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Sample records for carbamazepine

  1. Carbamazepine

    Science.gov (United States)

    ... depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Carbamazepine is in a class of medications called anticonvulsants. It works by reducing ...

  2. Carbamazepine.

    Science.gov (United States)

    Alrashood, S T

    2016-01-01

    This chapter includes the aspects of carbamazepine. The drug is synthesized by the use of 5H-dibenz[b,f]azepine and phosgene followed by subsequent reaction with ammonia. Carbamazepine is generally used for the treatment of seizure disorders and neuropathic pain, it is also important as off-label for a second-line treatment for bipolar disorder and in combination with an antipsychotic in some cases of schizophrenia when treatment with a conventional antipsychotic alone has failed. Other uses may include attention deficit hyperactivity disorder, schizophrenia, phantom limb syndrome, complex regional pain syndrome, borderline personality disorder, and posttraumatic stress disorder. The chapter discusses the drug metabolism and pharmacokinetics and presents various methods of analysis of this drug such electrochemical analysis, spectroscopic analysis, and chromatographic techniques of separation. It also discusses its physical properties such as solubility characteristics, X-ray powder diffraction pattern, and thermal methods of analysis. The chapter is concluded with a discussion on its biological properties such as activity, toxicity, and safety. PMID:26940169

  3. Markedly Elevated Carbamazepine-10,11-epoxide/Carbamazepine Ratio in a Fatal Carbamazepine Ingestion

    OpenAIRE

    Russell, Jason L.; Spiller, Henry A.; Baker, Daniel D.

    2015-01-01

    Carbamazepine is a widely used anticonvulsant. Its metabolite, carbamazepine-10,11-epoxide, has been found to display similar anticonvulsant and neurotoxic properties. While the ratio of parent to metabolite concentration varies significantly, at therapeutic doses the epoxide concentration is generally about 20% of the parent. We report a case of fatal carbamazepine overdose in which the epoxide metabolite concentration was found to be 450% higher than the parent compound, suggesting a potent...

  4. The mechanism of the carbamazepine-valproate interaction in humans

    OpenAIRE

    Bernus, I.; Dickinson, R G; Hooper, W D; Eadie, M J

    1997-01-01

    Aims The study investigated the mechanism of the interaction between valproate and carbamazepine which causes raised plasma carbamazepine-10,11-epoxide concentrations with unchanged plasma carbamazepine concentrations. This interaction has usually been attributed to valproate inhibiting epoxide hydrolase, the enzyme that catalyses the biotransformation of carbamazepine-10,11-epoxide to carbamazepine-10,11-trans-diol.

  5. Non-recurrence of carbamazepine induced vitiligo after rechallenge with carbamazepine.

    Directory of Open Access Journals (Sweden)

    Masoomeh Saeedloo

    2013-12-01

    Full Text Available Vitiligo is a rare side effect of carbamazepine whose exact mechanism is unknown. The aim of this report is to describe a single case of vitiligo induced by carbamazepine.The case was a patient with Bipolar I disorder whose medications were changed from valproate to carbamazepine and who developed vitiligo after a short while. We followed the case for about four years when he was rechallenged with carbamazepine.When depigmentation occurred, we immediately discontinued carbamazepine after which the depigmented areas improved gradually. About three years later, he received carbamazepine again, but depigmentation did not recur.Carbamazepine-induced vitiligo is not an absolute contraindication for the prescription of carbamazepine if other choices fail to respond or are not tolerated. The case has implications for the mechanism of medication induced vitiligo.

  6. Carbamazepine for acute psychosis with eeg abnormalities

    OpenAIRE

    Ivković Maja; Damjanović Aleksandar; Marinković Dragan; Paunović Vladimir R.

    2004-01-01

    Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6), and carbamazepine group (n=5) with the addition of carbamazepine (600 mg/day) to fluphenazine...

  7. Carbamazepine

    Science.gov (United States)

    ... pills; terfenadine (Seldane) (not available in the US); theophylline (Theobid, Theo-Dur); tramadol (Ultram); tranquilizers; troleandomycin (TAO); ... attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling ...

  8. Carbamazepine for acute psychosis with eeg abnormalities

    Directory of Open Access Journals (Sweden)

    Ivković Maja

    2004-01-01

    Full Text Available Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6, and carbamazepine group (n=5 with the addition of carbamazepine (600 mg/day to fluphenazine treatment. Clinical Global Impression (CGI, Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and EEG were assessed on the baseline and after 6 weeks of treatment. Paired and two-tailed t-tests were used for statistical significance. Results. All the patients showed significant improvement of mental state after 6 weeks of treatment with no significant differences in CGI, BPRS, and total SANS scores in relation to the therapy with carbamazepine. Nevertheless, after 6 weeks of the treatment, EEG findings were significantly better in carbamazepine group, in relation to the findings from the onset of the treatment, as well as in comparison to sole fluphenazine group. Conclusion. Although carbamazepine stabilized abnormal brain electrical activities it seemed that the associated EEG abnormalities were not significant for acute psychosis observed. These preliminary results suggested that there was no convincing evidence that carbamazepine was efficient as the augmentation of antipsychotic treatment for patients with both acute paranoid psychosis and EEG abnormalities.

  9. Is carbamazepine safe to take during pregnancy?

    OpenAIRE

    Matlow, Jeremy; Koren, Gideon

    2012-01-01

    Question Some of my pregnant patients are afraid to take their antiepileptic drugs during pregnancy because of the known risk of malformations and the neurodevelopmental problems associated with valproic acid. Are there similar concerns with carbamazepine?

  10. Bioavailability of rectally administered carbamazepine mixture.

    OpenAIRE

    Neuvonen, P J; Tokola, O.

    1987-01-01

    The relative bioavailability of carbamazepine mixture was studied after oral and rectal administration to healthy subjects. The absorption was significantly slower after the rectal than after the oral route but the total bioavailability was similar provided the mixture was not defaecated within 2 h of administration. We conclude that carbamazepine can be administered rectally, e.g. to postoperative patients in doses corresponding with oral doses.

  11. Compound list: carbamazepine [Open TG-GATEs

    Lifescience Database Archive (English)

    Full Text Available carbamazepine CBZ 00018 ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Human/in_vitro/car...bamazepine.Human.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vitro/car...bamazepine.Rat.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vivo/Liver/Single/car...edbc.jp/archive/open-tggates/LATEST/Rat/in_vivo/Liver/Repeat/carbamazepine.Rat.in_vivo.Liver.Repeat.zip ...

  12. Fate of Carbamazepine during Water Treatment

    DEFF Research Database (Denmark)

    Kosjek, T.; Andersen, Henrik Rasmus; Kompare, Boris; Ledin, Anna; Heath, E.

    2009-01-01

    Seven transformation products of carbamazepine generated by at least one of three common water treatment technologies (W-radiation, oxidation with chlorine dioxide (ClO2), and biological treatment with activated Sludge) were identified by complementary use of ion trap, single quadrupole, and...... quadrupole-time-of-flight mass spectrometers. Acridine was formed during all of the three treatment processes, while acridine 9-carbaldehyde was identified as an intermediate during ClO2 oxidation. Further treatment of acridine with ClO2 produced 9-hydroxy-acridine, UV-treatment resulted in the formation of...... compared the treatment technologies according to the removal of carbamazepine and the production and decay of its transformation products. The most successful method for the removal of carbamazepine was UV treatment, while acridine and acridone were more susceptible to biological treatment. Therefore...

  13. Carbamazepine Clearance and Seizure Stability during Pregnancy

    OpenAIRE

    Johnson, Emily L.; Stowe, Zachary N.; Ritchie, James C; Newport, D. Jeffrey; Newman, Melanee L.; Knight, Bettina; Pennell, Page B

    2014-01-01

    The aims of this study were to characterize the alterations in total and free carbamazepine (CBZ) and total and free carbamazepine-epoxide (CBZ-EPO) clearances during pregnancy; to calculate the change in free fractions of CBZ and CBZ-EPO during pregnancy; and to determine whether seizure worsening is associated with a low ratio to non-pregnant baseline concentration of total or free CBZ or CBZ-EPO. Women on CBZ were enrolled before conception or during pregnancy in this prospective, observat...

  14. Carbamazepine overdose after exposure to simethicone: a case report

    Directory of Open Access Journals (Sweden)

    Guneysel Ozlem

    2008-07-01

    Full Text Available Abstract Introduction Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine. Case presentation We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine. Conclusion Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.

  15. NQR frequencies of anhydrous carbamazepine polymorphic phases

    CERN Document Server

    Bonin, C J; Pusiol, D J

    2010-01-01

    In this work we propose the Nuclear Quadrupole Resonance (NQR) technique as an analytical method suitable for polymorphism detection in active parts (or active principles) of pharmaceuticals with high pharmacological risk. Samples of powder carbamazepine (5H-dibenz(b,f)-azepine-5-carboxamide) are studied. In its anhydrous state, this compound presents at least three different polymorphic forms: form III, the commercial one, form II, and form I. Of these, only form III possesses desirable therapeutic effects. By using the NQR technique, it was possible to characterize two of the three polymorphic phases (I and III) for anhydrous carbamazepine in few minutes at room temperature, detecting the characteristic frequencies of 14N nuclei (I=1) present in their chemical composition and in the frequency range 2.820-3.935 MHz. For form II, characteristic lines were not detected within this range of frequencies. The lines detected for form III are centered at the frequencies \

  16. Advanced photochemical oxidation of emergent micropollutants: carbamazepine.

    Science.gov (United States)

    Domínguez, Joaquín R; González, Teresa; Palo, Patricia; Cuerda-Correa, Eduardo M

    2014-01-01

    The combination of UV radiation with hydrogen peroxide has been widely used for the photodegradation of pollutants in aqueous solutions. Statistical design of experiments is a powerful tool to optimize this kind of process. Initial hydrogen peroxide concentration, pH and temperature were considered as the variables for the process optimization. The interactions existing between these three variables were analyzed. Initial concentration of hydrogen peroxide proved to be the most important variable conditioning the removal efficiency, followed by temperature, and pH shows a non-significant positive influence along the whole operation interval. The ANOVA test reported significance for five of the nine involved variables. The Response Surface Methodology technique was used to optimize carbamazepine degradation. Under optimal conditions (hydrogen peroxide concentration = 0.38·10(-3) mol L(-1), pH = 1 and temperature = 35.6°C) total carbamazepine degradation was achieved. PMID:24798897

  17. Carbamazepine overdose after exposure to simethicone: a case report

    OpenAIRE

    Guneysel Ozlem; Onur Ozge; Denizbasi Arzu; Saritemur Murat

    2008-01-01

    Abstract Introduction Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine. Case presentation We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twi...

  18. PREPARATION AND CHARACTERIZATION OF SPRAY DRIED MICROPARTICLE OF CARBAMAZEPINE

    OpenAIRE

    Dixit Mudit; Kulkarni Parthasarathi Keshavarao; Johri Akash; Kini G Ashwini

    2011-01-01

    Carbamazepine, an antiepileptic drug, exhibits poor water solubility and flow properties, poor dissolution and poor wetting. Consequently, the aim of this study was to improve the dissolution of Carbamazepine. Microparticle containing Carbamazepine was produced by spray drying using Isopropyl alcohol and water in the ratio of 40:60 (v/v) as solvent system to enhance dissolution rate. The prepared formulations were evaluated for in vitro dissolution and solubility. The prepared drug particles ...

  19. Ecotoxicity of carbamazepine and its UV photolysis transformation products

    DEFF Research Database (Denmark)

    Donner, E.; Kosjek, T.; Qualmann, Signe;

    2013-01-01

    considerably more toxic than carbamazepine itself may be produced during UV-treatment of wastewater effluents and/or photo-induced degradation of carbamazepine in natural waters. This study highlights the need to consider mixture toxicity and the formation and persistence of toxicologically relevant......Carbamazepine, an anti-epileptic pharmaceutical agent commonly found in wastewater, is highly recalcitrant to standard wastewater treatment practices. This study investigated the mixture toxicity of carbamazepine transformation products formed during ultraviolet (UV) photolysis using three standard...... treatment period, together with concurrent increases in acridine and acridone concentrations. Ecotoxicity was shown to increase in parallel with carbamazepine degradation indicating that the mixture of degradation products formed was more toxic than the parent compound, and all three ecotoxicity endpoints...

  20. Development and validation of SPE-HPLC method for the determination of carbamazepine and its metabolites carbamazepine epoxide and carbamazepine trans-diol in plasma

    Directory of Open Access Journals (Sweden)

    Spasić Mirjana

    2012-01-01

    Full Text Available SPE-HPLC method has been developed and validated for rapid analysis of carbamazepine and its two metabolites carbamazepine epoxide and carbamazepine trans-diol in human plasma. The analysis was performed using C18 Bakerbond-BDC analytical column (250 mm x 4.6 mm i.d., particle size 5 μm. The optimal conditions for the separation were established with the mobile phase acetonitrile - 10 mM phosphate buffer, pH 7.0 (30:70, v/v at the flow rate of 1.5 mL min-1, temperature 35°C, and UV detection at 210 nm. Total run time was about 8 minutes. SPE procedure for extraction of the analytes from plasma sample was developed using Oasis HLB cartridges and subsequently eluate was injected into the HPLC system for analysis. Afterwards, SPE-HPLC method was subjected to validation. Linearity was obtained over the concentration range of 0.2-25 μg/mL for carbamazepine, carbamazepine epoxide and carbamazepine trans-diol with correlation coefficients higher than 0.995. The method showed good intra-day and inter-day precision with relative standard deviation below 7.96%, while accuracy ranged from 92.09% to 108.5% for all analytes. Finally, the method was successfully applied to analysis of plasma samples of epileptic patients in monotherapy and polytherapy. [Acknowledgments. Projekat Ministarstva nauke Republike Srbije, br. OI 172033].

  1. Cognitive and Behavioral Effects of Topiramate Versus Carbamazepine Monotherapy

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    J Gordon Millichap

    2007-09-01

    Full Text Available The cognitive and behavioral effects of topiramate (TPM versus carbamazepine (CBZ were evaluated in a multicenter, randomized, open-label, parallel-group trial at Sanggye Paik Hospital, Seoul, and other university centers in Korea.

  2. Carbamazepine extended-release capsules in bipolar disorder

    OpenAIRE

    Weisler, Richard H

    2006-01-01

    Carbamazepine (CBZ) has long been a therapeutic option for bipolar disorder. Carbamazepine extended-release capsules (CBZ-ERC) are a recent formulation of CBZ approved by the US Food and Drug Administration in 2004 for the treatment of acute manic and mixed episodes associated with bipolar I disorder. This new formulation was developed to improve dosing convenience and decrease daily fluctuations in serum CBZ concentration, thereby lowering the incidence of adverse events. Two randomized, dou...

  3. Carbamazepine induces mitotic arrest in mammalian Vero cells

    International Nuclear Information System (INIS)

    We reported recently that the anticonvulsant drug carbamazepine, at supratherapeutic concentrations, exerts antiproliferative effects in mammalian Vero cells, but the underlying mechanism has not been elucidated. This motivates us to examine rigorously whether growth arrest was associated with structural changes in cellular organization during mitosis. In the present work, we found that exposure of the cells to carbamazepine led to an increase in mitotic index, mainly due to the sustained block at the metaphase/anaphase boundary, with the consequent inhibition of cell proliferation. Indirect immunofluorescence, using antibodies directed against spindle apparatus proteins, revealed that mitotic arrest was associated with formation of monopolar spindles, caused by impairment of centrosome separation. The final consequence of the spindle defects induced by carbamazepine, depended on the duration of cell cycle arrest. Following the time course of accumulation of metaphase and apoptotic cells during carbamazepine treatments, we observed a causative relationship between mitotic arrest and induction of cell death. Conversely, cells released from the block of metaphase by removal of the drug, continued to progress through mitosis and resume normal proliferation. Our results show that carbamazepine shares a common antiproliferative mechanism with spindle-targeted drugs and contribute to a better understanding of the cytostatic activity previously described in Vero cells. Additional studies are in progress to extend these initial findings that define a novel mode of action of carbamazepine in cultured mammalian cells

  4. Teratogenic effect of Carbamazepine use during pregnancy in the mice.

    Science.gov (United States)

    Elshama, Said Said; Osman, Hosam Eldin Hussein; El-Kenawy, Ayman El-Meghawry

    2015-01-01

    Carbamazepine use is the first choice of antiepileptic drugs among epileptic pregnant females. There are many inconclusive studies regard the safety of carbamazepine use during pregnancy. This study aims to investigate the morphological and histopathological teratogenic effects of carbamazepine use during pregnancy. The healthy pregnant females mice divided into equal five groups (each n=20). The first (control) group received distilled water/day. Second, third, fourth and fifth group received 8.75, 22.75, 52.5, 65 mg of carbamazepine/day respectively. Carbamazepine and water were given by gastric gavage throughout gestational period. Fetuses were delivered on the 18th day of gestation by hysterectomy. Fetal measurements and appearance were assessed with investigation the histopathological changes of brain and spinal cord. There was a significant decrease of weight, different organs weight, length, upper and lower limb length of mice in the first day of delivery in fifth group. There was a significant increase of weight, different organs weight, length, upper and lower limb length in the third group. Many congenital anomalies such as spina bifida, meromelia, microphalmia, oligodactyly, anencephaly, neurodegeneration of brain and spinal cord were noticedin fifth group. Teratogenic effect of carbamazepine represented as growth retardation and neurodevelopmental toxicity depending on its overdose degree. PMID:25553681

  5. Carbamazepine induces mitotic arrest in mammalian Vero cells

    Energy Technology Data Exchange (ETDEWEB)

    Perez Martin, J.M.; Fernandez Freire, P.; Labrador, V. [Departamento de Biologia, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, 28049 Madrid (Spain); Hazen, M.J. [Departamento de Biologia, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, 28049 Madrid (Spain)], E-mail: mariajose.hazen@uam.es

    2008-01-01

    We reported recently that the anticonvulsant drug carbamazepine, at supratherapeutic concentrations, exerts antiproliferative effects in mammalian Vero cells, but the underlying mechanism has not been elucidated. This motivates us to examine rigorously whether growth arrest was associated with structural changes in cellular organization during mitosis. In the present work, we found that exposure of the cells to carbamazepine led to an increase in mitotic index, mainly due to the sustained block at the metaphase/anaphase boundary, with the consequent inhibition of cell proliferation. Indirect immunofluorescence, using antibodies directed against spindle apparatus proteins, revealed that mitotic arrest was associated with formation of monopolar spindles, caused by impairment of centrosome separation. The final consequence of the spindle defects induced by carbamazepine, depended on the duration of cell cycle arrest. Following the time course of accumulation of metaphase and apoptotic cells during carbamazepine treatments, we observed a causative relationship between mitotic arrest and induction of cell death. Conversely, cells released from the block of metaphase by removal of the drug, continued to progress through mitosis and resume normal proliferation. Our results show that carbamazepine shares a common antiproliferative mechanism with spindle-targeted drugs and contribute to a better understanding of the cytostatic activity previously described in Vero cells. Additional studies are in progress to extend these initial findings that define a novel mode of action of carbamazepine in cultured mammalian cells.

  6. Oxidative Status in Epileptic Children Using Carbamazepine

    Directory of Open Access Journals (Sweden)

    Murat Tutanc

    2015-12-01

    Full Text Available Background: There is an increasing attention towards the relationship between oxidative stress and epilepsy. The effect of antiepileptic drugs on oxidant status is of major interest. Antiepileptic drugs can increase levels of free radicals, which consequently might lead to seizures. Carbamazepine (CBZ is an antiepileptic drug commonly used in childhood and adolescence. Objectives: Therefore we aimed to investigate the effects of CBZ on total antioxidant status, total oxidant stress, and oxidative stress index. Patients and Methods: The study included 40 epileptic patients and 31 healthy children between 4 and 12 years of age. Serum CBZ level, total antioxidant capacity and total oxidant status were measured. Oxidative stress index was also calculated both in controls and patients. Results: In the epileptic group, decreased levels of total antioxidant capacity, increased total oxidative stress and oxidative stress index levels were found. Positive correlation between plasma CBZ levels and total oxidant status was observed. Conclusions: Antioxidant action could not be playing any role in antiepileptic effect of CBZ. Furthermore, increased oxidative stress induced by CBZ could be the cause of CBZ-induced seizures. Therefore combining CBZ with antioxidants could be beneficial.

