摘要:

Interferon-β1b (IFNβ1b) was approved recently for the prophylactic treatment of relapsing–remitting multiple sclerosis (MS). In a controlled trial IFNβ1b at a dose of 8 million units s.c. every other day reduced the frequency of MS attacks by 35% and of major attacks by 50%. Accumulating disease burden as assessed by serial magnetic resonance imaging (MRI) scanning was reduced significantly by IFNβ1b treatment, as was the frequency of MRI scans showing ongoing disease activity. IFNβ1b is well tolerated and appears safe, though flu-like symptoms are frequently encountered upon induction and local erythema at injection sites is usual. The mechanism(s) by which IFNβ1b lessens MS attack frequency is not known. Possible mechanisms include inhibition of viral replication and hence the severity of viral infections, a known trigger for MS attacks; inhibition of immune cell proliferation; altered cell trafficking into and out of the lymphoid organs and into the central nervous system; interference with the antigen-presenting capacity of macrophages; reduced synthesis and release of the stimulatory cytokine IFNγ and of the toxic cytokines lymphotoxin and tumor necrosis factor; and augmented CD8 suppressor cell function and increased synthesis and release of the suppressive cytokines transforming growth factorβ1 and interleukin-10.

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Lamotrigine (LTG) is a novel anticonvulsant that is potent in the maximal electroshock animal model, indicating efficacy in partial and generalized tonic–clonic seizures. LTG exhibits excellent pharmacokinetic properties: low protein binding (55%), linear metabolism primarily by glucuronidation, an absence of enzyme induction, and a long half-life (25.4 h). One defined mechanism of action is the inhibition of glutamate and aspartate release by a blocking effect on use-dependent voltage sensitive sodium channels. Spontaneous glutamate release is not affected. Over an extensive series of clinical trials involving highly refractory adult patients with partial seizures, LTG has shown statistically significant reduction in mean seizure frequency, with 20–30% of patients achieving at least a 50% reduction in seizures. Perhaps more importantly, LTG has been associated with an improvement in behavior that appears to be related to an effect on the severity of seizures that can be independent of a reduction in seizure frequency. LTG is very well tolerated, the most serious side effect being rash, which led to withdrawal of the medication in 2% of patients enrolled in clinical trials.

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Vigabatrin is an irreversible inhibitor of the enzyme γ-aminobutyric acid (GABA) transaminase (GABA-T) and is marketed in >20 countries, including Canada but not the U.S.A., as an antiepileptic drug. Vigabatrin has demonstrated considerable efficacy against complex partial and secondarily generalized tonic-clonic seizures in patients refractory to conventional antiepileptic drugs. The most common side effects of vigabatrin are drowsiness, irritability, ataxia, dizziness, and headache. Behavioral disturbances are a rare and reversible side effect. The drug has no known systemic or irreversible side effects. The time course of action of vigabatrin depends principally upon regeneration of GABA-T inactivated by the drug.

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The potential therapeutic effect of sodium valproate (VPA) on the prophylaxis of migraine was assessed in 62 consecutive patients with severe migraine with and without aura subjected to an open label trial. Patients were given 400 mg VPA daily, divided in two oral doses, during 3 months and then asked to withdraw the drug for 3 months. The therapeutic response was measured with a scale of 15 items that assess the frequency and severity of migraine attacks, and the possible toxic side-effects were monitored by determinations of blood cells, liver enzymes, serum ammonia levels, and plasma VPA levels. Results indicate that 69.8% of patients obtained substantial benefit from this drug and that this beneficial effect lasted for at least 3 months after drug withdrawal in 67.6% of cases. No significant correlation was found between VPA levels and the therapeutic response as measured by the Migraine Assessment Scale. No serious side-effects were observed during the trial. Low-dose VPA is a safe alternative in the prophylaxis of severe migraine.

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We report a parkinsonian patient who presented an adynamic bowel syndrome afterl-dopa withdrawal during the course of a febrile illness. Due to lack of response tol-dopa attributable to gastrointestinal (GI) motility impairment, apomorphine treatment was started, and the adynamic bowel syndrome dramatically improved. The use of apomorphine in Parkinson's disease patients with acute GI motility disorders is recommended.

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0362-5664    

出版商:OVID    

年代:1994

数据来源: OVID