妥泰治疗儿童癫痫29例临床分析

本科从2000年6月开始使用抗癫痫药妥泰,对各种类型癫痫给予单药及联合用药,收到较好的效果,现将接受妥泰治疗的29例报告如下.     

磷霉素及其联合用药的药代动力学/药效学研究进展

<正>磷霉素作为“老”药,具有广谱抗菌活性和良好的药代动力学(pharmacokinetics,PK)特征,在临床抗感染治疗中日益受到重视^[1]。近年来随着对磷霉素研究的深入,发表了大量相关的研究论文,本综述总结了目前磷霉素PK/药效学(pharmacodynamics,PD)数据,重点关注其联合用药的PK/PD研究新进展,为临床合理应用提供参考。1体外PD磷霉素通过与尿苷二磷酸-N-乙酰氨基葡萄糖烯醇式丙酮酸转移酶不可逆地结合,阻止肽聚糖前体N-乙酰胞壁酸合成,从而破坏细胞壁结构导致细菌裂解死亡。     

癫痫的药物治疗

癫痫包括一组疾病和综合征,虽病因不同,均以在病程中有反复发生的大脑神经元过度放电所致的暂时性中枢神经系统功能失常为特征。按照有关神经元的部位和放电扩散范围,功能失常可能表现为运动、感觉、意识行为、自主神经等不同障碍或兼有之,每次发作或每种发作称为痛性发作,患者可有一种或数种痛性发作,作为其临床症状。 据流行病学调查,我国癫痫患病率在3.50‰～4.8‰,目前治疗以药物控制发作为主,如果坚持正规治疗,70％～80％患者可以完全控制发作,改善其生活质量。     

磁环穴位植入治疗癫痫临床研究

目的 观察磁环空位植入治疗癫痫的疗效,方法 将151例癫痫病人随机分为磁穴组（58例）,磁穴药物组（51例）,对照组（42例）进行治疗对照研究。结果 磁穴组显效明显高于对照组（P&;lt;0.05）,磁穴药物组比对照组总有效率显著提高（P&;lt;0.05）,其显效率更高（P&;lt;0.01）,磁穴药物组显效率明显高于磁穴组（P&;lt;0.05）。结论 磁环穴位内植对癫痫的治疗具有较好的疗效,常用抗抗药物配合磁环穴位内植治疗癫痫肯有协高作用,可明提高其治疗效果。     

妥泰治疗癫痫的疗效观察

癫痫是一种常见的神经系统疾病.作者于 2000年 8月～ 2002年 5月对 83例不同类型的癫痫患者使用妥泰添加或单药治疗,收到了较好疗效,现报告如下.     

合理联合应用抗癫痫药物

在美国临床应用的抗癫痫药有二十多种,一些新型的抗癫痫药也逐渐应用于临床。目前,我国临床常用的抗癫痫药有十余种。几年来,困扰医生的重要问题是病人用药的数量多少。多数专家认为,使用抗癫痫药的数量应尽量少,以避免不良反应的产生。通常不良反应与应用抗癫痫药的数量成正比。因此,一般单一药物比多种药物治疗发生的不良反应少,而且治疗费用也低,病人愿意接受单一药     

联合用药的注意事项

临床上在应用药物治疗疾病的过程中,常需联合用药,其目的是为了更好地发挥药物间的协同作用,减少不良反应或延缓抗药性的产生,以获得最佳疗效。但是,如果不了解药物问的相互作用,盲目滥联乱用,非但达不到预期目的,反而可能导致降低疗效、增强毒性,甚至造成药源性疾病而危及生命。     

654～2和维生素C辅助治疗癫痫66例分析

从1981年～1997年间笔诊治癫痫患129例．随机分成两组，即采用常规抗瘴痫药加654-2和维生素C治疗66例为治疗组．采用常规治疗63例为对照组。随访观察3年，结果表明治疗组疗效明显高于对照组．现总结分析如下。     

癫痫患者的临床观察及护理

现将我院近年应用抗癫痫药物治疗 2 6 8例癫痫患者的护理体会报道如下。1　资料与方法1 1　临床资料　 2 6 8例患者中男 139例 ,女 12 9例 ,1～ 6 5岁 ,病程≥ 1年 6 8例 ,1～ 10年 16 6例 ,>10年 34例 ,治疗前血常规、肝功能检查均正常 ;脑电图检查示正常 6 3例 ,中、重度异常 10 1例 ,癫痫样放电 47例 ,局限性异常 2 5例 ,儿童异常脑电图 32例。1 2　分组　按照癫痫发作频率及类型分为 3组 ,癫痫发作频率每年 <10次为低频组 ,每月或每周发作 1次为高频组 ,小发作为高频小发作组。按照癫痫发作类型分为全身性、局限性和混合性发作。1 3　方…     