  7. Formulation and optimization of carbamazepine floating tablets

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    Patel D

    2007-01-01

    Full Text Available Floating tablets of carbamazepine were developed using melt granulation technique. Bees wax was used as a hydrophobic meltable material. Hydroxypropylmethylcellulose, sodium bicarbonate and ethyl cellulose were used as matrixing agent, gas-generating agent and floating enhancer, respectively. The tablets were evaluated for in vitro buoyancy and dissolution studies. A simplex lattice design was applied to investigate the combined effect of 3 formulation variables i.e. amount of hydroxypropyl methylcellulose ( X 1 , ethyl cellulose ( X 2 and sodium bicarbonate ( X 3 . The floating lag time (F lag , time required for 50% (t 50 and 80% drug dissolution (t 80 were taken as responses. Results of multiple regression analysis indicated that, low level of X 1 and X 2 , and high level of X 3 should be used to manufacture the tablet formulation with desired in vitro floating time and dissolution. Formulations developed using simplex lattice design were fitted to various kinetic models for drug release. Formulation S3 was selected as a promising formulation and was found stable at 40 o and 75% relative humidity for 3 months. Present study demonstrates the use of simplex lattice design in the development of floating tablets with minimum experimentation.

  8. Neuroleptic Malignant Syndrome Caused by a Combination of Carbamazepine and Amitriptyline

    Directory of Open Access Journals (Sweden)

    A. Bruce Janati

    2012-01-01

    Full Text Available A 32-year-old female, with a history of secondarily-generalized convulsive epilepsy, mental retardation, and a psychiatric illness, developed neuroleptic malignant syndrome while receiving carbamazepine and amitriptyline concurrently. We hypothesize that the addition of amitriptyline to carbamazepine caused a decrease in the serum level of carbamazepine, resulting in NMS. We conclude that combination therapy with carbamazepine and amitriptyline should be avoided in patients who are predisposed to NMS. The purpose of this paper is to warn physicians against combination therapy with carbamazepine and tricyclic antidepressants which may be conducive to neuroleptic malignant syndrome in susceptible patients.

  9. Exfoliative Dermatitis Due To Carbamazepine In An Epileptic Patient

    Directory of Open Access Journals (Sweden)

    Ghosh Sadhan Kr

    1995-01-01

    Full Text Available A young epileptic girl of 17 years who was being treated with carbamazepine suddenly developed exanthematous skin eruption all over the body resulting in exfoliative dermatitis within 2 days of onset. The drug was withdrawn and the patient responded well with symptomatic treatment.

  10. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series

    Directory of Open Access Journals (Sweden)

    Maulin Mehta

    2014-01-01

    Full Text Available Hypersensitivity reactions are common adverse drug reactions (ADRs associated with antiepileptics. Carbamazepine is one of the routinely prescribed drugs for the treatment of epilepsy and neuropathic pain. ADRs due to carbamazepine range from mild maculopapular rash to severe anticonvulsant hypersensitivity syndrome (AHS. AHS is the triad of fever, rash, and internal organ involvement occurring 1-8 weeks after exposure to an anticonvulsant (1 in 1,000 to 10,000 exposures. Spontaneously reported three cases of AHS-drug hypersensitivity reactions induced by carbamazepine are discussed here. Seven to ten days after starting therapy, patients developed maculopapular skin rashes, fever and liver or kidney involvement. The causal relationship between drug and ADR was found to be ′certain′ in one case and ′probable′ in other two cases with both WHO-UMC and Naranjo causality assessment scale. All the three cases show category 4a according to Hartwig′s severity scale as ADR was the cause for hospital admission. On assessing preventability of ADRs by modified Schumock and Thorntons′ scale, one case was falling into category of ′definitely preventable′ and other two were ′not preventable′. AHS is rare but serious reaction with carbamazepine which requires vigilant monitoring by physicians to avoid major consequences.

  11. Inadequacy of carbamazepine-spiked model wastewaters for testing photocatalysis efficiency.

    Science.gov (United States)

    Gulyas, Holger; Ogun, Moses Kolade; Meyer, Wibke; Reich, Margrit; Otterpohl, Ralf

    2016-01-15

    The study was performed in order to clarify whether carbamazepine-spiked solutions used as model wastewaters are suitable for the assessment of carbamazepine removal from real secondary municipal effluents by photocatalytic oxidation in the presence and absence of activated carbon. Therefore, carbamazepine (10 mg L(-1)) was dissolved in deionized water or in secondary municipal effluent. Photocatalytic oxidation of these model wastewaters was carried out with TiO2 "P25" (100 mg L(-1)) and UV-A lamps in the absence and in the presence of 20 mg L(-1) powdered activated carbon (PAC). Carbamazepine was analyzed photometrically. In deionized water at pH 5.5, carbamazepine was nearly completely removed with a UV dose of 6.48 kJ L(-1). A similar efficiency of photocatalytic oxidation of carbamazepine added to secondary effluent was observed when the suspension pH was 2.7, while at pH 8 and 10.6, carbamazepine removal from spiked secondary effluent with the same UV dose was only 40 and 60%, respectively. Although PAC addition resulted in an initial adsorptive carbamazepine reduction of 20 to 35% from the model wastewaters, it did not lead to markedly enhanced carbamazepine removal in the subsequent photocatalysis phase. During photocatalytic oxidation of unspiked secondary effluent (initial carbamazepine concentration: 133 ng L(-1)) at pH 7.3 with and without PAC, carbamazepine concentrations were analyzed by HPLC/MS/MS. While PAC addition resulted in the adsorption of about 90% of the initial carbamazepine, photocatalysis did not lead to any carbamazepine removal at all. This indicates that the experiments with spiked model wastewaters – even in a secondary effluent matrix – are absolutely inadequate for predicting photocatalytic carbamazepine removal under real conditions. PMID:26544890

  12. Efficiency of combined carbamazepine and nootropics to reduce side effect of anticonvulsant therapy

    Directory of Open Access Journals (Sweden)

    Ivanov A.V.

    2013-01-01

    Full Text Available Background. The high rate of epileptic disease spreading determines the need of antiepileptic drugs investigation. Carbamazepine, being one of the most effective anticonvulsant drugs, has a wide spectrum of common side effects, and one of the supposed ways to solve this problem is to combine carbamazepine with nootrops. The possibility of the combined anticonvulsant and nootropic therapy still needs further researches. Objective. To study the efficiency of the combined carbamazepine and nootrops use in the experiment on rats and mice to reduce the side effects of anticonvulsant therapy in the form of impaired cognitive brain function and performance. Methods. The research was conducted on 50 white rats and 30 white mice divided randomly in 5 groups: group 1 received carbamazepine 40mg/kg; group 2 – carbamazepine 40 mg/kg + pyracetam 500 mg/kg; group 3 – carbamazepine 40 mg/kg + citicoline 500 mg/kg; group 4 – carbamazepine 40 mg/kg + memantine 10 mg/kg; group 5 – intact animals (control group. The myorelaxing effects of the therapy, physical working capacity, neurotoxity of the drugs were estimated on the 4th day of nootrops administration and 30 minutes after single carbamazepine administration. Histological examination of the brain specimens was performed; the doses of carbamazepine used in morphological study were 40 mg/kg, 150 mg/kg and 720 mg/kg intragastrally. Results. Administration of carbamazepine occurs moderate morphological changes of brain tissue caused by a reaction on the part of the microvasculature, the severity of which depends on the dose of the drug. Conclusion. The most effective combinations that remove the central side effects of carbamazepine are carbamazepine + gliatilin and carbamazepine + citicoline.

  13. PHENYTION, CARBAMAZEPINE, SODIUM VALPROATE AND LAMOTRIGINE INDUCED CUTANEOUS REACTIONS

    OpenAIRE

    M. Ghaffarpour; S. S. Hejazie; M. H. Harirchian; H. Pourmahmoodian

    2005-01-01

    Adverse effects of antiepileptic drugs including cutaneous reactions may not only affect the result of treatment and quality of life, but can also be fatal if severe. Skin rash is more likely to occur during the first few months of treatment. The objective of this study was description of skin rashes in users of four antiepileptic drugs. We identified skin rashes of phenytoin, carbamazepine, sodium valproate and lamotrigine in a prospective descriptive cross sectional study in 1086 cases. Pat...

  14. Impact of variability in carbamazepine raw materials on drug release

    OpenAIRE

    Flicker, Felicia

    2011-01-01

    Variability in raw materials presents a challenge for pharmaceutical companies. The varying physicochemical properties can critically influence drug release and bioavailability of the final dosage form. Therefore, a strategy to control this variability is required. In this study the well-established antiepileptic drug carbamazepine (CBZ) was selected as the model drug as it presents one example where variability in raw materials has been linked to bioinequivalence and clinical failures. CBZ s...

  15. Factors influencing plasma concentrations of carbamazepine and carbamazepine-10,11-epoxide in epileptic children and adults.

    Science.gov (United States)

    Lanchote, V L; Bonato, P S; Campos, G M; Rodrigues, I

    1995-02-01

    Plasma carbamazepine (CBZ) and carbamazepine-10,11-epoxide (CBZ-E) concentrations were measured in 160 epileptic patients in order to determine the effect of factors such as age, daily dosing schedule, formulation, and combination with other antiepileptic drugs on these concentrations in relation to the daily dose. The results showed that the CBZ plasma level/dose ratio was affected by all factors studied, whereas the CBZ-E plasma level/dose ratio was affected only by formulation and age. The ratio of CBZ-E to CBZ plasma levels (CBZ-E/CBZ) was affected by daily dosing schedule, age, and combination with other antiepileptic drugs. The present study demonstrated that many factors affect plasma CBZ/dose ratios, explaining the discrepancies observed in the literature. PMID:7725376

  16. Molecular recognition study of Carbamazepine, antiseizure drug, by p-t-butyl calix(8)arene

    Science.gov (United States)

    Meenakshi, C.; Jayabal, P.; Ramakrishnan, V.

    2014-03-01

    The formation of inclusion complex of Carbamazepine, a antiseizure drug molecule, with the supra molecule, p-t-butyl calix(8)arene was studied. p-t-Butyl calix(8)arene was the host molecule and Carbamazepine was the guest molecule. Optical absorption spectral studies were carried out to study the molecular recognition properties of p-t-butyl calix(8)arene with Carbamazepine. The stochiometry of the host-guest complex and the binding constant were determined.

  17. Efficiency of combined carbamazepine and nootropics to reduce side effect of anticonvulsant therapy

    OpenAIRE

    Ivanov A.V.; Opryshko V.I.

    2013-01-01

    Background. The high rate of epileptic disease spreading determines the need of antiepileptic drugs investigation. Carbamazepine, being one of the most effective anticonvulsant drugs, has a wide spectrum of common side effects, and one of the supposed ways to solve this problem is to combine carbamazepine with nootrops. The possibility of the combined anticonvulsant and nootropic therapy still needs further researches. Objective. To study the efficiency of the combined carbamazepine and nootr...

  18. Charcoal Hemoperfusion vs. High Efficiency Hemodialysis in Carbamazepine Intoxication: A Case Report

    Directory of Open Access Journals (Sweden)

    Arzu KAHVECİ

    2011-05-01

    Full Text Available Carbamazapine is a commonly used antiepileptic agent. Neurological abnormalities which can progress to coma, arrhythmias, respiratory depression and eye abnormalities such as nystagmus are seen in an intoxication setting. There is no specific antidote for the treatment of carbamazepine intoxication and supportive therapy is generally recommended. Carbamazepine is not removed through conventional hemodialysis as it highly bound to proteins. Charcoal hemoperfusion has been reported as the standard effective treatment method. Herein we report a 23-year-old woman with high dose carbamazepine overdose treated with high efficiency hemodialysis and charcoal hemoperfusion. We also discuss a comparison of the methods used for carbamazepine intoxication.

  19. Erythema multiforme as the result of taking carbamazepine

    Directory of Open Access Journals (Sweden)

    Maharani Laillyza Apriasari

    2010-06-01

    Full Text Available Background: Erythema multiforme is an acute mucocutaneus disease which is caused by the hypersensitivity reaction. It is characterized by target lesions on the skin or ulcerative oral lesion. Etiology of the disease is unknown, it is currently considered as immunologic disease. The triggering factors is the use of certain type of drugs like antibiotics, anticonvulsant, and NSAID. Most of the dentists do not know about it is mechanism, so a lot of people consider it as a malpractice. Purpose: This paper reported a case of a man, 46 years old which had ulcerative oral mucous, peeled and pain lips after taking carbamazepine drugs. Case: The clinical diagnosis of this case was erythema multiforme because of the hypersensitivity reaction as the result of taking carbamazepine. Case management: The final diagnosis based on anamnesis history of taking systemic drugs and clinical manifestation of erythema multiforme in the oral cavity. The drugs therapy that had been given were antihistamine, oral corticosteroid, gargle liquid contained of topical anesthetic, corticosteroid, and antibiotic. Conclusion: In this case, it can be concluded that erythema multiforme appeared was triggered by taking carbamazepine as the drug of choice for trigeminal neuralgia therapy. These drugs can cause type III hypersensitivity reaction. The final diagnosis based on anamnesis history of taking carbamazepine before lesions erupted and the characterized clinical manifestation.Latar belakang: Erythema multiforme adalah penyakit mukokutaneus akut yang menyerang kulit dan mukosa sebagai akibat dari reaksi hipersensitivitas. Secara karakteristik ditandai oleh lesi target pada kulit atau lesi ulserasi pada mukosa rongga mulut. Etiologi penyakit ini belum jelas, diduga karena adanya reaksi imunologi. Pencetusnya dikarenakan adanya pemakaian obat-obatan tertentu seperti antibiotik, antikonvulsan dan NSAID. Banyak dokter gigi kurang memahami mekanisme timbulnya penyakit ini, sehingga

  20. Secondary hypogammaglobilinemia after use of carbamazepine: case report and review

    Directory of Open Access Journals (Sweden)

    Castro Ana Paula B Moschione

    2001-01-01

    Full Text Available Immunologic disorders related to anticonvulsant therapy have been described in the last three decades, including cellular and humoral alterations that result in recurrent infections; however, the physiopathologic mechanisms are not completely understood. This report describes a patient with complex partial epilepsy and hypogammaglobulinemia while in treatment with carbamazepine, with significant improvement in clinical signs and laboratory tests after substitution to sodium valproate. The authors stress the importance of clinical and laboratory evaluation of patients in continuous anticonvulsant therapy, including immunoglobulins levels and peripheral blood evaluations.

  1. Concordance of primary generalised epilepsy and carbamazepine hypersensitivity in monozygotic twins

    OpenAIRE

    Edwards, S; Hubbard, V; Aylett, S; Wren, D

    1999-01-01

    In this paper we describe the previously unreported phenomenon of a carbamazepine-induced mucocutaneous syndrome in identical twins. These twins had developed primary generalised epilepsy within 2 months of each other.


Keywords: carbamazepine; hypersensitivity; twins; epilepsy

  2. Stevens-Johnson syndrome progressing to toxic epidermal necrolysis with haloperidol and carbamazepine combination

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2011-01-01

    Full Text Available Carbamazepine and other anticonvulsants are commoner cause of severe adverse cutaneous drug reactions such as erythema multiforme, toxic epidermal necrolysis (TEN, and Stevens-Johnson syndrome (SJS. We report a case of SJS rapidly progressing to TEN with a combination of haloperidol and carbamazepine in a patient with bipolar affective disorder. The pathophysiological mechanism underlying this reaction is discussed.

  3. Stevens–Johnson syndrome progressing to toxic epidermal necrolysis with haloperidol and carbamazepine combination

    OpenAIRE

    Ajay Kumar; Sukanto Sarkar; Samir Kumar Praharaj; Sayeed Akhtar; Diwakar, M.

    2011-01-01

    Carbamazepine and other anticonvulsants are commoner cause of severe adverse cutaneous drug reactions such as erythema multiforme, toxic epidermal necrolysis (TEN), and Stevens-Johnson syndrome (SJS). We report a case of SJS rapidly progressing to TEN with a combination of haloperidol and carbamazepine in a patient with bipolar affective disorder. The pathophysiological mechanism underlying this reaction is discussed.

  4. Effect of combination of aripiprazole with carbamazepine and fluvoxamine on liver functions in experimental animals

    Directory of Open Access Journals (Sweden)

    Chakrakodi S Shastry

    2013-01-01

    Conclusions: There would be an accumulation of aripiprazole when coadministered with fluvoxamine, a known inhibitor of CYP3A4, leading to hepatic damage and reduction in aripiprazole when administered along with carbamazepine. Therefore, aripiprazole with fluvoxamine and carbamazepine should be coprescribed with caution. The patients should be monitored for signs of adverse effects like hepatic damage or decreased efficacy of these drugs.

  5. HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans.

    LENUS (Irish Health Repository)

    McCormack, Mark

    2011-03-24

    Carbamazepine causes various forms of hypersensitivity reactions, ranging from maculopapular exanthema to severe blistering reactions. The HLA-B*1502 allele has been shown to be strongly correlated with carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) in the Han Chinese and other Asian populations but not in European populations.

  6. Clinical management of carbamazepine intoxication during anti-tubercular treatment: a case report

    Directory of Open Access Journals (Sweden)

    Massimo Calderazzo

    2015-06-01

    Full Text Available We describe a 67-year-old man with medical history of focal post-stroke seizure and type 2 diabetes mellitus treated with carbamazepine, clobazam, gliclazide, insulin glargine, and omeprazole we visited for the onset in the last 7 days of asthenia, cough with mucus, breathing difficulty, chest pain, and weight loss. After clinical and laboratory tests, pulmonary tuberculosis was diagnosed, and a treatment with isoniazid, ethambutol, pyrazinamide rifampicin, and pyridoxine was started. Therapeutic drug monitoring of tuberculosis treatment documented that all drugs were in normal therapeutic range. Four days after the beginning of the treatment, we documented the improvement of fever, and three days later the patient showed sleepiness, visual disorder and asthenia. Clinical and pharmacological evaluation suggested a carbamazepine toxicity probably related to a drug interaction (Drug Interaction Probability Scale score = 6. The impossibility to switch carbamazepine for another antiepileptic drug, due to a resistant form of seizure, induced the discontinuation of tuberculosis treatment, resulting in the normalization of serum carbamazepine levels in one day (10 µg/ml and in the worsening of fever, requiring a new clinical and pharmacological evaluation. The titration dosage of carbamazepine and its therapeutic drug monitoring allowed to continue the treatment with both antitubercular drugs and carbamazepine, without the development of adverse drug reactions. To date, tuberculosis treatment was stopped and clinical evaluation, radiology and microbiology assays documented the absence of tubercular infection and no seizures appeared (carbamazepine dosage 800 mg/bid; serum levels 9.5 µg/ml.

  7. A quick review of carbamazepine pharmacokinetics in epilepsy from 1953 to 2012

    Directory of Open Access Journals (Sweden)

    Zahra Tolou-Ghamari

    2013-01-01

    Full Text Available Background: Carbamazepine has been used as AEDs since 1965, and is most effective against partial seizures. Two basic mechanisms of action have been proposed: 1 enhancement of sodium channel inactivation by reducing high-frequency repetitive firing of action potentials, 2 and action on synaptic transmission. The aim of this study was to provide a review of carbamazepine pharmacokinetics and its management guidelines in Iranian epileptic population. Materials and Methods: Directory of Open Access Journals (DOAJ, Google Scholar, Pubmed (NLM, LISTA (EBSCO, Web of Science were searched; 1600, 722 and 167 research and review articles relevant to the topics; carbamazepine pharmacokinetics, carbamazepine pharmacokinetics in epilepsy and review on carbamazepine pharmacokinetics in epilepsy were found, respectively. Results: Carbamazepine is highly bound to plasma proteins. In patients the protein-bound fraction ranged from 75-80% of the total plasma concentration. Bioavailability ranges from 75-85%. The rate or extent of absorption was not be affected by food. It is completely metabolized and the main metabolite is carbamazepine-epoxide (CBZ-E. Carbamazepine induces its own metabolism, leading to increased clearance, shortened serum half-life, and progressive decrease in serum levels. Increases in daily dosage are necessary to maintain plasma concentration. Severe liver dysfunction may cause disordered pharmacokinetics. In cardiac failure, congestion of major vital organs, including kidneys, may result in abnormally slow absorption and metabolism. Conclusion: Carbamazepine shows variability due to its narrow therapeutic window. Therefore clinical management in a3n Iranian epileptic population should focus on results derived from therapeutic drug monitoring in order to reduce inter and intra- individual variability in plasma drug concentrations.

