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Titolo:
The new antiepileptic drugs: Pharmacological and clinical aspects
Autore:
Gatti, G; Bonomi, I; Jannuzzi, G; Perucca, E;
Indirizzi:
Univ Pavia, Dept Internal Med & Therapeut, Clin Pharmacol Unit, I-27100 Pavia, Italy Univ Pavia Pavia Italy I-27100 Clin Pharmacol Unit, I-27100 Pavia, Italy
Titolo Testata:
CURRENT PHARMACEUTICAL DESIGN
fascicolo: 8, volume: 6, anno: 2000,
pagine: 839 - 860
SICI:
1381-6128(200005)6:8<839:TNADPA>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEWLY-DIAGNOSED EPILEPSY; COMPLEX PARTIAL SEIZURES; LENNOX-GASTAUT-SYNDROME; NONCONVULSIVE STATUS EPILEPTICUS; PROGRESSIVE MYOCLONUS EPILEPSY; PREVIOUSLY UNTREATED EPILEPSY; ACUTE INTERMITTENT PORPHYRIA; HIGH-PROTEIN MEAL; DOUBLE-BLIND; PHARMACOKINETIC PROPERTIES;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
167
Recensione:
Indirizzi per estratti:
Indirizzo: Perucca, E Univ Pavia, Dept Internal Med & Therapeut, Clin Pharmacol Unit,Piazza Botta 10, I-27100 Pavia, Italy Univ Pavia Piazza Botta 10 Pavia Italy I-27100 00 Pavia, Italy
Citazione:
G. Gatti et al., "The new antiepileptic drugs: Pharmacological and clinical aspects", CUR PHARM D, 6(8), 2000, pp. 839-860

Abstract

In recent years several new drugs (oxcarbazepine, lamotrigine, topiramate,gabapentin, zonisamide, tiagabine, fosphenytoin, vigabatrin and felbamate)have been added to the therapeutic armamentarium against epilepsy. Some ofthese represent structural modifications of pre-existing compounds, otherswere developed with the specific objective of modifying neurotransmitter function, and many more were found to be clinically useful even though theirmode of action is unclear or differs from that originally planned. The pharmacokinetics of these drugs differ widely from one agent to another. Some (gabapentin and vigabatrin) are eliminated unchanged in urine and have little or no interaction potential; others (tiagabine, lamotrigine, topiramate,oxcarbazepine, zonisamide, felbamate) are subject to induction of metabolism by concomitant anticonvulsants; lamotrigine is vulnerable to metabolic inhibition by valproate, and felbamate is a powerful enzyme inhibitor in addition to being an inducer of the metabolism of carbamazepine and steroid oral contraceptives. All new antiepileptic drugs have been found to be effective in improving seizure control in patients with partial and secondarily generalized seizures. However, lamotrigine, topiramate, zonisamide and felbamate appear to have broader efficacy against both partial and many generalized seizure types, while vigabatrin is also valuable in the: management of infantile spasms. In monotherapy studies, new drugs have nor been found to be more efficacious than older agents, but some may offer limited advantages in terms of improved tolerability. On the other hand, serious toxicity restricts considerably the use of vigabatrin and felbamate. Overall, new drugs represent valuable tools in the fight against epilepsy, but because of limited experience and cost considerations their first-line use cannot be recommended in most situations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 03:26:51