癫痫患者血浆激素水平变化的研究

目的：（1）了解癫痫患者的血浆激素水平变化情况；（2）服抗癫痫药物（ami-epilepsy drugs，AEDs）对于癫痫患者血浆激素水平的影响。方法：用电化学发光法检测人组癫痫患者的泌乳素（prolactin，PRL）、雌二醇（estradiol，E2）、孕酮（progesterone，PG）以及总睾酮（totol testosterone，TTes）的血浆水平，并分别比较男、女患者未用抗癫痫药物组（NAEDs组）与用药组（AEDs组）的血浆激素水平的变化。结果：（1）人组71例患者，男性32例，女性39例；50．70％（36／71）有PRL水平升高，43．66％（35／71）患者E2水平升高，分别有18．31％（13／71）和25．35％（18／71）患者的TYes、PG水平下降。（2）女性癫痫患者中，AEDs组患者有77．78％（21／27）出现E2升高，NAEDs组为41．67％（5／12），两组有显著差异，P〈0．05；男性癫痫患者中，AEDs组33．33％（5／15）出现TTes水平下降，NAEDs组为5.90％（1／17），两组有显著差异。结论：（1）癫痫患者的激素水平有变化；（2）抗癫痫药物可影响激素水平。男女患者的激素受抗癫痫药物的影响变化不同，男性患者的TYes水平降低，女性患者的E2水平升高可能与抗癫痫药物的应用有关。     

抗癫痫药高敏反应综合征二例

1病例资料【例1】男,5个月。因口服苯巴比妥后发热9天入院。患儿21天前在本院诊断为病毒性脑炎,有癫样发作,予苯巴比妥15 mg,1日2次(3~5 mg·k-1g-1)口服治疗,12天后出现发热,体温38~39·5℃,收入院。查体:体温39·5℃。全身皮肤潮红,有散在点状红斑及斑丘疹,部分融合,压之褪色,不伴卡他症状,口腔柯氏斑(-),浅表淋巴结不大。肝剑突下3·0 cm,肋缘下4·5 cm,质中等,无压痛;脾轻度增大,质韧。实验室检查:天冬氨酸转氨酶389 U/L,丙氨酸转氨酶284 U/L,γ-谷氨酰转移酶580 U/L。血培养阴性,肺炎支原体抗体、EB病毒抗体、抗HIV抗体均阴性,甲…     

抗癫癎药高敏反应综合征二例

1病例资料【例1】男,5个月。因口服苯巴比妥后发热9天入院。患儿21天前在本院诊断为病毒性脑炎,有癫样发作,予苯巴比妥15 mg,1日2次(3~5 mg·k-1g-1)口服治疗,12天后出现发热,体温38~39·5℃,收入院。查体:体温39·5℃。全身皮肤潮红,有散在点状红斑及斑丘疹,部分融合,压之褪色,不伴卡他症状,口腔柯氏斑(-),浅表淋巴结不大。肝剑突下3·0 cm,肋缘下4·5 cm,质中等,无压痛;脾轻度增大,质韧。实验室检查:天冬氨酸转氨酶389 U/L,丙氨酸转氨酶284 U/L,γ-谷氨酰转移酶580 U/L。血培养阴性,肺炎支原体抗体、EB病毒抗体、抗HIV抗体均阴性,甲…     

Beyond Monotherapy: Rational Polytherapy in Migraine

The past decade has seen significant advances in both the scientific and clinical understanding of migraine. At present, a considerable body of data indicates that migraine is characterized by at least three major pathophysiological features: dopaminergic hypersensitivity, inflammation, and relatively "low" 5-HT levels. Clinically, blocking dopamine receptors, reducing inflammation, and/or stimulating a subpopulation of 5-HT, receptors are effective monotherapeutic approaches in many migraineurs. However, monotherapeutic approaches to migraine do not provide rapid, consistent, and complete relief in all migraineurs. Therefore, if monotherapy is suboptimal, it follows logically that concurrent therapy (ie, polytherapy) aimed at modulating two or three of the biological systems should be more efficacious than modulating only a single system. The rationale for the combination use of dopamine antagonists, anti-inflammatory agents, and 5-HT₁ agonists are described in the present report.     