  8. Electrochemical degradation of carbamazepine using modified electrode with graphene-AuAg composite

    Science.gov (United States)

    Pogacean, F.; Biris, A. R.; Socaci, C.; Floare-Avram, V.; Rosu, M. C.; Coros, M.; Pruneanu, S.

    2015-12-01

    Carbamazepine is a pharmaceutical drug which has been detected in surface and drinking water primarily due to human usage but also from the accidental disposal of pharmaceuticals into sewers. We have developed a graphene-modified electrode which was tested at the detection and degradation of carbamazepine. The oxidation process was studied by cyclic voltammetry in aqueous and organic solutions. The electrochemical degradation of carbamazepine was performed by polarizing the working electrode at a certain potential, for different times (from 5 to 60 minutes). The degradation efficiency was highly dependent on the type of solution and on the supporting electrolyte.

  9. Carbamazepine-induced Stevens Johnson syndrome: a case series of three case reports

    Directory of Open Access Journals (Sweden)

    Arvind Kumar

    2015-08-01

    Full Text Available Carbamazepine is an iminostilbene derivative that was initially used as an antiepileptic but has been used with increased frequency for different indications including chronic pain, trigeminal neuralgia, and herpetic neuralgias. This has resulted in increased incidence of carbamazepine related adverse effects such as nausea, vomiting, and serious hematological toxicities such as aplastic anemia, agranulocytosis, eosinophilia, lymphadenopathy, and splenomegaly. Life-threatening hypersensitivity reactions such as Steven Johnson syndrome (SJS and toxic epidermal necrolysis can also occur. We hereby present a series of three cases that were prescribed carbamazepine for different indications and presented with SJS. [Int J Basic Clin Pharmacol 2015; 4(4.000: 797-801

  10. Dose-dependency of the ratio between carbamazepine serum level and dosage in patients with epilepsy.

    Science.gov (United States)

    Kumps, A H

    1981-01-01

    Carbamazepine serum levels have been determined by gas-liquid chromatography in 24 children and 26 adults with epilepsy on chronic carbamazepine treatment. A significant correlation has been found between carbamazepine steady-state levels and doses per kilogram body weight in both children (p less than 0.01) and adults (p less than 0.05). This relationship is characterized by a significant decline in the level/dose ratio with the doses for adults (p less than 0.001) and, to a lesser extent, for children (p less than 0.05). These results are consistent with a dose-dependent bioavailability. PMID:7324091

  11. Sonolytic and sonophotolytic degradation of Carbamazepine: Kinetic and mechanisms.

    Science.gov (United States)

    Rao, Yongfang; Yang, Haisong; Xue, Dan; Guo, Yang; Qi, Fei; Ma, Jun

    2016-09-01

    An in-depth investigation on the ultrasonic decomposition of Carbamazepine (CBZ), one of the most regularly identified drugs in the environment, was conducted. The effects of diverse variables were evaluated, such as frequency, power, solution pH, initial CBZ concentration and varied inorganic anions. Reaction order was determined on the basis of analyzing reaction kinetics of CBZ degradation. The sonophotolysis and photolysis of CBZ was also examined in this contribution. The influence of water composition on the sonolytic and sonophotolytic elimination of CBZ was analyzed. Additionally, 21 intermediates were identified during sonolytic degradation of CBZ based on LC/ESI-MS/MS analysis, among which two escaped from the detection in previous studies. Possible decay pathways were proposed accordingly. The epoxidation, cleavage of double bond, hydration, hydroxylation, ring contraction and intramolecular cyclization were believed to be involved in sonochemical degradation of CBZ. PMID:27150783

  12. Adsorption of carbamazepine by carbon nanotubes: Effects of DOM introduction and competition with phenanthrene and bisphenol A

    International Nuclear Information System (INIS)

    Carbon nanotubes, organic contaminants and dissolved organic matter (DOM) are co-introduced into the environment. Thus, the interactions between these components have to be evaluated to better understand their environmental behavior. In this study, single-walled carbon nanotubes (SWCNTs) were used as sorbent, carbamazepine was the primary adsorbate, and bisphenol A and phenanthrene were used as competitors. Strong competition with bisphenol A and no effect of phenanthrene on adsorption of carbamazepine was obtained. The hydrophobic neutral fraction of the DOM exhibited the strongest reductive effect on carbamazepine adsorption, most probably due to interactions in solution. In contrast, the hydrophobic acid fraction decreased carbamazepine adsorption mainly via direct competition. When DOM and bisphenol A were co-introduced, the adsorption of carbamazepine was significantly reduced. This study suggests that the chemical nature of DOM can significantly affect the sorptive behavior of polar organic pollutants with carbon nanotubes when all are introduced to the aquatic system. Highlights: •Bisphenol A is an efficient competitor for carbamazepine. •Phenanthrene does not compete with carbamazepine. •DOM exhibited strong reductive effect on carbamazepine adsorption by SWCNTs. •HoN fraction decreased carbamazepine adsorption due to interactions in solution. •HoA fraction decreased carbamazepine adsorption via direct competition. -- In multi-component system including the main adsorbate and competitor, DOM exhibited significant effect on adsorption of contaminants by carbon nanotubes

  13. Charcoal Hemoperfusion vs. High Efficiency Hemodialysis in Carbamazepine Intoxication: A Case Report

    OpenAIRE

    Arzu KAHVECİ; Zeynep KUBİLAY; Ebru AŞICIOĞLU; Hakkı ARIKAN; KOÇ, Mehmet; Serhan TUĞLULAR; Çetin ÖZENER

    2011-01-01

    Carbamazapine is a commonly used antiepileptic agent. Neurological abnormalities which can progress to coma, arrhythmias, respiratory depression and eye abnormalities such as nystagmus are seen in an intoxication setting. There is no specific antidote for the treatment of carbamazepine intoxication and supportive therapy is generally recommended. Carbamazepine is not removed through conventional hemodialysis as it highly bound to proteins. Charcoal hemoperfusion has been reported as the stand...

  14. Study of efficacy of the combination of carbamazepine with nootropics on cognitive processes in epilepsy

    Directory of Open Access Journals (Sweden)

    Ivanov A.V.

    2013-03-01

    Full Text Available The authors studied the efficacy of combination of carbamazepine with nootropic drugs on cognitive processes in patients with epilepsy in experiment in order to reduce the side effects of anticonvulsant therapy. Analysis of anticonvulsant effect of the combination of drugs was carried out on 36 white nonlinear rats of both sexes weighing 160-180 g by the method of maximum electroshock, and the analysis of antiamnestic effect - using a model of retrograde amnesia on 80 white adult male rats weighing 160 - 200 g. For studying the mnemotropic activity of drug, the method of the conditioned reflex of active avoidance was used. The authors discovered that the isolated use of carbamazepine has the most negative influence on cognitive processes in animals, namely the formation of skill, memory engrams and consolidating memory trace as compared with the combined use of carbamazepine with neuroprotective drugs. It was found that the use of combinations of carbamazepine and nootropics in the experiment does not prevent the development of seizures completely, however, these combination can significantly reduce the duration of seizures (p <0.0001. Study of the effectiveness of the combined use of carbamazepine with nootropic drugs, revealed, that the tested drug combinations have a positive effect on cognitive processes and show neuroprotective effect on the brain structures of animals. The revealed effects of combined use of carbamazepine with nootropic drugs by the strength and intensity of the impact is much higher than isolated, while using carbamazepine. It was found, that the most effective combination is a combination of carbamazepine with Gliatilin.

  15. Outcome of children born to epileptic mothers treated with carbamazepine during pregnancy.

    OpenAIRE

    Ornoy, A; Cohen, E.

    1996-01-01

    AIM: The purpose of the study was to assess whether there was an increased rate of congenital anomalies or significant developmental delay in infants of women with epilepsy who had been treated with carbamazepine during pregnancy. METHODS: 47 children were studied, aged 6 months-6 years, who were born to 37 epileptic mothers on carbamazepine monotherapy (group A). All children had a complete physical and neurodevelopmental assessment by a developmental paediatrician, and 41 a complete psychol...

  16. Inhibition of epoxide hydrolase by valproic acid in epileptic patients receiving carbamazepine.

    OpenAIRE

    Robbins, D K; Wedlund, P J; Kuhn, R.; Baumann, R J; Levy, R.H.; Chang, S.L.

    1990-01-01

    The effect of valproic acid (VPA) on the disposition of carbamazepine-10,11-epoxide (epoxide) was studied in five epileptic patients on chronic carbamazepine (CBZ) therapy. The individual pharmacokinetic parameters influencing epoxide disposition were determined in the presence and absence of VPA. VPA significantly decreased the clearance of unbound epoxide (an in vivo index of epoxide hydrolase activity), but did not appear to affect epoxide formation. VPA also increased the free concentrati...

  17. Crystallization of Carbamazepine in Proximity to Its Precursor Iminostilbene and a Silica Surface

    Science.gov (United States)

    2016-01-01

    Amorphous films of the anticonvulsant drug carbamazepine are easily accessible by various methods, while the crystallization into specific polymorphs represents a challenging and time-consuming task. In this work, the crystallization of drop cast carbamazepine at silica surfaces is investigated by atomic force microscopy and both in situ and ex situ grazing incidence X-ray diffraction. The pristine films grow with low crystallization rates into a triclinic polymorph, exhibiting poor orientational order within films. However, if iminostilbene, a chemical precursor of carbamazepine, is added to the solution, enhanced crystallization rates result. The individual components crystallize phase-separated upon solvent evaporation without the formation of cocrystals. Iminostilbene reduces the time scale of carbamazepine crystallization from several hours to minutes. Besides the change in crystallization dynamics, iminostilbene induces order to the carbamazepine crystallites, evident as a 110 texture. In situ data of intermixed solutions demonstrate that iminostilbene crystallization occurs first. The iminostilbene crystals then act as templates for carbamazepine growth, whereby fully epitaxial growth is suggested from the results. The findings motivate such an approach for other systems, as this solution-processed, intrinsic epitaxial behavior might be employed in up-scaled manufacturing processes. PMID:27175105

  18. Tipepidine enhances the antinociceptive-like action of carbamazepine in the acetic acid writhing test.

    Science.gov (United States)

    Kawaura, Kazuaki; Miki, Risa; Urashima, Yuri; Honda, Sokichi; Shehata, Ahmed M; Soeda, Fumio; Shirasaki, Tetsuya; Takahama, Kazuo

    2011-01-25

    Several antidepressants have been used to treat severe pain in clinics. Recently, we reported that the centrally acting non-narcotic antitussive (cough suppressant drug), tipepidine produces an antidepressant-like effect in the forced swimming test, although the mechanism of action appears to be quite different from that of known antidepressants. In the present study, we investigated whether a combination of tipepidine and carbamazepine acts synergistically to induce an antinociceptive effect in the acetic acid-induced writhing test in mice. Prior to studying the combination of tipepidine and carbamazepine, the analgesic action of tipepidine alone was also examined in mice. Tipepidine at 5-40mg/kg i.p. significantly reduced the number of writhes induced by acetic acid in mice. Carbamazepine at 20mg/kg i.p. also significantly reduced the writhing reaction. Furthermore, co-administration of carbamazepine (5 and 10mg/kg, i.p.) and tipepidine (2.5mg/kg i.p.) significantly decreased the number of writhes induced by acetic acid. This finding suggests that a combination of carbamazepine and tipepidine may be a new strategy for the treatment of neuropathic pain such as what occurs in trigeminal neuralgia, because the use of carbamazepine is often limited by its adverse effects and by reduction of its analgesic efficacy by microsomal enzyme induction. PMID:21114989

  19. Pulsed corona discharge oxidation of aqueous carbamazepine micropollutant.

    Science.gov (United States)

    Ajo, Petri; Krzymyk, Ewelina; Preis, Sergei; Kornev, Iakov; Kronberg, Leif; Louhi-Kultanen, Marjatta

    2016-08-01

    The anti-epileptic drug carbamazepine (CBZ) receives growing attention due to slow biodegradation and inherent accumulation in the aquatic environment. The application of a gas-phase pulsed corona discharge (PCD) was investigated to remove CBZ from synthetic solutions and spiked wastewater effluent from a municipal wastewater treatment facility. The treated water was showered between high voltage (HV) wires and grounded plate electrodes, to which ultra-short HV pulses were applied. CBZ was readily oxidized and 1-(2-benzaldehyde)-4-hydroquinazoline-2-one (BQM) and 1-(2-benzaldehyde)-4-hydro-quinazoline-2,4-dione (BQD) were identified as the most abundant primary transformation products, which, contrary to CBZ ozonation data available in the literature, were further easily oxidized with PCD: BQM and BQD attributed to only a minor portion of the target compound oxidized. In concentrations commonly found in wastewater treatment plant effluents (around 5 µg L(-1)), up to 97% reduction in CBZ concentration was achieved at mere 0.3 kW h m(-3) energy consumption, and over 99.9% was removed at 1 kW h m(-3). The PCD application proved to be efficient in the removal of both the parent substance and its known transformation products, even with the competing reactions in the complex composition of wastewater. PMID:26758812

  20. Uptake of Carbamazepine by rhizomes and endophytic bacteria of Phragmites australis

    Directory of Open Access Journals (Sweden)

    Andres eSauvetre

    2015-02-01

    Full Text Available Carbamazepine is an antiepileptic and mood-stabilizing drug which is used widely in Europe and North America. In the environment, it is found as a persistent and recalcitrant conta¬mi-nant, being one of the most prominent hazardous pharmaceuticals and personal care products (PPCPs in effluents of wastewater treatment plants (WWTPs. Phragmites australis is one of the species with both, the highest potential of detoxification and phytoremediation. It has been used successfully in the treatment of industrial and municipal wastewater. Recently, the identification of endophytic micro¬organisms from different plant species growing in contaminated sites has provided a list of candidates which could be used as bio-inoculants for bioremediation of difficult compounds. In this study, Phragmites australis plants were exposed to 5 mg/L of carbamazepine. After 9 days the plants had removed 90% of the initial concentration. Endophytic bacteria were isolated from these plants and further characterized. Phylogenetic analysis based on 16S rDNA sequencing revealed that the majority of these isolates belong to three groups: Proteobacteria, Actinobacteria and Bacteroidetes. Carbamazepine uptake and plant growth promoting (PGP traits were analyzed among the isolates. Ninety percent of the isolates produce indole acetic acid (IAA and all of them possess at least one of the PGP traits tested. One isolate identified as Chryseobacterium taeanense combines good carbamazepine uptake and all of the PGP traits. Rhizobium daejeonense can remove carbamazepine and produces 23 µg/mL of IAA. Diaphorobacter nitroreducens and Achromobacter mucicolens are suitable for carbamazepine removal while both, Pseudomonas veronii and Pseudomonas lini show high siderophore production and phosphate solubilization. Alone or in combination, these isolates might be applied as inoculates in constructed wetlands in order to enhance the phyto-remediation of carbamazepine during wastewater

  1. Carbamazepine alone and in combination with doxycycline attenuates isoproterenol-induced cardiac hypertrophy

    Directory of Open Access Journals (Sweden)

    Harold Ray Garner

    2010-02-01

    Full Text Available β-adrenergic signaling is involved in the development of cardiac hypertrophy (CH, justifying the use of β-blockers as a therapy to minimize and postpone the consequences of this disease. Evidence suggests that adenylate cyclase, a downstream effector of the β-adrenergic pathway, might be a therapeutic target. We examined the effects of the anti-epileptic drug carbamazepine (CBZ, an inhibitor of adenylate cyclase. In a murine cardiac hypertrophy model, carbamazepine significantly attenuates isoproteronol (ISO-induced cardiac hypertrophy. Carbamazepine also has an effect in transverse aortic banding induced cardiac hypertrophy (TAB (P=0.07. When carbamazepine was given in combination with the antibiotic doxycycline (DOX, which inhibits matrix metalloproteinases (MMPs, therapeutic outcome measured by heart weight-to-body weight and heart weight-to-tibia length ratios was improved compared to either drug alone. Additionally, the combination therapy resulted in an increase in the survival rate over a 56-day period compared to that of untreated mice with cardiac hypertrophy or either drug used alone. Moreover, in support of a role for carbamaze­pine as a β-adrenergic antagonist via cAMP inhibition, a lower heart rate and a lower level of the activated phosphorylated form of the cAMP Response Element-Binding (CREB were observed in heart extracts from mice treated with carbamazepine. Gene expression analysis identified 19 genes whose expression is significantly altered in treated animals and might be responsible for the added benefit provided by the combination therapy. These results suggest that carbamazepine acts as a β-adrenergic antagonist. Carbamazepine and doxycycline are approved by the US Food and Drug Administration (FDA as drugs that might complement medications for cardiac hypertrophy or serve as an alternative therapy to traditional β-blockers. Furthermore, these agents reproducibly impact the expression of genes that may serve as

  2. Environmental concentration of carbamazepine accelerates fish embryonic development and disturbs larvae behavior.

    Science.gov (United States)

    Qiang, Liyuan; Cheng, Jinping; Yi, Jun; Rotchell, Jeanette M; Zhu, Xiaotong; Zhou, Junliang

    2016-09-01

    Environmental pollution caused by pharmaceuticals has been recognized as a major threat to the aquatic ecosystems. Carbamazepine, as the widely prescribed antiepileptic drug, has been frequently detected in the aquatic environment and has created concerns about its potential impacts in the aquatic organisms. The effects of carbamazepine on zebrafish embryos were studied by examining their phenotype, behavior and molecular responses. The results showed that carbamazepine disturbed the normal growth and development of exposed zebrafish embryos and larvae. Upon exposure to carbamazepine at 1 μg/L, the hatching rate, body length, swim bladder appearance and yolk sac absorption rate were significantly increased. Embryos in treatment groups were more sensitive to touch and light stimulation. At molecular level, exposure to an environmentally relevant concentration (1 μg/L) of carbamazepine disturbed the expression pattern of neural-related genes of zebrafish embryos and larvae. This study suggests that the exposure of fish embryo to antiepileptic drugs, at environmentally relevant concentrations, affects their early development and impairs their behavior. Such impacts may have future repercussions by affecting fish population structure. PMID:27386877

  3. Pharmacokinetic and pharmacodynamic drug interactions of carbamazepine and glibenclamide in healthy albino Wistar rats

    Directory of Open Access Journals (Sweden)

    S Prashanth

    2011-01-01

    Full Text Available Aims: To find out the pharmacokinetic and pharmacodynamic drug interaction of carbamazepine, a protype drug used to treat painful diabetic neuropathy with glibenclamide in healthy albino Wistar rats following single and multiple dosage treatment. Materials and Methods: Therapeutic doses (TD of glibenclamide and TD of carbamazepine were administered to the animals. The blood glucose levels were estimated by GOD/POD method and the plasma glibenclamide concentrations were estimated by a sensitive RP HPLC method to calculate pharmacokinetic parameters. Results: In single dose study the percentage reduction of blood glucose levels and glibenclamide concentrations of rats treated with both carbamazepine and glibenclamide were significantly increased when compared with glibenclamide alone treated rats and the mechanism behind this interaction may be due to inhibition of P-glycoprotein mediated transport of glibenclamide by carbamazepine, but in multiple dose study the percentage reduction of blood glucose levels and glibenclamide concentrations were reduced and it may be due to inhibition of P-glycoprotein mediated transport and induction of CYP2C9, the enzyme through which glibenclamide is metabolised. Conclusions: In the present study there is a pharmacokinetic and pharmacodynamic interaction between carbamazepine and glibenclamide was observed. The possible interaction involves both P-gp and CYP enzymes. To investigate this type of interactions pre-clinically are helpful to avoid drug-drug interactions in clinical situation.

  4. Comparative efficacy of phenytoin, steroid and carbamazepine in herpes zoster and post herpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Agarwal S

    1991-01-01

    Full Text Available Three hundred patients of different ages were sequentially assigned three therapy groups (100 in each group viz. phenytoin, steroid (prednisolone and carbamazepine. Effect of these drugs on herpes zoster neuralgia and in prevention of post herpetic neuralgia was studied. Phenytoin was found to be superior to both steroid and carbamazepine in relieving the pain of herpes zoster and in reducing the incidence of post herpetic neuralgia. Only 16.1% of the patients in phenytoin treated group developed post herpetic neuralgia lasting for 2-4 weeks while 22.7% and 29.6% of the steroid and carbamazepine treated patients respectively developed post herpetic neuralgia and that too lasting for longer duration. No patient under 40 years developed post herpetic neuralgia.

