepine acetate for epileptic seizures can be shared between the specialist and general practitioner (GP). You are invited to participate however, if you do not feel confident to undertake this role, then you are not obliged to do so. In such an event, the total clinical responsibility for the patient for the diagnosed condition remains with the specialist. Sharing of care assumes communication between the specialist, GP and patient. The intention to share care will be explained to the patient by the specialist initiating treatment. It is important that patients are consulted about treatment and are in agreement with it. Patients with epilepsy are usually under regular specialist follow-up, which provides an opportunity to discuss drug therapy. The doctor who prescribes the medication legally assumes clinical responsibility for the drug and the consequences of its use. RESPONSIBILITIES and ROLES Specialist responsibilities 1. Confirm the diagnosis of epilepsy. 2. Confirm the patient has used oxcarbazepine (at maximum tolerated dose) or has documentation of intolerance. 3. Obtain approval via Trust’s DTC (or equivalent decision making body) before eslicarbazepine acetate is initiated. Please complete details on page 3. 4. Perform baseline assessment and periodic review of renal and hepatic function (as indicated for each patient). 5. Discuss the potential benefits, treatment side effects, and possible drug interactions with the patient.
[Show full text]
Ventricular Tachycardia Drugs Versus Devices John Camm St
Cardiology Update 2015 Davos, Switzerland: 8-12th February 2015 Ventricular Arrhythmias Ventricular Tachycardia Drugs versus Devices John Camm St. George’s University of London, UK Imperial College, London, UK Declaration of Interests Chairman: NICE Guidelines on AF, 2006; ESC Guidelines on Atrial Fibrillation, 2010 and Update, 2012; ACC/AHA/ESC Guidelines on VAs and SCD; 2006; NICE Guidelines on ACS and NSTEMI, 2012; NICE Guidelines on heart failure, 2008; NICE Guidelines on Atrial Fibrillation, 2006; ESC VA and SCD Guidelines, 2015 Steering Committees: multiple trials including novel anticoagulants DSMBs: multiple trials including BEAUTIFUL, SHIFT, SIGNIFY, AVERROES, CASTLE- AF, STAR-AF II, INOVATE, and others Events Committees: one trial of novel oral anticoagulants and multiple trials of miscellaneous agents with CV adverse effects Editorial Role: Editor-in-Chief, EP-Europace and Clinical Cardiology; Editor, European Textbook of Cardiology, European Heart Journal, Electrophysiology of the Heart, and Evidence Based Cardiology Consultant/Advisor/Speaker: Astellas, Astra Zeneca, ChanRX, Gilead, Merck, Menarini, Otsuka, Sanofi, Servier, Xention, Bayer, Boehringer Ingelheim, Bristol- Myers Squibb, Daiichi Sankyo, Pfizer, Boston Scientific, Biotronik, Medtronic, St. Jude Medical, Actelion, GlaxoSmithKline, InfoBionic, Incarda, Johnson and Johnson, Mitsubishi, Novartis, Takeda Therapy for Ventricular Tachycardia Medical therapy Antiarrhythmic drugs Autonomic management Ventricular tachycardia Monomorphic Polymorphic Ventricular fibrillation Ventricular storms Ablation therapy Device therapy Surgical Defibrillation Catheter Antitachycardia pacing History of Antiarrhythmic Drugs 1914 - Quinidine 1950 - Lidocaine 1951 - Procainamide 1946 – Digitalis 1956 – Ajmaline 1962 - Verapamil 1962 – Disopyramide 1964 - Propranolol 1967 – Amiodarone 1965 – Bretylium 1972 – Mexiletine 1973 – Aprindine, Tocainide 1969 - Diltiazem 1975- Flecainide 1976 – Propafenone Encainide Ethmozine 2000 - Sotalol D-sotalol 1995 - Ibutilide (US) Recainam 2000 – Dofetilide US) IndecainideX Etc.
[Show full text]
Pharmacokinetic and Pharmacodynamic Interactions Between Antiepileptics and Antidepressants Domenico Italiano University of Messina, Italy
University of Kentucky UKnowledge Psychiatry Faculty Publications Psychiatry 11-2014 Pharmacokinetic and Pharmacodynamic Interactions between Antiepileptics and Antidepressants Domenico Italiano University of Messina, Italy Edoardo Spina University of Messina, Italy Jose de Leon University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits oy u. Follow this and additional works at: https://uknowledge.uky.edu/psychiatry_facpub Part of the Psychiatry and Psychology Commons Repository Citation Italiano, Domenico; Spina, Edoardo; and de Leon, Jose, "Pharmacokinetic and Pharmacodynamic Interactions between Antiepileptics and Antidepressants" (2014). Psychiatry Faculty Publications. 40. https://uknowledge.uky.edu/psychiatry_facpub/40 This Article is brought to you for free and open access by the Psychiatry at UKnowledge. It has been accepted for inclusion in Psychiatry Faculty Publications by an authorized administrator of UKnowledge. For more information, please contact [email protected]. Pharmacokinetic and Pharmacodynamic Interactions between Antiepileptics and Antidepressants Notes/Citation Information Published in Expert Opinion on Drug Metabolism & Toxicology, v. 10, Issue 11, p. 1457-1489. © 2014 Taylor & Francis Group This is an Accepted Manuscript of an article published by Taylor & Francis Group in Expert Opinion on Drug Metabolism & Toxicology in Nov. 2014, available online: http://www.tandfonline.com/10.1517/ 17425255.2014.956081 Digital Object Identifier (DOI) http://dx.doi.org/10.1517/17425255.2014.956081 This article is available at UKnowledge: https://uknowledge.uky.edu/psychiatry_facpub/40 1 This is an Accepted Manuscript of an article published by Taylor & Francis Group in Expert Opinion on Drug Metabolism & Toxicology in Nov.