Antiepileptic drugs in migraine prophylaxis

Research in the field of headache treatment has experienced a marked impetus in the last few years. In the era of the triptans, the treatment modality of this disease has been revolutionised, and though most of the studies conducted have investigated the symptomatic treatment of migraine, less attention has been dedicated to migraine prophylaxis. This review considers the current data available in the literature regarding the use of antiepileptic drugs in migraine prophylaxis, noting the clinical studies that have yielded statistically significant data.     

Antiepileptic hypersensitivity syndrome in children

OBJECTIVE: To assess clinical features and outcomes of childhood antiepileptic hypersensitivity syndrome (AHS). AHS is an idiosyncratic reaction to aromatic anticonvulsants that can result in severe multiorgan dysfunction and death. METHODS: Children with suspected AHS (fever, rash, lymphadenopathy, liver dysfunction) were identified by an in-house computerized adverse drug event reporting system. The medical charts of children with suspected AHS were reviewed. A MEDLINE search (from 1966 to October 1999) was performed using the term antiepileptic hypersensitivity syndrome. RESULTS: Fourteen of 36 children who experienced a rash, urticaria, pruritus, fever, or hepatotoxicity associated with aromatic anticonvulsants met the criteria for AHS (mean age 10.4 +/- 6.5 y; males to females 8:6, white to African-American to biracial 10:3:1). Eight patients were receiving phenytoin, six carbamazepine, and four phenobarbital alone or in combination. The mean time from exposure to development of symptoms was 23.0 +/- 14.8 days. In addition to rash and fever (present in all patients by definition), other common features of AHS were lymphocytosis (71.4%), elevated erythrocyte sedimentation rate (64.3%), elevated aminotransferases (64.3%), lymphadenopathy (57.1%), eosinophilia (42.8%, coagulopathy (42.8%), leukocytosis (35.7%), leukopenia (35.7%), hyperbilirubinemia (35.7%), and nephritis (7.1%). All children recovered except one, who died from complications of liver failure. Clinical outcome was simimlar between children who received systemic steroid therapy (n=5) and those who did not. Antiepileptics producing AHS were discontinued in all patients. CONCLUSIONS: AHS can be fatal in children if not promptly recognized. Fever, rash, and hepatotoxicity should serve as presumptive evidence for AHS, which requires immediate discontinuation of an offending anticonvulsant.     

Antiepileptic drug withdrawal: literature review

Of patients with epilepsy, 60% to 70% achieve control with antiepileptic medication. Antiepileptic drugs may be associated with unwanted adverse effects, inconvenience, and cost. Remission may occur in some patients, raising the issue of whether continued treatment is necessary. Identifying patients from whom treatment can be withdrawn successfully would be beneficial on many levels, but selecting patients may be difficult. Several published antiepileptic drug withdrawal studies show variable rates of success, with relapse rates ranging from 12% to 63%. Several prognostic factors help identify patients who may be amenable to antiepileptic drug withdrawal. The results and limitations described in the antiepileptic drug withdrawal literature, prognostic factors, and general guidelines for antiepileptic drug withdrawal are presented in this article.     

Antiepileptic drug therapy: Clinical laboratory significance

When evaluating a patient who is taking an antiepileptic medication, it is important for the emergency physician to correlate the clinical presentation with the antiepileptic drug level. Therapeutic ranges have been suggested for most antiepileptic medications, but these must be interpreted in light of clinical efficacy and patient tolerance. When considering the efficacy of antiepileptic medications, it is necessary to consider the patient's unique metabolism, side-effect tolerance, and overall response to therapy. Suggested therapeutic ranges should be the first reference for the emergency physician. The purpose of this report is to discuss the laboratory values of commonly prescribed antiepileptic medications. Therapeutic ranges, side-effects, and common medication interactions are discussed concerning phenytoin, phenobarbital, carbamezapine, and valproic acid.     

抗癫痫药物的非神经系统副作用

抗癫痫药物常累及其它组织器官 ,如 :对皮肤、造血系统、消化系统、肾脏、内分泌及代谢等非神经系统的毒副作用 ,其发生率虽较神经系统少见 ,但同样应受到临床医生的关注 ,本文综述了近年来抗癫痫药物的非神经系统副作用