  5. Lamotrigine versus carbamazepine in treating newly diagnosed epilepsy:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Ya; PENG Ya-Wen; ZHOU Ke-Cheng; QU Cheng-Hao; HU Wei

    2014-01-01

    First-line therapy for newly diagnosed epilepsy (e.g. carbamazepine)is generally considered effective.However,in a significant proportion of patients (especially in the elderly),us-age may be limited by unwanted adverse events.To synthesize ev-idence regarding efficacy and tolerability of lamotrigine as first line, monotherapy or prophylactic antiepileptic. MEDLINE, PsycINFO,Scopus,EMBASE,and the Cochrane Central Register of Controlled Trials (CENTRAL)were searched from inception to June 2014.Randomised controlled trials (RCTs)comparing lam-otrigine with carbamazepine monotherapy for newly diagnosed epi-lepsy.Eligible studies were independently selected and methodo-logical quality was independently evaluated by two reviewers. Effects were summarized using standardized hazard ratio (HR)or odds ratio (OR)with suitable effect models.Pre-specified sensi-tivity analyses were performed to explain heterogeneity.Nine stud-ies involving 2793 participants met the inclusion criteria.The effects of lamotrigine compared with carbamazepine in patients with newly diagnosed seizures were investigated in all studies.We found that carbamazepine was inferior in comparison to lamotrigine when measuring the proportion of remaining seizure free in the elderly (hazard ratio (HR)1.71;95%confidence interval (CI) 1.27 to 2.29)but notthe children and the adult.There was strong evidence for the tolerability profile of lamotrigine compared with carbamazepine in the Retention rates (HR 1 .67;95%CI 1 . 43 to 1.94).Moreover,lamotrigine lead to less adverse events. Lamotrigine and carbamazepine showed similar efficacy on newly diagnosed epilepsy but better efficacy in the elderly than carbam-azepine.Furthermore,lamotrigine was better tolerated.

  6. Association of HLA-BFNx011502 allele and carbamazepine-induced Stevens-Johnson syndrome among Indians

    Directory of Open Access Journals (Sweden)

    Mehta Timir

    2009-01-01

    Full Text Available Background: Stevens-Johnson Syndrome (SJS and toxic epidermal necrolysis are severe cutaneous reactions caused by certain drugs, including antiepileptic carbamazepine. A strong association has been reported between human leucocyte antigen (HLA-BFNx011502 and carbamazepine-induced SJS in Han Chinese patients. European studies suggested that HLA-BFNx011502 is not a universal marker but is ethnicity-specific for Asians. Aim: To study the association between HLA-BFNx011502 and carbamazepine-induced SJS in Indian patients. Methods: Eight individuals who fulfilled the diagnostic criteria of SJS induced by carbamazepine were identified and HLA-B molecular typing was performed. HLA-B genotyping was carried out by polymerase chain reaction using sequence-specific primers. Results: Out of eight patients studied for genotype, six patients were found to have the HLA-BFNx011502 allele. Conclusion: This study suggests an association between HLA-BFNx011502 and carbamazepine-induced SJS in Indian patients.

  7. The assessment of genotoxicity of carbamazepine using cytokinesis-block (CB) micronucleus assay in cultured human blood lymphocytes.

    Science.gov (United States)

    Celik, Ayla

    2006-01-01

    The genotoxic effect of CBZ has been investigated in few studies. There is little evidence linking carbamazepine (CBZ) with any genotoxic effects, particularly in vitro micronucleus test using cytogenesis-block technique. In this study, the genotoxicity of the antiepileptic drug, carbamazepine, was tested using cytokinesis-block (CB) micronucleus assay. In vitro analysis was performed in human blood lymphocytes from four healthy persons at five different concentrations of carbamazepine (6, 8, 10, 12, 14 microg/mL). Genotoxic potential and cytotoxic effects of carbamazepine were evaluated by using micronucleus assay and cytokinesis-block proliferation index (CBPI), called the parameter of cytotoxicity in human peripheral blood lymphocyte cultures, respectively. The results of this study indicate that CBZ caused the genotoxic effect under in vitro conditions, except at the dose of 6 microg/mL, and cytotoxic effects of carbamazepine were revealed by a decrease in the cytokinesis-block proliferation index at all the concentrations. PMID:16707330

  8. Biomimetic oxidation of carbamazepine with hydrogen peroxide catalyzed by a manganese porphyrin

    Directory of Open Access Journals (Sweden)

    Cláudia M. B. Neves

    2012-01-01

    Full Text Available This laboratory project is planned for an undergraduate chemistry laboratory in which students prepare a manganese porphyrin able to mimic the oxidative metabolism of carbamazepine, one of the most frequently prescribed drugs in the treatment of epilepsy. The in vitro oxidation of carbamazepine results in the formation of the corresponding 10,11-epoxide, the main in vivo metabolite. The reaction is catalyzed by manganese porphyrin in the presence of H2O2, an environmentally-friendly oxidant. Through this project students will develop their skills in organic synthesis, coordination chemistry, chromatographic techniques such as TLC and HPLC, UV-visible spectrophotometry, and NMR spectroscopy.

  9. Biomimetic oxidation of carbamazepine with hydrogen peroxide catalyzed by a manganese porphyrin

    Energy Technology Data Exchange (ETDEWEB)

    Neves, Claudia M.B.; Simoes, Mario M.Q.; Domingues, Fernando M.J.; Neves, M. Graca P.M.S.; Cavaleiro, Jose A.S., E-mail: msimoes@ua.pt [Dept. de Quimica, QOPNA, Universidade de Aveiro (Portugal)

    2012-07-01

    This laboratory project is planned for an undergraduate chemistry laboratory in which students prepare a manganese porphyrin able to mimic the oxidative metabolism of carbamazepine, one of the most frequently prescribed drugs in the treatment of epilepsy. The in vitro oxidation of carbamazepine results in the formation of the corresponding 10,11-epoxide, the main in vivo metabolite. The reaction is catalyzed by manganese porphyrin in the presence of H{sub 2}O{sub 2}, an environmentally-friendly oxidant. Through this project students will develop their skills in organic synthesis, coordination chemistry, chromatographic techniques such as TLC and HPLC, UV-visible spectrophotometry, and NMR spectroscopy. (author)

  10. Biomimetic oxidation of carbamazepine with hydrogen peroxide catalyzed by a manganese porphyrin

    International Nuclear Information System (INIS)

    This laboratory project is planned for an undergraduate chemistry laboratory in which students prepare a manganese porphyrin able to mimic the oxidative metabolism of carbamazepine, one of the most frequently prescribed drugs in the treatment of epilepsy. The in vitro oxidation of carbamazepine results in the formation of the corresponding 10,11-epoxide, the main in vivo metabolite. The reaction is catalyzed by manganese porphyrin in the presence of H2O2, an environmentally-friendly oxidant. Through this project students will develop their skills in organic synthesis, coordination chemistry, chromatographic techniques such as TLC and HPLC, UV-visible spectrophotometry, and NMR spectroscopy. (author)

  11. Effect of pomegranate juice pre-treatment on the transport of carbamazepine across rat intestine

    Directory of Open Access Journals (Sweden)

    D Adukondalu

    2010-12-01

    Full Text Available "n  "nBackground and the purpose of the study: Many drug substances along with a variety of naturally occurring dietary or herbal components interact with the CYP enzyme system.The present study was aimed to investigate the effect of pomegranate juice pre-treatment on the transport of carbamazepine across the rat intestine "nMethods: The transport of carbamazepine across different parts of rat intestine was studied by everted and non-everted sac methods. The control and pomegranate juice (10 ml Kg-1 for 7 days pre-treated rats were sacrificed and isolated the intestine. The sacs of intestine were prepared, treated with carbamazepine solution and then placed in dulbeccos buffer. Samples were collected periodically and the drug content was estimated using HPLC. Results and conclusion: The results show that there was a significant (p<0.05 difference in the transport of carbamazepine from the intestinal sacs of pretreated with pomegranate juice and control. It seems that pomegranatejuice might have induced CYP3A4enzymes and hence drug is extensively metabolized.

  12. Visualizing solvent mediated phase transformation behavior of carbamazepine polymorphs by principal component analysis

    DEFF Research Database (Denmark)

    Tian, Fang; Rades, Thomas; Sandler, Niklas

    2008-01-01

    The purpose of this research is to gain a greater insight into the hydrate formation processes of different carbamazepine (CBZ) anhydrate forms in aqueous suspension, where principal component analysis (PCA) was applied for data analysis. The capability of PCA to visualize and to reveal simplified...

  13. A retrospective study of carbamazepine therapy in the treatment of idiopathic generalised epilepsy

    LENUS (Irish Health Repository)

    O'Connor, G

    2011-05-01

    Objective: The exacerbation of idiopathic generalised epilepsy (IGE) by some anti-epileptic drugs (AEDs) such as carbamazepine (CBZ) has been well documented. However, it is unclear whether IGE is always worsened by the use of CBZ, or whether some patients with IGE benefit from its use. \\r\

  14. Formulation of unidirectional release buccal patches of carbamazepine and study of permeation through porcine buccal mucosa

    Institute of Scientific and Technical Information of China (English)

    Parthasarathy Govindasamy; Bhaskar Reddy Kesavan; Jayaveera Korlakunta Narasimha

    2013-01-01

    Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches. Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using hydroxypropyl methyl cellulose, polyvinyl alcohol, polyvinyl pyrrolidone and ethyl cellulose by solvent casting method. Water impermeable backing layer (Pidilite® Biaxially-oriented polypropylene film) of patches provided unidirectional drug release. They were evaluated for thickness, mass uniformity, surface pH and folding endurance. Six formulations FA2, FA8, FA10, FB1, FB14 and FB16 (folding endurance above 250) were evaluated further for swelling studies, ex vivo mucoadhesive strength, ex vivo mucoadhesion time, in vitro drug release, ex vivo permeation, accelerated stability studies and FTIR and XRD spectral studies. Results: The ex vivo mucoadhesion time of patches ranged between 109 min (FA10) to 126 min (FB14). The ex vivo mucoadhesive force was in the range of 0.278 to 0.479 kg/m/s. The in vitro drug release studies revealed that formulation FA8 released 84%and FB16 released 99.01%of drug in 140 min. Conclusions: The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic delivery of carbamazepine.

  15. Relaxation and crystallization of amorphous carbamazepine studied by terahertz pulsed spectroscopy

    DEFF Research Database (Denmark)

    Zeitler, J Axel; Taday, Philip F; Pepper, Michael; Rades, Thomas

    2007-01-01

    At the example of carbamazepine the crystallization of a small organic molecule from its amorphous phase was studied using in situ variable temperature terahertz pulsed spectroscopy (TPS). Even though terahertz spectra of disordered materials in the glassy state exhibit no distinct spectral featu...

  16. The Effect of Long-Term Carbamazepine Monotherapy on Serum Lipid Levels in Epilepsy Patients

    Directory of Open Access Journals (Sweden)

    İsmail Apak

    2008-01-01

    Full Text Available The aim of this study was to determine the effect of carbamazepine on serum lipid levels in epileptic patients who were on long-term carbamazepine monotherapy. The study group were comprised of 30 epileptic patients (10 female, 20 male who have been on carbamazepine monotherapy for at least one year whereas control group consisted of 30 age and sex matched healthy controls. Serum cholesterol (total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels were measured and LDL/HDL ratio was calculated in all subjects. Serum HDL cholesterol and triglyceride levels of study group were significantly higher than control group whereas serum LDL cholesterol levels and LDL/HDL ratios of study group were lower than control group. Mean total cholesterol level of study group was lower than control group, however the difference did not reach statistical significance level. Because of its effect on cholesterol levels, long term carbamazepine could possibly have a positive influence in decreasing the risk of developing aterosclerosis and coronary heart disease. Long term prospective follow-up studies would be helpful to us in enlightening this issue definitely.

  17. "The effect of solvent and crystallization conditions on habit modification of Carbamazepine "

    Directory of Open Access Journals (Sweden)

    "Bolourtchian N

    2001-07-01

    Full Text Available Physical characteristics of carbamazepine crystals grown from pure ethanol or acetone under different conditions were studied for the morphology of crystals by scanning electron microscope, x-ray powder diffraction and FT-IR, and for thermodynamic properties by differential scanning calorimeter. Also the dissolution behavior and compaction properties of crystals were studied. The results showed that crystallization of carbamazepine using watering-out method produced needle shape crystals while by the other methods such as reducing temperature or solvent evaporation produced polyhedral crystals in alcohol and thin plate-like crystals in acetone. The crystals which were grown from acetone were larger than those from alcohol. Differential scanning calorimetery and x-ray powder diffraction showed no evidence of poly-morphism for carbamazepine crystallized by reducing the temperature or by the solvent evaporation in contrast with the crystals produced by the watering out technique. Crystallization of carbamazepine by different methods especially watering-out technique improved its dissolution rate and compactibility and produced high crushing strength compacts without capping.

  18. A comparative study of thyroid status of patients on phenytoin, carbamazepine and valproate monotherapy

    Directory of Open Access Journals (Sweden)

    Dinesh K. Dhodi

    2016-04-01

    Conclusions: Valproate monotherapy does not alter serum levels of thyroid hormones. On the contrary, alterations of thyroid hormone function were seen in patients treated with carbamazepine and phenytoin. However, all the patients were euthyroid and were not associated with clinical or even subclinical hypothyroidism. [Int J Basic Clin Pharmacol 2016; 5(2.000: 362-365

  19. Systemic and presystemic conversion of carbamazepine to carbamazepine-10,11-epoxide during long term treatment Conversão da carbamazepina para 10,11-epóxido-carbamazepina no tratamento prolongado

    OpenAIRE

    Pietro Fagiolino; Marta Vázquez; Ivette Olano; Aurora Delfino

    2006-01-01

    INTRODUCTION: Carbamazepine (CBZ) undergoes biotransformation, being CYP3A4 the major cytocrome P450 (CYP) enzyme catalyzing the carbamazepine-10,11-epoxide (EPOX) formation, which is quantitatively the most important pathway in CBZ metabolism. There is evidence of dose-dependent elimination of this drug due to its autoinduction capacity. Moreover, published data showed an incomplete bioavailability of CBZ since its absorption increases when grapefruit juice was administered. Both CYP3A4 and ...

  20. Bioaccumulation and bioconcentration of carbamazepine and other pharmaceuticals in fish under field and controlled laboratory experiments. Evidences of carbamazepine metabolization by fish.

    Science.gov (United States)

    Valdés, M E; Huerta, B; Wunderlin, D A; Bistoni, M A; Barceló, D; Rodriguez-Mozaz, S

    2016-07-01

    There is a growing interest in evaluating the presence of pharmaceutical residues and their metabolites in aquatic biota. In this study, twenty pharmaceuticals, including carbamazepine (CBZ) and two metabolites, were analyzed in homogenates of two fish species (Gambusia affinis and Jenynsia multidentata) captured in polluted areas of the Suquía River (Córdoba, Argentina). The twenty target pharmaceuticals were found in G. affinis, while only fifteen were detected in J. multidentata. We observed a noticeable difference in the accumulation pattern of both fish species, suggesting different pathways for the bioaccumulation of polar pharmaceuticals in each fish. In order to investigate uptake and tissue distribution of pharmaceuticals, a detailed study was performed under controlled laboratory conditions in J. multidentata, exposed to CBZ. CBZ and two of its metabolites (carbamazepine-10,11-epoxide - CBZ-EP and 2-hydroxycarbamazepine - 2-OH-CBZ) were monitored in five organs of fish under laboratory exposure. To our knowledge, this is the first report on the presence of CBZ and its metabolite 2-OH-CBZ in gills, intestine, liver, brain and muscle of fish, while the metabolite carbamazepine-10,11-epoxide (CBZ-EP) was detected in gills and muscle. A ratio CBZ-EP/CBZ close to 0.1 suggests that gills and muscle of J. multidentata could metabolize CBZ through the CBZ-EP pathway. Our results reinforce the need of analyzing multiple species to account for the environmental impact of pollutants, negating the simplification of a single, "representative model" during ecotoxicological biomonitoring. To our knowledge, the biotransformation of CBZ to its metabolites (CBZ-EP, 2-OH-CBZ) in fish, under controlled laboratory in vivo exposures, is reported for the first time. PMID:26994794

  1. A multicentre comparative trial of sodium valproate and carbamazepine in adult onset epilepsy. Adult EPITEG Collaborative Group.

    OpenAIRE

    Richens, A; Davidson, D L; Cartlidge, N. E.; Easter, D J

    1994-01-01

    The long-term efficacy and safety of sodium valproate and carbamazepine in adult outpatients with newly diagnosed primary generalised or partial and secondarily generalised seizures were compared in a randomised, open, multicentre study at 22 neurology outpatient clinics. Patients were randomised to oral sodium valproate (Epilim EC enteric coated 200 mg tablets twice daily, n = 149) or oral carbamazepine (100 mg twice daily increasing to 200 mg twice daily in week 2, n = 151) and followed up ...

  2. Characterization and biodegradation kinetics of a new cold-adapted carbamazepine-degrading bacterium, Pseudomonas sp. CBZ-4.

    Science.gov (United States)

    Li, Ang; Cai, Rui; Di, Cui; Qiu, Tian; Pang, Changlong; Yang, Jixian; Ma, Fang; Ren, Nanqi

    2013-11-01

    Carbamazepine is frequently detected in waters and hardly eliminated during conventional wastewater treatment processes due to its complicated chemical structure and resistance to biodegradation. A carbamazepine-degrading bacterium named CBZ-4 was isolated at a low temperature (10 degreeC) from activated sludge in a municipal wastewater treatment plant. Strain CBZ-4, which can use carbamazepine as its sole source of carbon and energy, was identified as Pseudomonas sp. by the 16S rRNA gene sequence. The composition and percentage of fatty acids, which can reveal the cold-adaptation mechanism of strain CBZ-4, were determined. Strain CBZ-4 can effectively degrade carbamazepine at optimal conditions: pH 7.0, 10 degreeC, 150 r/min rotation speed, and 13% inoculation volume. The average removal rate of carbamazepine was 46.6% after 144 hr of incubation. The biodegradation kinetics of carbamazepine by CBZ-4 was fitted via the Monod model. Vmax and Ks were found to be 0.0094 hr-1 and 32.5 mg/L, respectively. PMID:24552057

  3. Quantitative bioanalytical and analytical method development of dibenzazepine derivative, carbamazepine: A review

    Directory of Open Access Journals (Sweden)

    Prasanna A. Datar

    2015-08-01

    Full Text Available Bioanalytical methods are widely used for quantitative estimation of drugs and their metabolites in physiological matrices. These methods could be applied to studies in areas of human clinical pharmacology and toxicology. The major bioanalytical services are method development, method validation and sample analysis (method application. Various methods such as GC, LC–MS/MS, HPLC, HPTLC, micellar electrokinetic chromatography, and UFLC have been used in laboratories for the qualitative and quantitative analysis of carbamazepine in biological samples throughout all phases of clinical research and quality control. The article incorporates various reported methods developed to help analysts in choosing crucial parameters for new method development of carbamazepine and its derivatives and also enumerates metabolites, and impurities reported so far.

  4. Optimization of preparation conditions of poly(ε-caprolactone microspheres for controlled release of carbamazepine

    Directory of Open Access Journals (Sweden)

    Pepić Dragana S.