[Show full text]
APTIOM (Eslicarbazepine Acetate) Is (S)-10-Acetoxy-10,11-Dihydro-5H Dibenz[B,F]Azepine-5-Carboxamide
HIGHLIGHTS OF PRESCRIBING INFORMATION Monitor and discontinue if another cause cannot be established. (5.2, 5.3, These highlights do not include all the information needed to use 5.4) APTIOM safely and effectively. See full prescribing information for • Hyponatremia: Monitor sodium levels in patients at risk or patients APTIOM. experiencing hyponatremia symptoms. (5.5) • Neurological Adverse Reactions: Monitor for dizziness, disturbance in gait APTIOM® (eslicarbazepine acetate) tablets, for oral use and coordination, somnolence, fatigue, cognitive dysfunction, and visual Initial U.S. Approval: 2013 changes. Use caution when driving or operating machinery. (5.6) • Withdrawal of APTIOM: Withdraw APTIOM gradually to minimize the ---------------------------RECENT MAJOR CHANGES------------------------- risk of increased seizure frequency and status epilepticus. (2.6, 5.7, 8.1) Indications and Usage (1) 9/2017 • Dosage and Administration (2) 9/2017 Drug Induced Liver Injury: Discontinue APTIOM in patients with jaundice Warnings and Precautions (5) 9/2017 or evidence of significant liver injury. (5.8) • Hematologic Adverse Reactions: Consider discontinuing. (5.10) ----------------------------INDICATIONS AND USAGE-------------------------- APTIOM is indicated for the treatment of partial-onset seizures in patients 4 ------------------------------ADVERSE REACTIONS------------------------------ years of age and older. (1) • Most common adverse reactions in adult patients receiving APTIOM (≥4% and ≥2% greater than placebo): dizziness, somnolence, nausea, headache, ----------------------DOSAGE AND ADMINISTRATION---------------------- diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, and tremor. (6.1) • Adult Patients: The recommended initial dosage of APTIOM is 400 mg • Adverse reactions in pediatric patients are similar to those seen in adult once daily. For some patients, treatment may be initiated at 800 mg once patients. daily if the need for seizure reduction outweighs an increased risk of adverse reactions.
[Show full text]
Neuropathic Pain – Pharmacological Management: Draft Scope for Consultation [11Th June to 9Th July 2012] Page 1 of 9 DRAFT
DRAFT NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE 1 Guideline title Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist settings 1.1 Short title Neuropathic pain – pharmacological management 2 The remit This is an update of ‘Neuropathic pain – pharmacological management’ (NICE clinical guideline 96). 3 Clinical need for the guideline 3.1 Epidemiology a) Neuropathic pain refers to a heterogeneous group of disorders resulting from damage to, and dysfunction of, the peripheral and central nervous systems. Common examples of peripheral neuropathic pain include painful diabetic neuropathy, post-herpetic neuralgia and trigeminal neuralgia. Common examples of central neuropathic pain include pain after stroke and after spinal cord injury. b) The main clinical features of neuropathic pain are continuous or intermittent spontaneous pain, typically described as burning, aching or shooting in quality. It is an unpleasant sensory and emotional experience and can have a significant impact on the Neuropathic pain – pharmacological management: draft scope for consultation [11th June to 9th July 2012] Page 1 of 9 DRAFT quality of life, general health, psychological health, and social and economic well-being of people with neuropathic pain. c) Neuropathic pain is an important cause of chronic pain and commonly occurs in people with diabetes and following herpes zoster infection. Neuropathic pain is diagnosed and managed in primary care and secondary care as well as by specialist pain management services (services that provide comprehensive assessment and multi-modal management of all types of pain, including neuropathic pain). However, there is limited evidence on the incidence and prevalence of neuropathic pain outside of specialist pain management services.
[Show full text]
Journal of Central Nervous System Disease a Review Of
Journal of Central Nervous System Disease OPEN ACCESS Full open access to this and thousands of other papers at EXPERT REVIEW http://www.la-press.com. A Review of Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Epilepsy Rajinder P. Singh and Jorge J. Asconapé Department of Neurology, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois 60153, USA. Corresponding author email: [email protected] Abstract: Eslicarbazepine acetate (ESL) is a novel antiepileptic drug indicated for the treatment of partial-onset seizures. Structurally, it belongs to the dibenzazepine family and is closely related to carbamazepine and oxcarbazepine. Its main mechanism of action is by blocking the voltage-gated sodium channel. ESL is a pro-drug that is rapidly metabolized almost exclusively into S-licarbazepine, the biologically active drug. It has a favorable pharmacokinetic and drug-drug interaction profile. However, it may induce the metabolism of oral contraceptives and should be used with caution in females of child-bearing age. In the pre-marketing placebo-controlled clinical trials ESL has proven effective as adjunctive therapy in adult patients with refractory of partial-onset seizures. Best results were observed on a single daily dose between 800 and 1200 mg. In general, ESL was well tolerated, with most common dose-related side effects including dizziness, somnolence, headache, nausea and vomiting. Hyponatremia has been observed (0.6%–1.3%), but the incidence appears to be lower than with the use of oxcarbazepine. There is very limited information on the use of ESL in children or as monotherapy. Keywords: eslicarbazepine, licarbazepine, dibenzazepine, voltage-gated sodium channel, partial-onset seizures, epilepsy Journal of Central Nervous System Disease 2011:3 179–187 doi: 10.4137/JCNSD.S4888 This article is available from http://www.la-press.com.
[Show full text]