Newly updated reference on pediatric antiepileptic drugs. TwitteRx
is the most commonly prescribed AED of the 20th century. It is a very potent anticonvulsant with a broad spectrum of action. Currently, its use is limited because of its adverse effects. It is a free acid, relatively insoluble in water. The sodium salt is soluble in water but unstable in solution. It has a direct action on GABA-A receptors by binding to the barbiturate-binding site that prolongs the duration of chloride channel opening.
PHB has a very long elimination half-life ; in infants, the half-life is much longer, up to 400 hours. In individuals older than 6 months, the half-life falls to 20-75 hours. PHB is metabolized in the liver. The major metabolite is p-hydroxy phenobarbital, which is excreted as a glucuronide conjugate. PHB has extensive urinary resorption, which is enhanced by acidification of the urine.
PHB is available in tablets of 15 mg, 30 mg, 50 mg, 60 mg, and 100 mg; elixirs ; and injections . The usual starting dose is 30-60 mg once a day. The dose can be titrated up to 240 mg/d. Slow titration is better tolerated. Therapeutic blood levels are 15-40 mg/L. Physical dependence and withdrawal seizures occur with long-term use. Therefore, very slow withdrawal over several weeks to months is recommended.
Primidone has the same indications as PHB. It is available in tablets of 50 mg and 250 mg and suspension of 250 mg/5 mL; 250 mg of primidone is equivalent to 60 mg of PHB. The average therapeutic doses range from 500-1500 mg. TGB’s volume of distribution is 1 L/kg, and the drug is bound extensively to human plasma proteins. It is metabolized extensively in the liver by the P-450 system. None of the TGB metabolites has any antiepileptic action, and less than 3% of the drug appears unchanged in the urine.
In the long-term extension studies, 772 patients were treated with TGB , with reduction in seizure frequency by 50% or more in about 30-40% of patients treated for 3-6 months. This effect was maintained for 12 months in patients with partial seizures but not in patients with secondarily generalized seizures. The drug is available for use as second-line add-on therapy in patients with partial or secondarily generalized seizures that are refractory to treatment.
Ireland Latest News, Ireland Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
Yankees minor leaguer Derek Dietrich, four others suspended for performance-enhancing drugsNew York Yankees minor leaguer Derek Dietrich was one of five players handed a steroid suspension Friday by Major League Baseball. Dietrich tested positive for DMPA.
Read more »
Indiana lawmaker pushed ban on erectile dysfunction drugs during abortion debate“If in fact an unwanted pregnancy is an act of god, then impotency must be an act of god,' Indiana state Rep. John Bartlett said.
Read more »
Trans Activist Pledges to Send Hormone Drugs to Youth Across State LinesA transgender activist has pledged to send hormone replacement drugs across state lines to youth who are not legally able to obtain the substances in their states.
Read more »
Mark Cuban’s pharmacy startup is actually making drugs less expensive. It's still working on solving the real problemMark Cuban's Cost Plus Drugs is delivering steep discounts on hundreds of prescription drugs, but it may not have the brand-name drugs you need yet. Here's why.
Read more »
Suicide: Practice Essentials, Overview, EtiologySuicide ranks as the 10th leading cause of death in the United States. Globally, an estimated 700,000 people take their own lives annually.
Read more »
Analyzing The Tesla Shareholder Proposals That FailedThis article offers an overview of Tesla shareholder proposals that failed, largely due to Tesla board rejection.
Read more »