    2010-01-01

    Full Text Available Poly (ε-caprolactone, PCL, is an aliphatic polyester suitable for controlled drug release due to its biodegradability, biocompatibility, non-toxicity and high permeability to many therapeutic drugs. This study investigates the effect of the preparation parameters on the size and the morphology of the PCL microspheres and on the release profile of carbamazepine from these microspheres. The PCL microspheres were prepared using oil-in-water (o/w emulsion solvent evaporation method with the poly(vinyl alcohol, PVA, as the emulsion stabilizer. The influence of the stirring rate applied during the emulsion formation, the homogenization time and the emulsifier concentration on diameter and size distribution of the microspheres was analyzed by scanning electron microscope (SEM. The initial emulsion was formed applying high stirring rates of 10000, 18000 and 23000 rpm, for homogenization times: 5, 10 and 15 min. The diameter was strongly influenced by the stirring rate, and the average particle size decreased from 9.2 to 2.8 µm with the increase of the stirring rate. Increasing the amount of PVA in the water phase from 0.2 to 1 mass% improved stabilization of the oil droplets and led to a slight decrease of the average particle diameter. Drug-loaded microspheres were prepared by the same technique using different amounts of carbamazepine (10 and 15 mass%, under given conditions (1 mass% PVA, stirring rate of 18000 rpm for a period of 5 min of emulsion formation. Additionally, microspheres were prepared by applying low stirring rate of 1000 rpm with 10 and 15 mass% of the drug. The SEM analysis showed that microspheres created with 18000 rpm stirring rate, had average diameters of 3-4 µm, and the microspheres prepared with 1000 rpm stirring rate were larger than 100 µm. It was also observed that, in the case of the large microspheres, carbamazepine was deposited on their surfaces, while the small microspheres had smooth surfaces without observable

  5. Side effects of phenobarbital and carbamazepine in childhood epilepsy: randomised controlled trial

    OpenAIRE

    Banu, S. H.; Jahan, M.; Koli, U. K.; Ferdousi, S.; Khan, N. Z.; Neville, B.

    2007-01-01

    Objective: To compare the behavioural side effects associated with two commonly used antiepilepsy drugs--phenobarbital and carbamazepine--in children in Bangladesh. Design: Prospective randomised controlled single centre trial. Setting: Specialist children's hospital in Dhaka, Bangladesh. Participants: 108 children aged 2-15 with generalised tonic-clonic (n=51) or partial and secondary generalised seizures (n=57). Main outcome measures: Seizure control and behavioural side effects. Results: 9...

  6. Preparation and evaluation of polymeric carbamazepin spherical crystals by emulsion solvent diffusion technique

    OpenAIRE

    Yadav Adhikrao; Yadav Venkat

    2009-01-01

    In this study, a significant effect of different polymers on improving the solubility, dissolution rate, and physicochemical properties of carbamazepine (CBZ) has been demonstareted by emulsion solvent diffusion technique, with ethanol-chloroform-water as the solvent system. The hydrophilic polymers like polyethylene glycol, chitosan, and hydrophobic polymer Eudragit RSPO were used in the recrystallization process. The pure drug CBZ and the prepared spherical crystals of CBZ with different po...

  7. Solar photo-Fenton like using persulphate for carbamazepine removal from domestic wastewater

    OpenAIRE

    Ahmed, M M; Chiron, Serge

    2014-01-01

    This work aimed at decontaminating biologically treated domestic wastewater effluent from pharmaceutical residues by using sulphate radical based homogeneous photo-Fenton involving persulphate (PS) as an oxidant, ferrous iron (Fe(II)) as a catalyst and simulated solar irradiation as a light source. This is the first time that the beneficiary use of solar energy in PS/Fe(II)/UV-Vis system was evaluated by using carbamazepine (CBZ) as a probe compound. In wastewater, CBZ was fully degraded in 3...

  8. Anticonvulsant treatments of dysphoric mania: a trial of gabapentin, lamotrigine and carbamazepine in Iran

    OpenAIRE

    Mokhber, Naghmeh; Lane, Carol J.; Azarpazhooh, Mohamad R; Elham SALARI*; Fayazi, Reza; Shakeri, Mohamad T; Young, Allan H.

    2008-01-01

    The treatment of dysphoric mania is challenging given the need to treat symptoms of both depression and mania simultaneously without provoking any clinical exacerbation. The newer antiepileptic drugs such as gabapentin, lamotrogine, and carbamazepine are often used as adjuncts to either lithium or valproic acid in the treatment of bipolar disorder. We decided to undertake a monotherapy trial because previous evidence suggested mixed states may be more responsive to anticonvulsants than more t...

  9. Intranasal administration of carbamazepine to mice: a direct delivery pathway for brain targeting

    OpenAIRE

    Serralheiro, Ana; Alves, Gilberto; Fortuna, Ana; Falcão, Amílcar

    2014-01-01

    The currently available antiepileptic drugs are typically administered via oral or intravenous (IV) routes which commonly exhibit high systemic distribution into non-targeted tissues, leading to peripheral adverse effects and limited brain uptake. In order to improve the efficacy and tolerability of the antiepileptic drug therapy, alternative administration strategies have been investigated. The purpose of the present study was to assess the pharmacokinetics of carbamazepine administered via ...

  10. Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

    OpenAIRE

    Sophia Yui Kau Fong; Qiong Gao; Zhong Zuo

    2013-01-01

    Background. Carbamazepine (CBZ) is a first-line antiepileptic drug which may be prone to drug interactions. Systematic review of herb- and food-drug interactions on CBZ is warranted to provide guidance for medical professionals when prescribing CBZ. Method. A systematic review was conducted on six English databases and four Chinese databases. Results. 196 out of 3179 articles fulfilled inclusion criteria, of which 74 articles were reviewed and 33 herbal products/dietary supplement/food intera...

  11. Study of efficacy of the combination of carbamazepine with nootropics on cognitive processes in epilepsy

    OpenAIRE

    Ivanov A.V.; Opryshko V.I.

    2013-01-01

    The authors studied the efficacy of combination of carbamazepine with nootropic drugs on cognitive processes in patients with epilepsy in experiment in order to reduce the side effects of anticonvulsant therapy. Analysis of anticonvulsant effect of the combination of drugs was carried out on 36 white nonlinear rats of both sexes weighing 160-180 g by the method of maximum electroshock, and the analysis of antiamnestic effect - using a model of retrograde amnesia on 80 white adult male rats we...

  12. A COMPARATIVE STUDY OF SIDE-EFFECTS OF LITHIUM, CARBAMAZEPINE AND HALOPERIDOL IN ACUTE MANIA

    OpenAIRE

    Trivedi, J. K.; Lata, Arun; Dalal, P.K.; Sinha, P.K.; Srivastava, Shrikant

    1996-01-01

    In an open trial on manic patients, side-effects of carbamazepine, lithium and haloperidol were evaluated weekly over a 4-week period. The total side-effects with the three drugs were not significantly different, but the rate of amelioration of the same was best for lithium and least for haloperidol. It was indicative that lithium was better tolerated drug than the other two.

  13. Effects of sodium valproate and carbamazepine on food competition aggression in pigeons

    OpenAIRE

    C. Fachinelli; Ahumada, M.; J.M. Fachinellizz; M. Torrecilla; E.L. Rodríguez-Echandía

    2007-01-01

    Valproate and carbamazepine (CAR) have been proposed as adjunct alternatives for the control of aggression in psychiatric patients, although no definite conclusions have been reached. We examined the effects of these drugs on food competition offensive aggression and other behaviors in high- and low-aggression food-restricted pigeons. These were divided into pairs containing previously ranked high-aggression (N = 10 pairs) and low-aggression females (N = 10 pairs). In Experiment 1, a pigeon i...

  14. Effects of phenytoin and carbamazepine on human natural killer cell activity and genotoxicity in vitro.

    Science.gov (United States)

    Margaretten, N C; Hincks, J R; Warren, R P; Coulombe, R A

    1987-01-01

    Human peripheral blood mononuclear cells (PBMC) were isolated from healthy volunteers and exposed in vitro to phenytoin or carbamazepine, two widely used antiepileptic drugs (AED). This study investigated the effects of these drugs on natural killer (NK) cell activity and antibody-dependent cell-mediated cytotoxicity (ADCC), which are both thought to protect against developing neoplasms. Also, the genotoxicity of phenytoin on human PBMC was investigated by gravity-flow alkaline elution. Concentrations of phenytoin considered therapeutic (10 and 20 micrograms/ml) and a dose considered acutely toxic (40 micrograms/ml) were used while carbamazepine levels of 8 micrograms/ml (therapeutic) and 10 and 16 micrograms/ml (acutely toxic) were tested. Phenytoin at all three concentrations significantly suppressed NK cell activity in a dose-dependent manner. Carbamazepine had no significant effect on NK cell activity at the dose levels studied. Incubation in propylene glycol, the diluent for carbamazepine, significantly decreased NK cell activity compared to saline. Phenytoin also significantly depressed interferon augmentation of NK cell cytotoxicity in a dose dependent manner. ADCC activity was significantly depressed with 20 and 40 micrograms/ml phenytoin. Alkaline elution showed a slight but significant increase in DNA single-strand breaks of PBMC exposed to 40 micrograms/ml phenytoin for 18 or 72 hr. These results show phenytoin may induce pronounced immunosuppression of NK cell and ADCC activity in patients receiving antiepileptic therapy and that this agent has a potential for genotoxic side effects. Phenytoin may also increase the potential for neoplasm development by a direct interaction with cellular DNA and/or an indirect mechanism by immunosuppression. PMID:3798446

  15. Simultaneous Quantification of Three Polymorphic Forms of Carbamazepine in the Presence of Excipients Using Raman Spectroscopy

    OpenAIRE

    Marco Farias; Renato Carneiro

    2014-01-01

    The occurrence of polymorphic transitions is a serious problem for pharmaceutical companies, because it can affect the bioavailability of the final product. With several known polymorphic forms carbamazepine is one of the most problematic drugs in this respect. Raman spectroscopy is a vibrational technique that is becoming very important in the pharmaceutical field, mainly due to its highly specific molecular fingerprint capabilities and easy use as a process analytical tool. However, multiva...

  16. Pharmaceutical evaluation of carbamazepine modifications: comparative study for photostability of carbamazepine polymorphs by using Fourier-transformed reflection-absorption infrared spectroscopy and colorimetric measurement.

    Science.gov (United States)

    Matsuda, Y; Akazawa, R; Teraoka, R; Otsuka, M

    1994-03-01

    The tablet surface was evaluated without physical damage by means of Fourier-transform infrared reflection-absorption spectroscopy (FT-IR-RAS) and colorimetric measurement (colour difference, delta E) of the carbamazepine polymorphs I, II and III, after photodegradation at two irradiation intensities (3.0 and 12.0 J cm-2s-1) under a near-UV fluorescent lamp. The surface of sample pellets of all crystalline forms turned gradually from white to yellow-orange upon exposure to light, and the discoloration rate of form II was faster than that of forms I and III, indicating that form II was the most unstable of the three. The major photoproducts were identified by HPLC, NMR and MS analyses. The carbamazepine content on the surface of the tablet was determined based on the absorption at 1685 cm-1 attributable to C=O stretch vibration in the FT-IR-RAS spectra before and after irradiation by a near-UV fluorescent lamp. The semilogarithmic plots of the photodegradation profiles of the various polymorphs were straight lines, including the induction period, indicating that degradation of the drug on the surface followed first-order kinetics. The induction periods of all forms were not significantly different. However, the degradation rate constant of form II at 12.0 J cm-2s-1 was 5.1 and 1.5 times larger than those of forms I and III, respectively. PMID:8027920

  17. Derivation of water quality standards for carbamazepine, metoprolol, and metformin and comparison with monitoring data.

    Science.gov (United States)

    Moermond, Caroline T A; Smit, C Els

    2016-04-01

    Environmental quality standards (EQSs) for 3 pharmaceuticals in surface water were derived: carbamazepine (epilepsy), metoprolol (heart failure), and metformin (diabetes). In recent years, these pharmaceuticals have been detected frequently in Dutch surface waters. The proposed standards are based on ecotoxicity data from national and European authorization dossiers and additional information obtained from open literature. The methods used are in accordance with the methodology of the Water Framework Directive and national frameworks for risk limit derivation. Only the exposure route regarding direct ecotoxic effects on ecosystems could be taken into account for deriving EQSs. The exposure route of secondary poisoning of fish-eating animals was not triggered, and not enough data were available or accessible to derive an EQS for the exposure of humans due to consumption of fish. Monitoring data for surface waters worldwide show that the proposed quality standards for carbamazepine may be exceeded. It could be expected that when carbamazepine use increases or effluents are diluted less during dry seasons, standards will be exceeded more often. Environ Toxicol Chem 2016;35:882-888. © 2015 SETAC. PMID:26211655

  18. Simultaneous quantification of three polymorphic forms of carbamazepine in the presence of excipients using Raman spectroscopy.

    Science.gov (United States)

    Farias, Marco; Carneiro, Renato

    2014-01-01

    The occurrence of polymorphic transitions is a serious problem for pharmaceutical companies, because it can affect the bioavailability of the final product. With several known polymorphic forms carbamazepine is one of the most problematic drugs in this respect. Raman spectroscopy is a vibrational technique that is becoming very important in the pharmaceutical field, mainly due to its highly specific molecular fingerprint capabilities and easy use as a process analytical tool. However, multivariate methods are necessary both for identification and quantification. In this work an analytical methodology using Raman spectroscopy and interval Partial Least Squares Regression (iPLS), was developed in order to quantify mixtures of carbamazepine polymorphs in the presence of the most common excipients. The three polymorphs CBZ I, CBZ III and CBZ DH (which is a dihydrate) were synthesized and characterized by PXRD and DSC. Subsequently, tablets were manufactured using excipients and 15 different mixtures of carbamazepine polymorphs. The iPLS model presented average prediction validation errors of 1.58%, 1.04% and 0.22% wt/wt, for CBZ I, CBZ III and CBZ DH, respectively, considering the whole mass of the tablet. The model presents a good prediction capacity and the proposed methodology could be used to perform quality control in final products. PMID:25207717

  19. Simultaneous Quantification of Three Polymorphic Forms of Carbamazepine in the Presence of Excipients Using Raman Spectroscopy

    Directory of Open Access Journals (Sweden)

    Marco Farias

    2014-09-01

    Full Text Available The occurrence of polymorphic transitions is a serious problem for pharmaceutical companies, because it can affect the bioavailability of the final product. With several known polymorphic forms carbamazepine is one of the most problematic drugs in this respect. Raman spectroscopy is a vibrational technique that is becoming very important in the pharmaceutical field, mainly due to its highly specific molecular fingerprint capabilities and easy use as a process analytical tool. However, multivariate methods are necessary both for identification and quantification. In this work an analytical methodology using Raman spectroscopy and interval Partial Least Squares Regression (iPLS, was developed in order to quantify mixtures of carbamazepine polymorphs in the presence of the most common excipients. The three polymorphs CBZ I, CBZ III and CBZ DH (which is a dihydrate were synthesized and characterized by PXRD and DSC. Subsequently, tablets were manufactured using excipients and 15 different mixtures of carbamazepine polymorphs. The iPLS model presented average prediction validation errors of 1.58%, 1.04% and 0.22% wt/wt, for CBZ I, CBZ III and CBZ DH, respectively, considering the whole mass of the tablet. The model presents a good prediction capacity and the proposed methodology could be used to perform quality control in final products.

  20. Development and Validation of HPTLC Method for Estimation of Carbamazepine in Formulations and Its In Vitro Release Study

    Directory of Open Access Journals (Sweden)

    Rashmin B. Patel

    2011-01-01

    Full Text Available A new, simple, and rapid high-performance thin-layer chromatographic method was developed and validated for quantitative determination of Carbamazepine. Carbamazepine was chromatographed on silica gel 60 F254 TLC plate using ethyl acetate-toluene-methanol (5.0 + 4.0 + 1.0 v/v/v as mobile phase. Carbamazepine was quantified by densitometric analysis at 285 nm. The method was found to give compact spots for the drug (Rf=0.47 ± 0.01. The linear regression analysis data for the calibration plots showed good linear relationship with r2=.9995 in the concentration range 100–600 ng/spot. The method was validated for precision, recovery, repeatability, and robustness as per the International Conference on Harmonization guidelines. The minimum detectable amount was found to be 16.7 ng/spot, whereas the limit of quantitation was found to be 50.44 ng/spot. Statistical analysis of the data showed that the method is precise, accurate, reproducible, and selective for the analysis of Carbamazepine. The method was successfully employed for the estimation of equilibrium solubility, quantification of Carbamazepine as a bulk drug, in commercially available preparation, and in-house developed mucoadhesive microemulsion formulations and solution.

  1. Anticonvulsant treatments of dysphoric mania: a trial of gabapentin, lamotrigine and carbamazepine in Iran

    Directory of Open Access Journals (Sweden)

    Naghmeh Mokhber

    2008-05-01

    Full Text Available Naghmeh Mokhber1, Carol J Lane2, Mohamad R Azarpazhooh3, Elham Salari4, Reza Fayazi5, Mohamad T Shakeri6, Allan H Young71Assistant Professor of Psychiatry, 3Assistant Professor of Neurology, 4Mashhad Department of Forensic Psychiatry, 5Assistant Professor of Psychiatry, 6Assistant Professor of Statistics, Mashhad University of Medical Science, Mashhad, Iran; 2Department of Psychiatry, University of British Columbia, Vancouver, Canada7Abstract: The treatment of dysphoric mania is challenging given the need to treat symptoms of both depression and mania simultaneously without provoking any clinical exacerbation. The newer antiepileptic drugs such as gabapentin, lamotrogine, and carbamazepine are often used as adjuncts to either lithium or valproic acid in the treatment of bipolar disorder. We decided to undertake a monotherapy trial because previous evidence suggested mixed states may be more responsive to anticonvulsants than more traditional antimanic agents. 51 patients with a DSM IV diagnosis of dysphoric mania were randomized to three groups comprising gapbapentin, lamotrogine or carbamazepine and followed for 8 weeks. Psychiatric diagnosis was verified by the structural clinical interview for the DSM-IV (SCID. The MMPI-2 in full was used to assess symptoms at baseline and 8 weeks. All three groups showed significant changes in MMPI-2 scores for depression and mania subscales. Gabapentin showed the greatest change in depression symptom improvement relative to lamotrogine and carbamazepine, respectively. Although manic symptoms improved overall, there were no differences between groups in the degree of manic symptom improvement.Keywords: dysphoric mania, manic-depression, depression, anticonvulsant, mood stabilizer

  2. Application of Fenton-like oxidation as pre-treatment for carbamazepine biodegradation

    OpenAIRE

    Monsalvo, VM.; Pedro, ZM. de; M. Muñoz; Casas, JA; Mohedano, AF.; Rodríguez, JJ

    2015-01-01

    Degradation of carbamazepine (CBZ) upon Fenton-like oxidation has been investigated analyzing the effect of H2O2 dose and temperature at a very low catalyst concentration (2mgL-1 of Fe3+). Fenton-like oxidation allowed complete conversion of CBZ, the oxidation rate depending on the amount of H2O2 used. The addition of the theoretical stoichiometric amount of H2O2 led to the complete conversion of CBZ in 1h reaction time. The reduction of the H2O2 initial concentration down to 10% of the stoic...

  3. [False positive dexamethasone suppression test in a patient being treated with carbamazepine].

    Science.gov (United States)

    Iversen, Ane Bull; Trolle, Christian; Poulsen, Per Løgstrup

    2014-01-13

    We present a case story of a patient suspected having Cushing's syndrome (CS), with spuriously elevated P-cortisol level diagnosed by overnight and two days dexamethasone suppression test (DST). The patient was being treated with carbamazepine, and after two weeks withdrawal from this drug, both two-day DST and urinary free cortisol showed normal results. There are many pitfalls in the process of diagnosing CS. Several conditions mimic the disease and others cause hypercortisolism. Liver and kidney failure as well as several drugs can influence the test results. It is important to bare this in mind during the diagnostic work-up of suspected CS. PMID:25347181

  4. Effect of Sophora flavescens on the pharmacokinetics of carbamazepine in rats.

    Science.gov (United States)

    Shi, Lei; Dang, Xue-Liang; Liu, Xin-You; Wei, Hua-Mei; Yang, Meng-Meng; Zhang, Yan

    2014-12-01

    Carbamazepine (CBZ), an antiepileptic with narrow therapeutic window, is a substrate of CYP 3A4 which metabolizes CBZ to carbamazepine-10,11-epoxide (CBZE). CBZE is an active and toxicity metabolite, and it is a substrate of MRP-2. Using CBZ for a long time can cause hepatic injury. Sophora flavescens (SF) is a medicinal herb used for the protected hepatic injury. This study investigated the acute and chronic effects of SF on the pharmacokinetics of CBZ in rats. The concentrations of CBZ and CBZE in plasma and tissues were determined by HPLC method. The results showed that SF which significantly decreased the AUC0-t of CBZ, increased CBZE conversely. Tissue analysis showed that the concentrations of CBZ and CBZE in brain and liver were decreased by SF. In addition, the distribution of CBZE in kidney was reduced significantly, which influenced the CBZE excretion and increased the drug toxic potentially. Results in the current study suggest that patients using CBZ might be cautioned in the use of SF extract or Sophora-derived products. Meanwhile, patients receiving drugs which are substrates of CYP 3A4 and/or MRP-2 should be advised of the potential herb-drug interaction to reduce the risk of therapeutic failure or increased toxicity of conventional drug therapy. PMID:24691829

  5. [DRESS syndrome. Rare and potentially lethal allergic reaction to carbamazepine - a case report].

    Science.gov (United States)

    Werber, A; Schiltenwolf, M; Barié, A

    2013-08-01

    A 64-year-old man with chronic low back pain had been treated with tramadol, meloxicam and metamizole for several years. Due to additional neuropathic pain in the lower extremities, the medication was complemented with carbamazepine. After 5 weeks of treatment, the patient developed maculopapulose exanthema and fever, followed by hepatitis, leukocytosis and eosinophilia. The patient was diagnosed with so-called DRESS (drug rash with eosinophilia and systemic symptoms) syndrome, a severe anaphylactic reaction to carbamazepine treatment. Immunosuppressive therapy was complicated by an additional septic reaction. After recovery, the patient was referred to our clinic for a multimodal pain therapy. Fear, depressive episodes and fear-avoidance behavior were additional social factors responsible for the chronic pain syndrome of the patient. The previously diagnosed neuropathic pain syndrome cannot be verified. After appropriate modification of therapy, the patient's pain perception was significantly reduced, allowing for complete withdrawal of pain-relieving medication. This case report illustrates that merely pharmacological treatment of chronic pain syndromes bears only little prospect of success but increased risk of side effects. PMID:23761029

  6. Uptake of carbamazepine by cucumber plants--a case study related to irrigation with reclaimed wastewater.

    Science.gov (United States)

    Shenker, Moshe; Harush, Daniella; Ben-Ari, Julius; Chefetz, Benny

    2011-02-01

    Reclaimed wastewater is an important source of irrigation in semiarid and arid zones. Here we report data on carbamazepine (CBZ) uptake by cucumber plants in hydroponic culture and greenhouse experiments using different soil types irrigated with fresh water or reclaimed wastewater. Data obtained from the hydroponic culture experiments suggest that CBZ is mainly translocated by water mass flow, and thus it is concentrated and accumulated to the largest extent in the mature/older leaves. Carbamazepine concentration in cucumber fruits and leaves was negatively correlated with soil organic matter content. The concentrations of CBZ in the roots and stems were relatively low, and most CBZ in the plant (76-84% of total uptake) was detected in the leaves. A greenhouse experiment using fresh water and reclaimed wastewater spiked, or not, with CBZ at 1 μg L(-1) (typical concentration in effluents) revealed that CBZ can be taken up and bioaccumulated from its background concentration in reclaimed wastewater. Bioaccumulation factor (calculated as the ratio of CBZ concentration in the plant to that in the soil solution) for the fruits (0.8-1) was significantly lower than the value calculated for the leaves (17-20). This study emphasizes the potential uptake of active pharmaceutical compounds by crops in organic-matter-poor soils irrigated with reclaimed wastewater and highlights the potential risks associated with this agricultural practice. PMID:21071061

  7. Analytical method by high resolution liquid chromatography for the determination of carbamazepine in human plasma

    International Nuclear Information System (INIS)

    One of the requirements to develop the studies of bioavailability and bioequivalence is to have analytic methodologies validated for the work with samples in biological fluids. A method was developed by high resolution liquid chromatography for the determination of carbamazepine in human plasma. A mixture of hydrogen phosphate of sodium: acetonitrile (65:35) adjusted to pH= 3.3 with phosphoric acid, flow of 1.2 mL/min and ultraviolet detection at 210 nm, was used as mobile phase. Propylparabene was used as an internal standard. According to the established regulations for the validation of the methods in biological fluids, the following parameters were studied: stability of the samples, lineality, specificity, precision, accuracy and limit of detection and quantification. The method proved to be specific and sensitive with a detection and quantification limit of 0.9 and 1.0 ng, respectively. The method was lineal, precise and exact in the range of concentrations of 1. 07 at 12.67 μg/mL. The mean recovery was not statistically different from 100.0 %. The analito in the proposed biological matrix remained in the studied period. The methodology described in this work is applied in our case to the study that evaluates the bioavailability and bioequivalence of a Cuban formulation of carbamazepine in healthy volunteers. (Author)

  8. Thermoanalytical studies of carbamazepine: hydration/dehydration, thermal decomposition, and solid phase transitions

    Directory of Open Access Journals (Sweden)

    Mônia Aparecida Lemos Pinto

    2014-12-01

    Full Text Available Carbamazepine (CBZ, a widely used anticonvulsant drug, can crystallize and exhibits four polymorphic forms and one dihydrate. Anhydrous CBZ can spontaneously absorb water and convert to the hydrate form whose different crystallinity leads to lower biological activity. The present study was concerned to the possibility of recovering the hydrated form by heating. The thermal behavior of spontaneously hydrated carbamazepine was investigated by TG/DTG-DTA and DSC in dynamic atmospheres of air and nitrogen, which revealed that the spontaneous hydration of this pharmaceutical resulted in a Form III hydrate with 1.5 water molecules. After dehydration, this anhydrous Form III converted to Form I, which melted and decomposed in a single event, releasing isocyanic acid, as shown by evolved gas analysis using TG-FTIR. Differential scanning calorimetry analyses revealed that Form III melted and crystallized as Form I, and that subsequent cooling cycles only generated Form I by crystallization. Solid state decomposition kinetic studies showed that there was no change in the substance after the elimination of water by heating to 120 °C. Activation energies of 98 ± 2 and 93 ± 2 kJ mol-1 were found for the hydrated and dried samples, respectively, and similar profiles of activation energy as a function of conversion factor were observed for these samples.

  9. Photochemical degradation of atenolol, carbamazepine, meprobamate, phenytoin and primidone in wastewater effluents.

    Science.gov (United States)

    Dong, Mei Mei; Trenholm, Rebecca; Rosario-Ortiz, Fernando L

    2015-01-23

    The photochemical degradation of five pharmaceuticals was examined in two secondary wastewater effluents. The compounds, which included atenolol, carbamazepine, meprobamate, phenytoin and primidone, were evaluated for both direct and sensitized photolysis. In the two wastewaters, direct photolysis did not lead to significant compound degradation; however, sensitized photolysis was an important removal pathway for the five pharmaceuticals. Upon solar irradiation, hydroxyl radical (HO) was quantified using the hydroxylation of benzene and singlet oxygen ((1)O2) formation was monitored following the degradation of furfuryl alcohol. Degradation via sensitized photolysis was observed following five-day exposures for atenolol (69-91%), carbamazepine (67-98%), meprobamate (16-52%), phenytoin (44-85%), and primidone (34-88%). Varying removal is likely a result of the differences in reactivity with transient oxidants. Averaged steady state HO concentrations ranged from 1.2 to 4.0×10(-16)M, whereas the concentrations of (1)O2 were 6.0-7.6×10(-14)M. Partial removal due to presence of HO indicates it was not the major sink for most compounds examined. Other transient oxidants, such as (1)O2 and triplet state effluent organic matter, are likely to play important roles in fates of these compounds. PMID:24798495

  10. Molecular structure and spectroscopic characterization of Carbamazepine with experimental techniques and DFT quantum chemical calculations.

    Science.gov (United States)

    Suhasini, M; Sailatha, E; Gunasekaran, S; Ramkumaar, G R

    2015-04-15

    A systematic vibrational spectroscopic assignment and analysis of Carbamazepine has been carried out by using FT-IR, FT-Raman and UV spectral data. The vibrational analysis were aided by electronic structure calculations - ab initio (RHF) and hybrid density functional methods (B3LYP) performed with standard basis set 6-31G(d,p). Molecular equilibrium geometries, electronic energies, natural bond order analysis, harmonic vibrational frequencies and IR intensities have been computed. A detailed interpretation of the vibrational spectra of the molecule has been made on the basis of the calculated Potential Energy Distribution (PED) by VEDA program. UV-visible spectrum of the compound was also recorded and the electronic properties, such as HOMO and LUMO energies and λmax were determined by HF/6-311++G(d,p) Time-Dependent method. The thermodynamic functions of the title molecule were also performed using the RHF and DFT methods. The restricted Hartree-Fock and density functional theory-based nuclear magnetic resonance (NMR) calculation procedure was also performed, and it was used for assigning the (13)C and (1)H NMR chemical shifts of Carbamazepine. PMID:25682215

  11. Genotoxic assessment of oxcarbazepine and carbamazepine in drosophila wing spot test.

    Science.gov (United States)

    Sarikaya, Rabia; Yüksel, Muammer

    2008-09-01

    In this study, different concentrations of two antiepileptic drugs, carbamazepine (CBZ) and oxcarbazepine (OXC), have been evaluated for genotoxicity in the wing spot test of Drosophila melanogaster. The wing spot test detects different kinds of somatic mutations and allows detection of mitotic recombinations. Third-instar larvae trans-heterozygous for two genetic markers mwh and flr, were treated at different concentrations of the drugs. Oxcarbazepine exposure concentrations were 1.88, 3.75, 7.50 and 15microg/ml. Carbamazepine exposure concentrations were 5, 10, 20 and 40microg/ml. In addition, the observed mutations were classified according to size and type of mutation per wing. CBZ was genotoxic in terms of total mutations per wing in the highest two doses; the same was true for OXC in the highest three doses. Survival rates of flies used in the experiments were significantly lower than that of the control group showing both drugs to have toxic effects to Drosophila melanogaster larvae. Clone formation frequency for 10(5) cells was lower in OXC than CBZ. However this was lower than the critical genotoxicity frequency of 2.0. PMID:18656520

  12. Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

    Directory of Open Access Journals (Sweden)

    Okujava Michael

    2001-11-01

    Full Text Available Abstract Background and Purpose It is not known whether carbamazepine (CBZ; a drug widely used in neurology and psychiatry influences the blood oxygenation level dependent (BOLD contrast changes induced by neuronal activation and measured by functional MRI (fMRI. We aimed to investigate the influence of CBZ on memory induced activation of the mesial temporal lobes in patients with symptomatic temporal lobe epilepsy (TLE. Material and Methods Twenty-one individual patients with refractory symptomatic TLE with different CBZ serum levels and 20 healthy controls were studied using BOLD fMRI. Mesial temporal lobe (MTL activation was induced by a task that is based on the retrieval of individually familiar visuo-spatial knowledge. The extent of significant MTL fMRI activation was measured and correlated with the CBZ serum level. Results In TLE patients, the extent of significant fMRI activation over both MTL was negatively correlated to the CBZ serum level (Spearman r = -0.654, P Conclusions In TLE patients, carbamazepine reduces the fMRI-detectable changes within the mesial temporal lobes as induced by effortful memory retrieval. FMRI appears to be suitable to study the effects of chronic drug treatment in patients with epilepsy.

  13. Fate of carbamazepine, its metabolites, and lamotrigine in soils irrigated with reclaimed wastewater: Sorption, leaching and plant uptake.

    Science.gov (United States)

    Paz, Anat; Tadmor, Galit; Malchi, Tomer; Blotevogel, Jens; Borch, Thomas; Polubesova, Tamara; Chefetz, Benny

    2016-10-01

    Irrigation with reclaimed wastewater may result in the ubiquitous presence of pharmaceutical compounds (PCs) and their metabolites in the agroecosystem. In this study, we focused on two highly persistent anticonvulsant drugs, lamotrigine and carbamazepine and two of its metabolites (EP-CBZ and DiOH-CBZ), aiming to elucidate their behavior in agricultural ecosystem using batch and lysimeter experiments. Sorption of the studied compounds by soils was found to be governed mainly by the soil organic matter level. Sorption affinity of compounds to soils followed the order lamotrigine > carbamazepine > EP-CBZ > DiOH-CBZ. Sorption was reversible, and no competition between sorbates in bi-solute systems was observed. The results of the lysimeter studies were in accordance with batch experiment findings, demonstrating accumulation of lamotrigine and carbamazepine in top soil layers enriched with organic matter. Detection of carbamazepine and one of its metabolites in rain-fed wheat previously irrigated with reclaimed wastewater, indicates reversibility of their sorption, resulting in their potential leaching and their availability for plant uptake. This study demonstrates the long-term implication of introduction of PCs to the agroecosystem. PMID:27351902

  14. The use of quantum chemistry in pharmaceutical research as illustrated by case studies of indometacin and carbamazepine

    DEFF Research Database (Denmark)

    Gordon, Keith C; McGoverin, Cushla M; Strachan, Clare J;

    2007-01-01

    A number of case studies that illustrate how quantum chemistry may be used in studying pharmaceutical systems are reviewed. A brief introduction to quantum methods is provided and the use of these methods in understanding the structure and properties of indometacin and carbamazepine is discussed...

  15. Human Exposure to Wastewater-Derived Pharmaceuticals in Fresh Produce: A Randomized Controlled Trial Focusing on Carbamazepine.

    Science.gov (United States)

    Paltiel, Ora; Fedorova, Ganna; Tadmor, Galit; Kleinstern, Geffen; Maor, Yehoshua; Chefetz, Benny

    2016-04-19

    Fresh water scarcity has led to increased use of reclaimed wastewater as an alternative and reliable source for crop irrigation. Beyond microbiological safety, concerns have been raised regarding contamination of reclaimed wastewater by xenobiotics including pharmaceuticals. This study focuses on carbamazepine, an anticonvulsant drug which is ubiquitously detected in reclaimed wastewater, highly persistent in soil, and taken up by crops. In a randomized controlled trial we demonstrate that healthy individuals consuming reclaimed wastewater-irrigated produce excreted carbamazepine and its metabolites in their urine, while subjects consuming fresh water-irrigated produce excreted undetectable or significantly lower levels of carbamazepine. We also report that the carbamazepine metabolite pattern at this low exposure level differed from that observed at therapeutic doses. This "proof of concept" study demonstrates that human exposure to xenobiotics occurs through ingestion of reclaimed wastewater-irrigated produce, providing real world data which could guide risk assessments and policy designed to ensure the safe use of wastewater for crop irrigation. PMID:27021726

  16. Phytoremediation of carbamazepine and its metabolite 10,11-epoxycarbamazepine by C3 and C4 plants.

    Science.gov (United States)

    Ryšlavá, Helena; Pomeislová, Alice; Pšondrová, Šárka; Hýsková, Veronika; Smrček, Stanislav

    2015-12-01

    The anticonvulsant drug carbamazepine is considered as an indicator of sewage water pollution: however, its uptake by plants and effect on metabolism have not been sufficiently documented, let alone its metabolite (10,11-epoxycarbamazepine). In a model system of sterile, hydroponically cultivated Zea mays (as C4 plant) and Helianthus annuus (as C3 plant), the uptake and effect of carbamazepine and 10,11-epoxycarbamazepine were studied in comparison with those of acetaminophen and ibuprofen. Ibuprofen and acetaminophen were effectively extracted from drug-supplemented media by both plants, while the uptake of more hydrophobic carbamazepine was much lower. On the other hand, the carbamazepine metabolite, 10,11-epoxycarbamazepine, was, unlike sunflower, willingly taken up by maize plants (after 96 h 88 % of the initial concentration) and effectively stored in maize tissues. In addition, the effect of the studied pharmaceuticals on the plant metabolism (enzymes of Hatch-Slack cycle, peroxidases) was followed. The activity of bound peroxidases, which could cause xylem vessel lignification and reduction of xenobiotic uptake, was at the level of control plants in maize leaves contrary to sunflower. Therefore, our results indicate that maize has the potential to remove 10,11-epoxycarbamazepine from contaminated soils. PMID:26310701

  17. A 3-D hydrologic transport model of a water recharge system using carbamazepine and chloride as tracers

    Science.gov (United States)

    Rona, Michael; Gasser, Guy; Negev, Ido; Pankratov, Irena; Elhanany, Sara; Lev, Ovadia; Gvirtzman, Haim

    2014-05-01

    Wastewater recharge facilities are often used as a final water treatment before the discharge to the sea or before water reclamation. These facilities are often located in active aquifers that supply drinking water. Thus, leakage from the water recharge facility and gradual expansion of the underground wastewater plume are of considerable health concern. Hydrological modeling of water recharge systems are widely used as operational and predictive tools. These models rely on distributed water head monitoring and at least one chemical or physical tracer to model solutes' transport. Refractory micropollutants have proven useful in qualitative identification of pollution leakages and for quantification of pollution to a specific site near water recharge facilities. However, their usefulness as tracers for hydrological modeling is still questionable. In this article, we describe a long term, 3-D hydraulic model of a large-scale wastewater effluents recharge system in which a combination of chloride and a refractory micropollutant, carbamazepine is used to trace the solute transport. The combination of the two tracers provides the model with the benefits of the high specificity of the carbamazepine and the extensive historic data base that is available for chloride. The model predicts westward expansion of the pollution plume, whereas a standing front is formed at the east. These trends can be confirmed by the time trace of the carbamazepine concentrations at specific locations. We show that the combination of two tracers accounts better (at least at some locations) for the evolution of the pollution plume than a model based on chloride or carbamazepine alone.

  18. Do Carbamazepine, Gabapentin, or Other Anticonvulsants Exert Sufficient Radioprotective Effects to Alter Responses From Trigeminal Neuralgia Radiosurgery?

    International Nuclear Information System (INIS)

    Purpose: Laboratory studies have documented radioprotective effects with carbamazepine. We sought to determine whether carbamazepine or other anticonvulsant/neuroleptic drugs would show significant radioprotective effects in patients undergoing high-dose small-volume radiosurgery for trigeminal neuralgia. Methods and Materials: We conducted a retrospective review of 200 patients undergoing Gamma Knife (Elekta Instrument AB, Stockholm, Sweden) stereotactic radiosurgery for trigeminal neuralgia between February 1995 and May 2008. We selected patients treated with a maximum dose of 80 Gy with 4-mm diameter collimators, with no previous microvascular decompression, and follow-up ≥6 months (median, 24 months; range, 6–153 months). At the time of radiosurgery, 28 patients were taking no anticonvulsants, 62 only carbamazepine, 35 only gabapentin, 21 carbamazepine plus gabapentin, 17 carbamazepine plus other anticonvulsants, and 9 gabapentin plus other anticonvulsants, and 28 were taking other anticonvulsants or combinations. Results: Pain improvement developed post-radiosurgery in 187 of 200 patients (93.5%). Initial complete pain relief developed in 84 of 200 patients (42%). Post-radiosurgery trigeminal neuropathy developed in 27 of 200 patients (13.5%). We could not significantly correlate pain improvement or initial complete pain relief with use of carbamazepine, gabapentin, or use of any anticonvulsants/neuroleptic drugs or other factors in univariate or multivariate analysis. Post-radiosurgery numbness/paresthesias correlated with the use of gabapentin (1 of 36 patients with gabapentin vs. 7 of 28 without, p = 0.017). In multivariate analysis, decreasing age, purely typical pain, and use of gabapentin correlated (p = 0.008, p = 0.005, and p = 0.021) with lower risks of developing post-radiosurgery trigeminal neuropathy. New post-radiosurgery numbness/paresthesias developed in 3% (1 of 36), 5% (4 of 81), and 13% (23 of 187) of patients on gabapentin alone, with

  19. Do Carbamazepine, Gabapentin, or Other Anticonvulsants Exert Sufficient Radioprotective Effects to Alter Responses From Trigeminal Neuralgia Radiosurgery?

    Energy Technology Data Exchange (ETDEWEB)

    Flickinger, John C. [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); College of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA (United States); Kim, Hyun [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Kano, Hideyuki [Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Greenberger, Joel S.; Arai, Yoshio [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Niranjan, Ajay [Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Lunsford, L. Dade; Kondziolka, Douglas [Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Flickinger, John C., E-mail: flickingerjc@upmc.edu [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States)

    2012-07-15

    Purpose: Laboratory studies have documented radioprotective effects with carbamazepine. We sought to determine whether carbamazepine or other anticonvulsant/neuroleptic drugs would show significant radioprotective effects in patients undergoing high-dose small-volume radiosurgery for trigeminal neuralgia. Methods and Materials: We conducted a retrospective review of 200 patients undergoing Gamma Knife (Elekta Instrument AB, Stockholm, Sweden) stereotactic radiosurgery for trigeminal neuralgia between February 1995 and May 2008. We selected patients treated with a maximum dose of 80 Gy with 4-mm diameter collimators, with no previous microvascular decompression, and follow-up {>=}6 months (median, 24 months; range, 6-153 months). At the time of radiosurgery, 28 patients were taking no anticonvulsants, 62 only carbamazepine, 35 only gabapentin, 21 carbamazepine plus gabapentin, 17 carbamazepine plus other anticonvulsants, and 9 gabapentin plus other anticonvulsants, and 28 were taking other anticonvulsants or combinations. Results: Pain improvement developed post-radiosurgery in 187 of 200 patients (93.5%). Initial complete pain relief developed in 84 of 200 patients (42%). Post-radiosurgery trigeminal neuropathy developed in 27 of 200 patients (13.5%). We could not significantly correlate pain improvement or initial complete pain relief with use of carbamazepine, gabapentin, or use of any anticonvulsants/neuroleptic drugs or other factors in univariate or multivariate analysis. Post-radiosurgery numbness/paresthesias correlated with the use of gabapentin (1 of 36 patients with gabapentin vs. 7 of 28 without, p = 0.017). In multivariate analysis, decreasing age, purely typical pain, and use of gabapentin correlated (p = 0.008, p = 0.005, and p = 0.021) with lower risks of developing post-radiosurgery trigeminal neuropathy. New post-radiosurgery numbness/paresthesias developed in 3% (1 of 36), 5% (4 of 81), and 13% (23 of 187) of patients on gabapentin alone, with age

  20. Application of experimental design in examination of the dissolution rate of carbamazepine from formulations: Characterization of the optimal formulation by DSC, TGA, FT-IR and PXRD analysis

    Directory of Open Access Journals (Sweden)

    Krstić Marko

    2015-01-01

    Full Text Available Poor solubility is one of the key reasons for the poor bioavailability of these drugs. This paper displays a formulation of a solid surfactant system with carbamazepine, in order to increase its dissolution rate. Solid state surfactant systems are formed by application of fractal experimental design. Poloxamer 237 and Poloxamer 338 were used as surfactants and Brij® 35 was used as the co-surfactant. The ratios of the excipients and carbamazepine were varied and their effects on the dissolution rate of carbamazepine were examined. Moreover, the effects of the addition of natural (diatomite and a synthetic adsorbent carrier (Neusiline UFL2 on the dissolution rate of carbamazepine were also tested. The prepared surfactant systems were characterized and the influence of the excipients on possible changes of the polymorphous form of carbamazepine examined by application of analytical techniques (DSC, TGA, FT-IR, PXRD. It was determined that an appropriate selection of the excipient type and ratio could provide a significant increase in the carbamazepine dissolution rate. By application of analytical techniques, it was found that that the employed excipients induce a transition of carbamazepine into the amorphous form and that the selected sample was stable for three months, when kept under ambient conditions. [Projekat Ministarstva nauke Republike Srbije, br. TR34007

  1. Carbamazepine as indicator for potential short-term contamination of karst springs

    Science.gov (United States)

    Doummar, J.; Baierl, M.; Noedler, K.; Licha, T.; Sauter, M.; Geyer, T.

    2012-04-01

    Karst aquifers are complex systems which vulnerability is very difficult to assess mainly because of the duality of recharge processes and duality of flow. Recharge to a karst aquifer occurs as diffuse or concentrated (sinkholes and dolines). Moreover, karst aquifers are formed by an unsaturated zone comprising soil, epikarst and unsaturated rock matrix, and a saturated zone formed of highly permeable conduits and low permeability matrix storage. In the case of contamination of groundwater by wastewater effluent polluted water can be either transported rapidly and have short term major risk on spring water quality or infiltrate into fractured rock matrix and therefore have a long term effect on the water quality. In order to identify the risk of wastewater infiltrating into an aquifer, researches have focused to date on the identification of indicative wastewater markers. Carbamazepine (CBZ) was frequently detected in surface water as well as in effluents of sewage treatment plants, as less than 10% of carbamazepine are usually eliminated during sewage treatment. Moreover, CBZ is not attenuated in aquifers (Heberer, 2002), is unlikely degradable or adsorbed, and can be detected in groundwater (Clara et al., 2004). Therefore, CBZ is considered to be fairly persistent in groundwater (Tixier et al., 2003), and is consequently regarded as an effective wastewater marker. In this case study, the Jeita spring in Lebanon (spring discharge: 1-20 m3/s) was monitored and sampled for major ions and micro-pollutants following a combined precipitation/snowmelt events. A total of 28 samples (major ions and micro-pollutants) were taken over a total sampling time of 16 days at interval varying between 4 and 24 hours. Based on the variation with time of discharge and electrical conductivity (monitored every 20 minutes) as well as the concentrations of the major ions, a conceptual model showing the response of the aquifer compartments to the precipitation event was generated. A

  2. CORRELATION OF THE SERUM LEVEL OF CARBAMAZEPINE WITH SEIZURE CONTROL AND ADVERSE DRUG REACTIONS AMONG EPILEPTICS IN IBADAN, NIGERIA

    Directory of Open Access Journals (Sweden)

    Joseph O. Fadare

    2010-12-01

    Full Text Available Background: Epilepsy is a chronic neurological disorder requiring long-term treatment. Seizure control requires adequate blood levels of anti-seizure drugs. Carbarmazepine is one of the most prescribed antiepileptic drugs in Nigeria. This study was carried out to investigate the correlation between serum levels of carbamazepine and seizure control and adverse drug reactions among epileptics in Ibadan, Nigeria. Methods: In a cross-sectional study, sixty-nine patients with confirmed diagnosis of epilepsy who had been on treatment with carbamazepine alone or in combination with phenytoin for at least one month were enrolled into the study and divided into two groups based on seizure control. Drug level in pre-dose (steady state venous blood was analyzed using high performance liquid chromatography. Result: The mean serum concentration of carbamazepine (CBZ and carbamazepine-epoxide (CBZ-EP was 13.5±9.3ìg/mL and 6.34±12.61ìg/mL respectively. Patients with good seizure control had mean serum CBZ concentration of 12.7 ± 9.2ìg/mL versus 15.02 ± 9.7ìg/mL among patients with poor seizure control (P=0.33. The serum concentration of CBZ-EP in patients with good seizure control was 8.05 ± 15.2ìg/mL while it was 3.11 ± 3.5ìg/mL in the second group (P=0.122. Drowsiness was the commonest adverse drug reaction (26.1% and it did not necessitate withdrawal of the drug. Conclusion The study showed that serum level of carbamazepine does not correlate with seizure control and adverse drug reactions.

  3. Changes in unbound and total valproic acid concentrations after replacement of carbamazepine with oxcarbazepine.

    Science.gov (United States)

    Battino, D; Croci, D; Granata, T; Bernardi, G; Monza, G

    1992-10-01

    Total and free valproic acid (VPA) concentrations were measured in patients switched from a combined VPA and carbamazepine (CBZ) to a combined VPA and oxcarbazepine (OXC) therapy, both administered in individualized daily doses. Four young epileptic patients (13-17 years old) were studied for a 12-week period, total and free VPA concentrations being analyzed just before and 4 h after the morning dose, at the end of VPA and CBZ therapy, and 2 and 10 weeks after CBZ was replaced by OXC. The expected increase in the level/dose (L/D) ratio of total VPA observed at the end of the study was preceded by a clear-cut increase in the L/D ratio of free VPA, which led to VPA-related side effects and required the retitration of VPA daily doses. PMID:1448844

  4. A within-subject analysis of carbamazepine disposition related to development in children with epilepsy.

    Science.gov (United States)

    Albani, F; Riva, R; Contin, M; Baruzzi, A

    1992-12-01

    The effect of aging on carbamazepine (CBZ) plasma level/dose ratio was evaluated retrospectively in 15 children who were receiving CBZ monotherapy and who were followed up for at least 3 years. Subjects of the study were selected from a population of roughly 4,500 patients attending our therapeutic drug monitoring service during a 12-year period. Results showed that the CBZ plasma level/dose ratio increases within subject during childhood, in agreement with data obtained in between-patient studies. However, the increase is not linear with age, the greatest modifications being observed between 9 and 13 years of age. Weight gain alone does not seem to explain this finding, implicating the involvement of complex physiological changes occurring during puberty. PMID:1485365

  5. Removal of carbamazepine and clofibric acid from water using double templates-molecularly imprinted polymers.

    Science.gov (United States)

    Dai, Chao-meng; Zhang, Juan; Zhang, Ya-lei; Zhou, Xue-fei; Duan, Yan-ping; Liu, Shu-guang

    2013-08-01

    A novel double templates-molecularly imprinted polymer (MIP) was prepared by precipitation polymerization using carbamazepine (CBZ) and clofibric acid (CA) as the double templates molecular and 2-vinylpyridine as functional monomer. The equilibrium data of MIP was well described by the Freundlich isotherm model. Two kinetic models were adopted to describe the experimental data, and the pseudo second-order model well-described adsorption of CBZ and CA on the MIP. Adsorption experimental results showed that the MIP had good selectivity and adsorption capacity for CBZ and CA in the presence of competitive compounds compared with non-imprinted polymer, commercial powdered activated carbon, and C18 adsorbents. The feasibility of removing CBZ and CA from water by the MIP was demonstrated using tap water, lake water, and river water. PMID:23436062

  6. Photochemical degradation of atenolol, carbamazepine, meprobamate, phenytoin and primidone in wastewater effluents

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Mei Mei [Civil, Environmental and Architectural Engineering, 428 UCB, University of Colorado, Boulder, CO 80309 (United States); Southern Nevada Water Authority (SNWA), P.O. Box 99954, Las Vegas, NV 89193-9954 (United States); Trenholm, Rebecca [Southern Nevada Water Authority (SNWA), P.O. Box 99954, Las Vegas, NV 89193-9954 (United States); Rosario-Ortiz, Fernando L., E-mail: Fernando.rosario@colorado.edu [Civil, Environmental and Architectural Engineering, 428 UCB, University of Colorado, Boulder, CO 80309 (United States)

    2015-01-23

    Highlights: • The photochemical degradation of 5 compounds was evaluated in wastewater effluents. • Attenuation by sensitized photolysis was the most important degradation pathway. • Hydroxyl radical accounted for most of the degradation for aliphatic compounds. • Other transient oxidants could also significantly impact the degradation of the compounds. - Abstract: The photochemical degradation of five pharmaceuticals was examined in two secondary wastewater effluents. The compounds, which included atenolol, carbamazepine, meprobamate, phenytoin and primidone, were evaluated for both direct and sensitized photolysis. In the two wastewaters, direct photolysis did not lead to significant compound degradation; however, sensitized photolysis was an important removal pathway for the five pharmaceuticals. Upon solar irradiation, hydroxyl radical (HO·) was quantified using the hydroxylation of benzene and singlet oxygen ({sup 1}O{sub 2}) formation was monitored following the degradation of furfuryl alcohol. Degradation via sensitized photolysis was observed following five-day exposures for atenolol (69–91%), carbamazepine (67–98%), meprobamate (16–52%), phenytoin (44–85%), and primidone (34–88%). Varying removal is likely a result of the differences in reactivity with transient oxidants. Averaged steady state HO· concentrations ranged from 1.2 to 4.0 × 10{sup −16} M, whereas the concentrations of {sup 1}O{sub 2} were 6.0–7.6 × 10{sup −14} M. Partial removal due to presence of HO· indicates it was not the major sink for most compounds examined. Other transient oxidants, such as {sup 1}O{sub 2} and triplet state effluent organic matter, are likely to play important roles in fates of these compounds.

  7. Carbamazepine suppresses calpain-mediated autophagy impairment after ischemia/reperfusion in mouse livers

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae-Sung, E-mail: Jae.Kim@surgery.ufl.edu; Wang, Jin-Hee, E-mail: jin-hee.wang@surgery.ufl.edu; Biel, Thomas G., E-mail: Thomas.Biel@surgery.ufl.edu; Kim, Do-Sung, E-mail: do-sung.kim@surgery.med.ufl.edu; Flores-Toro, Joseph A., E-mail: Joseph.Flores-Toro@surgery.ufl.edu; Vijayvargiya, Richa, E-mail: rvijayvargiya@ufl.edu; Zendejas, Ivan, E-mail: ivan.zendejas@surgery.ufl.edu; Behrns, Kevin E., E-mail: Kevin.Behrns@surgery.ufl.edu

    2013-12-15

    Onset of the mitochondrial permeability transition (MPT) plays a causative role in ischemia/reperfusion (I/R) injury. Current therapeutic strategies for reducing reperfusion injury remain disappointing. Autophagy is a lysosome-mediated, catabolic process that timely eliminates abnormal or damaged cellular constituents and organelles such as dysfunctional mitochondria. I/R induces calcium overloading and calpain activation, leading to degradation of key autophagy-related proteins (Atg). Carbamazepine (CBZ), an FDA-approved anticonvulsant drug, has recently been reported to increase autophagy. We investigated the effects of CBZ on hepatic I/R injury. Hepatocytes and livers from male C57BL/6 mice were subjected to simulated in vitro, as well as in vivo I/R, respectively. Cell death, intracellular calcium, calpain activity, changes in autophagy-related proteins (Atg), autophagic flux, MPT and mitochondrial membrane potential after I/R were analyzed in the presence and absence of 20 μM CBZ. CBZ significantly increased hepatocyte viability after reperfusion. Confocal microscopy revealed that CBZ prevented calcium overloading, the onset of the MPT and mitochondrial depolarization. Immunoblotting and fluorometric analysis showed that CBZ blocked calpain activation, depletion of Atg7 and Beclin-1 and loss of autophagic flux after reperfusion. Intravital multiphoton imaging of anesthetized mice demonstrated that CBZ substantially reversed autophagic defects and mitochondrial dysfunction after I/R in vivo. In conclusion, CBZ prevents calcium overloading and calpain activation, which, in turn, suppresses Atg7 and Beclin-1 depletion, defective autophagy, onset of the MPT and cell death after I/R. - Highlights: • A mechanism of carbamazepine (CBZ)-induced cytoprotection in livers is proposed. • Impaired autophagy is a key event contributing to lethal reperfusion injury. • The importance of autophagy is extended and confirmed in an in vivo model. • CBZ is a potential

  8. Carbamazepine suppresses calpain-mediated autophagy impairment after ischemia/reperfusion in mouse livers

    International Nuclear Information System (INIS)

    Onset of the mitochondrial permeability transition (MPT) plays a causative role in ischemia/reperfusion (I/R) injury. Current therapeutic strategies for reducing reperfusion injury remain disappointing. Autophagy is a lysosome-mediated, catabolic process that timely eliminates abnormal or damaged cellular constituents and organelles such as dysfunctional mitochondria. I/R induces calcium overloading and calpain activation, leading to degradation of key autophagy-related proteins (Atg). Carbamazepine (CBZ), an FDA-approved anticonvulsant drug, has recently been reported to increase autophagy. We investigated the effects of CBZ on hepatic I/R injury. Hepatocytes and livers from male C57BL/6 mice were subjected to simulated in vitro, as well as in vivo I/R, respectively. Cell death, intracellular calcium, calpain activity, changes in autophagy-related proteins (Atg), autophagic flux, MPT and mitochondrial membrane potential after I/R were analyzed in the presence and absence of 20 μM CBZ. CBZ significantly increased hepatocyte viability after reperfusion. Confocal microscopy revealed that CBZ prevented calcium overloading, the onset of the MPT and mitochondrial depolarization. Immunoblotting and fluorometric analysis showed that CBZ blocked calpain activation, depletion of Atg7 and Beclin-1 and loss of autophagic flux after reperfusion. Intravital multiphoton imaging of anesthetized mice demonstrated that CBZ substantially reversed autophagic defects and mitochondrial dysfunction after I/R in vivo. In conclusion, CBZ prevents calcium overloading and calpain activation, which, in turn, suppresses Atg7 and Beclin-1 depletion, defective autophagy, onset of the MPT and cell death after I/R. - Highlights: • A mechanism of carbamazepine (CBZ)-induced cytoprotection in livers is proposed. • Impaired autophagy is a key event contributing to lethal reperfusion injury. • The importance of autophagy is extended and confirmed in an in vivo model. • CBZ is a potential

  9. Photochemical degradation of atenolol, carbamazepine, meprobamate, phenytoin and primidone in wastewater effluents

    International Nuclear Information System (INIS)

    Highlights: • The photochemical degradation of 5 compounds was evaluated in wastewater effluents. • Attenuation by sensitized photolysis was the most important degradation pathway. • Hydroxyl radical accounted for most of the degradation for aliphatic compounds. • Other transient oxidants could also significantly impact the degradation of the compounds. - Abstract: The photochemical degradation of five pharmaceuticals was examined in two secondary wastewater effluents. The compounds, which included atenolol, carbamazepine, meprobamate, phenytoin and primidone, were evaluated for both direct and sensitized photolysis. In the two wastewaters, direct photolysis did not lead to significant compound degradation; however, sensitized photolysis was an important removal pathway for the five pharmaceuticals. Upon solar irradiation, hydroxyl radical (HO·) was quantified using the hydroxylation of benzene and singlet oxygen (1O2) formation was monitored following the degradation of furfuryl alcohol. Degradation via sensitized photolysis was observed following five-day exposures for atenolol (69–91%), carbamazepine (67–98%), meprobamate (16–52%), phenytoin (44–85%), and primidone (34–88%). Varying removal is likely a result of the differences in reactivity with transient oxidants. Averaged steady state HO· concentrations ranged from 1.2 to 4.0 × 10−16 M, whereas the concentrations of 1O2 were 6.0–7.6 × 10−14 M. Partial removal due to presence of HO· indicates it was not the major sink for most compounds examined. Other transient oxidants, such as 1O2 and triplet state effluent organic matter, are likely to play important roles in fates of these compounds

  10. Combining boron isotopes and carbamazepine to trace sewage in salinized groundwater: A case study in Cap Bon, Tunisia

    International Nuclear Information System (INIS)

    Highlights: • Boron isotopes and carbamazepine contents were combined to assess groundwater contamination by effluents. • Carbamazepine contents ranged from 20 to 900 ng/L in groundwaters mixed with treated wastewaters. • The chemical and isotopic data showed a high spatial and temporal variability. • The system is highly vulnerable and permanently disturbed by the different temporal dynamics. • Wastewater treatments need to be greatly improved before recharge to prevent further degradation of groundwater quality. - Abstract: The Korba aquifer on the east coast of Cape Bon has been overexploited since the 1960s with a resultant reversal of the hydraulic gradient and a degradation of the quality due to seawater intrusion. In 2008 the authorities introduced integrated water resources planning based on a managed aquifer recharge with treated wastewater. Water quality monitoring was implemented in order to determine the different system components and trace the effectiveness of the artificial recharge. Groundwater samples taken from recharge control piezometers and surrounding farm wells were analyzed for their chemical contents, for their B isotopes, a proven tracer of groundwater salinization and domestic sewage, and their carbamazepine content, an anti-epileptic known to pass through wastewater treatment and so recognized as a pertinent tracer of wastewater contamination. The system equilibrium was permanently disturbed by the different temporal dynamics of continuous processes such as cation exchange, and by threshold processes linked to oxidation–reduction conditions. The B isotopic compositions significantly shifted back-and-forth due to mixing with end-members of various origin. Under the variable contribution of meteoric recharge, the Plio-Quaternary groundwater (δ11B of 35–40.6‰, a mean B concentration of 30 μmol/L, no carbamazepine, n = 7) was subject to seawater intrusion that induced a high δ11B level (δ11B of 41.5–48.0‰, a mean B

  11. Competitive sorption of atenolol, trimetoprim, carbamazepine and sulfamethoxazole in three soil types

    Science.gov (United States)

    Kočárek, Martin; Kodešová, Radka; Klement, Aleš; Golovko, Oksana; Fér, Miroslav; Nikodem, Antonín; Vondráčková, Lenka; Jakšík, Ondřej; Grabic, Roman

    2016-04-01

    Transport of human and veterinary pharmaceuticals in soils and consequent ground-water contamination are influenced by many factors, including compound sorption on soil particles and dissipation. Batch sorption experiment for 9 soils (3 soil types with 3 (Greyic Phaeozem on loess), 4 (Haplic Luvisol on loess) and 2 (Haplic Cambisol on gneiss) horizons) and mixture of 4 pharmaceuticals (atenolol, trimetoprim, carbamazepine and sulfamethoxazole) was performed to study competitive sorption of compounds in each soil sample. Sorption affinities and dissipation half-lives of all compounds in topsoils were previously studied by Kodešová et al. (2015 and 2016). Ten grams of dry soil was placed directly into the plastic centrifuge tubes and 20 ml of solution of a known pharmaceutical concentration was added. The same concentrations (0.5, 1, 2.5, 5 and 10 mg/l) were used for all compounds. Three replicates of each concentration were applied for each soil. Tube was shaken for 24 h using the shaking apparatus at 20 C. After shaking, the analyzed soil suspension was centrifuged for 10 min at 6,000 rotations per minute. The actual initial and final equilibrium pharmaceutical concentrations were measured using two-dimensional liquid chromatography-tandem mass spectrometry LC/LC-MS/MS using isotope dilution and internal standard methods. The pharmaceutical concentration adsorbed on soil particles was calculated using the initial and final (i.e. after incubation) pharmaceutical concentrations. The Freundlich equations were used to fit data points of the measured adsorption isotherms. In the case of carbamazepine (neutral form) and sulfamethoxazole (partly negatively charged) sorption affinity of compounds decrease with soil depth. On the other hand in the case of atenolol and trimethoprim (both positively charged) compound sorption affinity was not depth dependent. Data obtained for top soils were compared with sorption affinities for single compounds published by (Kodešová et

  12. Electro-oxidation of carbamazepine metabolites: Characterization and influence in the voltammetric determination of the parent drug

    OpenAIRE

    Ginja Teixeira, Jorge; Veiga, Alfredina; Palace Carvalho, Alfredo J.; Martins Teixeira, Dora

    2013-01-01

    Abstract The electro-oxidation behavior of five important metabolites of carbamazepine (CBZ) and their potential influence on the voltammetric determination of the parent drug in biological fluids was investigated for the first time. This investigation was performed using cyclic voltammetry, in combination with controlled potential electrolysis and HPLC-DAD-MS analysis of oxidation products of these compounds. Using a sensitive glassy carbon electrode modified with multi-walled carbon nan...

  13. Chemometrics enhanced HPLC-DAD performance for rapid quantification of carbamazepine and phenobarbital in human serum samples.

    Science.gov (United States)

    Vosough, Maryam; Ghafghazi, Shiva; Sabetkasaei, Masoumeh

    2014-02-01

    This paper describes development and validation of a simple and efficient bioanalytical procedure for simultaneous determination of phenobarbital and carbamazepine in human serum samples using high performance liquid chromatography with photodiode-array detection (HPLC-DAD) regarding a fast elution methodology in less than 5 min. Briefly, this method consisted of a simple deproteinization step of serum samples followed by HPLC analysis on a Bonus-RP column using an isocratic mode of elution with acetonitrile/K2HPO4 (pH=7.5) buffer solution (45:55). Due to the presence of serum endogenous components as non-calibrated components in the sample, second-order calibration based on multivariate curve resolution-alternating least squares (MCR-ALS), has been applied on a set of absorbance matrices collected as a function of retention time and wavelengths. Acceptable resolution and quantification results were achieved in the presence of matrix interferences and the second-order advantage was fully exploited. The average recoveries for carbamazepine and phenobarbital were 89.7% and 86.1% and relative standard deviation values were lower than 9%. Additionally, computed elliptical joint confidence region (EJCR) confirmed the accuracy of the proposed method and indicated the absence of both constant and proportional errors in the predicted concentrations. The developed method enabled the determination of the analytes in different serum samples in the presence of overlapped profiles, while keeping experimental time and extraction steps at minimum. Finally, the serum concentration levels of carbamazepine in three time intervals were reported for morphine-dependents who had received carbamazepine for treating their neuropathic pain. PMID:24401380

  14. A study of the use of carbamazepine, pregabalin and alpha lipoic acid in patients of diabetic neuropathy

    OpenAIRE

    Patel, Niral; Mishra, Vishal; Patel, Prakruti; Ram K Dikshit

    2014-01-01

    Background Diabetic peripheral neuropathy (DPN) is a common, symptomatic, long-term complication of diabetes mellitus. Many of the agents used to treat DN have not been compared with each other. This study was, therefore, undertaken to compare the efficacy and safety of carbamazepine, pregabalin and alpha-lipoic acid in diabetic neuropathy patients. Methods This was a prospective, observational study. The patients were categorized into three groups, Group I included those patients who were pr...

  15. Prevalence of Side Effects Treatment with Carbamazepine and Other Antiepileptics in Patients with Epilepsy

    Science.gov (United States)

    Koliqi, Rozafa; Polidori, Carlo; Islami, Hilmi

    2015-01-01

    Objective: This paper reveals the studies of carbamazepine monitoring in the manifestation of side effects during clinical use. It is important to realize that these ranges are derived statistically, with most patients who have high levels suffering side effects and some with poor control having low levels. Broadly, the newer agents have advantages of lower risk of side effects and less drug interaction. At the presence they are more expensive than the, than “older” agents. Current recommendations and practice are to use newer agents as second line drugs, although in some countries there are gaining favour as potential first line agents. Methods: In the study 91 patients with epilepsy were involved from which 53 or 58.2% were female and 38 or 41.8% were male with no great significant difference between two genders (X2=2.47, P=0.116). However, according to the study results female patients had slightly greater prevalence of epilepsy than man. Average age of epileptic patients was 23.2 years (SD ± 16.4 years), in the range 1–66 years. Patient distribution was present within all age-groups, but 59.4% of all patients were up to 20 years old. The highest prevalence of epilepsy was in the group age 6-15 years old: 33.0%. There were also children 1 – 5 years old with 7 or 7.7% of the patients, and the patients older than 60 years with 4 or 4.4% of the patients. Patient distribution according to the age and gender results with no female patient over 60 year old and more female patients in the age group 1-5 years. However statistically this did not produce a highly significant difference (T-test= 0.72, P=0.437) between average age according to the gender. The average age of the female gender was 22.1 year (SD ± 14.2 years), with the range 2-55 years, while the average age of the male patients was 24.6 year (SD ±19.2 years), with the range 1-66 years. Conclusion: Unwanted side effects of antiepileptic drugs analyzed in the study are frequent, but not so severe as

  16. Region-selective effects of long-term lithium and carbamazepine administration on cyclic AMP levels in rat brain

    International Nuclear Information System (INIS)

    The effect of lithium and carbamazepine in the treatment of bipolar affective disorder is well established. Althougt a number of biochemical effects have been found, the exact molecular mechanisms underlying their therapeutic actions have not been elucidated nor are the target regions in the brain identified. Taken into account the important role of the cyclic AMP second messenger system in the regulation of neuronal exitability and the indications of its involvement in the pathophysiology of bipolar affective disorder, we have focused on the drug effects on cyclic AMP levels. The objectives of this investigation were to measure the effects on basal cyclic AMP levels, and to locate target regions within the rat brain after long-term administration of lithium and carbamazepine. Drug treatments were carried out for a period of 28 days. After either drug treatment the cyclic AMP level was increased 3-4 times in frontal cortex but unchanged in hippocampus, hypothalamus, thalamus, amygdala and in cerebellum. In neostratum the cyclic AMP level was decreased to about 30% after treatment with lithium. We suggest the common region-selective effect, observed for both drugs in frontal cortex, to be essential for the therapeutic actions of lithium and carbamazepine. (au)

  17. (1)H NMR-based metabolomics of Daphnia magna responses after sub-lethal exposure to triclosan, carbamazepine and ibuprofen.

    Science.gov (United States)

    Kovacevic, Vera; Simpson, André J; Simpson, Myrna J

    2016-09-01

    Pharmaceuticals and personal care products are a class of emerging contaminants that are present in wastewater effluents, surface water, and groundwater around the world. There is a need to determine rapid and reliable bioindicators of exposure and the toxic mode of action of these contaminants to aquatic organisms. (1)H nuclear magnetic resonance (NMR)-based metabolomics in combination with multivariate statistical analysis was used to determine the metabolic profile of Daphnia magna after exposure to a range of sub-lethal concentrations of triclosan (6.25-100μg/L), carbamazepine (1.75-14mg/L) and ibuprofen (1.75-14mg/L) for 48h. Sub-lethal triclosan exposure suggested a general oxidative stress condition and the branched-chain amino acids, glutamine, glutamate, and methionine emerged as potential bioindicators. The aromatic amino acids, serine, glycine and alanine are potential bioindicators for sub-lethal carbamazepine exposure that may have altered energy metabolism. The potential bioindicators for sub-lethal ibuprofen exposure are serine, methionine, lysine, arginine and leucine, which showed a concentration-dependent response. The differences in the metabolic changes were related to the dissimilar modes of toxicity of triclosan, carbamazepine and ibuprofen. (1)H NMR-based metabolomics gave an improved understanding of how these emerging contaminants impact the keystone species D. magna. PMID:26809854

  18. A new herb–drug interaction of Polygonum cuspidatum, a resveratrol‐rich nutraceutical, with carbamazepine in rats

    Energy Technology Data Exchange (ETDEWEB)

    Chi, Ying-Chang [Graduate Institute of Pharmaceutical Chemistry, China Medical University, Taichung, 40402, Taiwan (China); Lin, Shiuan-Pey [School of Pharmacy, China Medical University, Taichung, 40402, Taiwan (China); Hou, Yu-Chi, E-mail: hou5133@gmail.com [School of Pharmacy, China Medical University, Taichung, 40402, Taiwan (China); Department of Medical Research, China Medical University Hospital, Taichung, 40402, Taiwan (China)

    2012-09-15

    Carbamazepine (CBZ), an antiepileptic with narrow therapeutic window, is a substrate of CYP 3A which metabolizes CBZ to carbamazepine-10,11-epoxide (CBZE), an active metabolite. This study investigated the acute and chronic effects of Polygonum cuspidatum (PC), a resveratrol‐rich nutraceutical, on the pharmacokinetics of CBZ in rats and the underlying mechanisms. Rats were orally administered CBZ (200 mg/kg) alone and coadministered with a single dose and the 7th dose of PC (2 g/kg) in a crossover design. The concentrations of CBZ and CBZE in serum and various tissues were determined by HPLC method. The results showed that PC significantly increased the AUC{sub 0-t} of CBZ and CBZE, whereas the formation rate of CBZE was decreased. Tissue analysis showed that the concentrations of CBZ and CBZE in brain, liver and kidney were significantly increased by PC. Cell studies indicated that the efflux function of MRP 2 was inhibited by the serum metabolites of PC. In conclusion, PC markedly increased the systemic exposure and brain concentration of CBZ and CBZE through inhibiting the activities of CYP 3A and MRP 2. Highlights: ► Polygonum cuspidatum elevated brain carbamazepine (CBZ) levels. ► Polygonum cuspidatum inhibited the activities of CYP 3A and MRP 2. ► Coadministration of PC with CBZ may enhance efficacy or toxicity.

  19. Comparison of a high-performance liquid chromatography method for quantification of carbamazepine with chemiluminescent microparticle immunoassay.

    Science.gov (United States)

    Guerrero Garduño, Óscar; González-Esquivel, Dinora F; Escalante-Membrillo, Carmen; Fernández, Ángeles; Rojas-Tomé, Irma Susana; Jung Cook, Helgi; Castro, Nelly

    2016-06-01

    Carbamazepine is an antiepileptic drug widely used for the treatment of epilepsy. In the National Institute of Neurology, monitoring has been performed using the technique chemiluminescent microparticle immunoassay (CMIA) in an automated way during the last five years. The aim of this study was to develop a simple and rapid HPLC analytical method coupled to DAD-UV detection for the determination of plasma concentrations of carbamazepine and compare its feasibility with those used in routine analysis. The developed HPLC method was fully validated and the applicability of the proposed method was verified through the analysis of plasma samples of patients and later compared with the quantification of the same plasma samples with the CMIA method. The limit of quantification obtained was 0.5 μg/mL. The mean value for recovery was 99.05% and the coefficient of variation (CV) was 5.6%. The precision and accuracy of this method were within the acceptable limits; inter- and intraday CV values were method and the developed HPLC method was very good (r ≈ 0.999). A Bland-Altman plot showed no significant bias between the results. The HPLC-DAD method may be an alternative to determine and monitoring the carbamazepine levels in human plasma or serum. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26433002

  20. A new herb–drug interaction of Polygonum cuspidatum, a resveratrol‐rich nutraceutical, with carbamazepine in rats

    International Nuclear Information System (INIS)

    Carbamazepine (CBZ), an antiepileptic with narrow therapeutic window, is a substrate of CYP 3A which metabolizes CBZ to carbamazepine-10,11-epoxide (CBZE), an active metabolite. This study investigated the acute and chronic effects of Polygonum cuspidatum (PC), a resveratrol‐rich nutraceutical, on the pharmacokinetics of CBZ in rats and the underlying mechanisms. Rats were orally administered CBZ (200 mg/kg) alone and coadministered with a single dose and the 7th dose of PC (2 g/kg) in a crossover design. The concentrations of CBZ and CBZE in serum and various tissues were determined by HPLC method. The results showed that PC significantly increased the AUC0-t of CBZ and CBZE, whereas the formation rate of CBZE was decreased. Tissue analysis showed that the concentrations of CBZ and CBZE in brain, liver and kidney were significantly increased by PC. Cell studies indicated that the efflux function of MRP 2 was inhibited by the serum metabolites of PC. In conclusion, PC markedly increased the systemic exposure and brain concentration of CBZ and CBZE through inhibiting the activities of CYP 3A and MRP 2. Highlights: ► Polygonum cuspidatum elevated brain carbamazepine (CBZ) levels. ► Polygonum cuspidatum inhibited the activities of CYP 3A and MRP 2. ► Coadministration of PC with CBZ may enhance efficacy or toxicity.

  1. Degradation of the endocrine disrupting chemicals (EDCs) carbamazepine, clofibric acid, and iopromide by corona discharge over water.

    Science.gov (United States)

    Krause, Holger; Schweiger, Bianca; Schuhmacher, Jörg; Scholl, Saskia; Steinfeld, Ute

    2009-04-01

    Common wastewater treatment plants often do not eliminate endocrine disrupting chemicals (EDCs). Aqueous solutions of three EDCs were treated with an enhanced corona discharge technology. The three EDCs were clofibric acid, a blood lipid regulator, carbamazepine, an antiepileptic drug, and iopromide, a contrast media. To simulate real conditions, EDC solutions containing landfill leachate were also used. In our setup, two barrier electrodes provided an atmospheric pressure corona discharge over a thin water film, in which the counter-electrode was submerged. Clofibric acid, carbamazepine, and iopromide were effectively removed from a single solution. After a treatment of 15min, there were no traces of iopromide estrogen activity either as a single substance or as degradation products when using an E-Screen Assay. Continuous treatment was compared with pulsed treatment using carbamazepine solutions mixed with pretreated landfill leachate. Best degradation results were achieved with a 500 W continuous duty cycle treatment. Counter-electrodes from materials such as boron doped diamond (BDD), titanium iridium oxide, and iron were investigated for their influences on the process effectivity. Significant improvements were achieved by using an enclosed reactor, BDD electrodes, and circulating only a fresh air or argon/air mixture as cooling gas through the barrier electrodes. PMID:19150730

  2. Biosorption of clofibric acid and carbamazepine in aqueous solution by agricultural waste rice straw.

    Science.gov (United States)

    Liu, Zhanguang; Zhou, Xuefei; Chen, Xiaohua; Dai, Chaomeng; Zhang, Juan; Zhang, Yalei

    2013-12-01

    Due to their widespread use, clofibric acid (CA) and carbamazepine (CBZ) have been frequently detected simultaneously at relatively high concentrations in aquatic environments. In this study, agricultural waste rice straw was employed as a potentially low-cost, effective and easy-to-operate biosorbent (RSB) to remove CA and CBZ. The adsorption of both pharmaceuticals followed pseudo second-order kinetics, and intraparticle diffusion was an important rate-limiting step. The adsorption isotherms of both drugs were fit well with Freundlich model. The adsorption of CA onto RSB was exothermic and was more likely to be dominated by physical processes, while the adsorption of CBZ was endothermic. Solution pH was determined to be the most important factor for CA adsorption, such that the adsorption capacity of CA onto RSB increased with the decline of solution pH. In the lower range of solution pH below 3.1, the CA removal efficiency was enhanced with the increase of biosorbent dosage. The CBZ removal efficiency was enhanced with the increase of RSB dosage without pH control. The maximum adsorption capacities were 126.3 mg/g for CA and 40.0 mg/g for CBZ. PMID:24649668

  3. Preparation and evaluation of polymeric carbamazepin spherical crystals by emulsion solvent diffusion technique

    Directory of Open Access Journals (Sweden)

    Yadav Adhikrao

    2009-01-01

    Full Text Available In this study, a significant effect of different polymers on improving the solubility, dissolution rate, and physicochemical properties of carbamazepine (CBZ has been demonstareted by emulsion solvent diffusion technique, with ethanol-chloroform-water as the solvent system. The hydrophilic polymers like polyethylene glycol, chitosan, and hydrophobic polymer Eudragit RSPO were used in the recrystallization process. The pure drug CBZ and the prepared spherical crystals of CBZ with different polymers were characterized in terms of morphology (microscopical photograph, X-ray diffraction (XRD, Fourier transform infrared spectroscopy (FTIR, drug contents, solubility, dissolution rate, crushing strength, wettability, flowability, and packability. The FTIR spectra of the prepared spherical crystals showed that changes in the chemical nature occur and do not present great fingerprint difference. The XRD also revealed a characteristic decrease in crystallinity. The solubility and dissolution studies demonstrated a marked increase in solubility and dissolution rate in comparison with the pure drug. The prepared spherical crystals with different polymers exhibited excellent physicochemical properties like flowability, packability, and wettability compared with the pure drug. The spherical crystals with polyethylene glycol and chitosan showed higher crushing strength when compared with the hydrophobic polymer (Eudragit RSPO.

  4. Solar photo-Fenton like using persulphate for carbamazepine removal from domestic wastewater.

    Science.gov (United States)

    Ahmed, Moussa Mahdi; Chiron, Serge

    2014-01-01

    This work aimed at decontaminating biologically treated domestic wastewater effluent from pharmaceutical residues by using sulphate radical based homogeneous photo-Fenton involving persulphate (PS) as an oxidant, ferrous iron (Fe(II)) as a catalyst and simulated solar irradiation as a light source. This is the first time that the beneficiary use of solar energy in PS/Fe(II)/UV-Vis system was evaluated by using carbamazepine (CBZ) as a probe compound. In wastewater, CBZ was fully degraded in 30 min for an initial CBZ concentration of 50 μM and an optimal PS:Fe(II) molar ratio of 2:1 thanks to the high selectivity in reactivity of the sulphate radical limiting scavenging effects of organic matter and inorganic ions. Seventeen by-products were identified using liquid chromatography-high resolution-mass spectrometry allowing for the establishment of degradation pathways. CBZ first underwent degradation through one electron transfer oxidation processes due to sulphate radical reactivity followed by hydroxylation processes through hydroxyl radical formed by Fe(III) photoreduction. The sequential generation of sulphate radical and hydroxyl radical has made PS/Fe(II)/UV-Vis a kinetically effective process in removing CBZ from wastewater without the accumulation of toxic intermediates and opens new remediation strategies for tertiary treatment in domestic wastewater treatment plants. PMID:24095595

  5. [Improvement of peduncular hallucinosis by surgical resection and carbamazepin administration in a young patient with pineocytoma].

    Science.gov (United States)

    Kawabori, Masahito; Sawamura, Yutaka; Iwasaki, Yoshinobu

    2009-07-01

    Peduncular hallucinosis is a rare phenomenon characterized by visual hallucination consisting of vivid, colored image of people, animals, scenes or geometric patterns. In most of the cases the hallucination is accompanied by sleeping disorder, and is by the patient recognized as not being real. It can be observed mainly in patients with thalamic/midbrain vascular disease, and is less frequently seen in brain stem tumor. The damage of the ascending reticular activating system by brain stem compression causing dream activity releasing what is normally suppressed during wakefulness is thought to be the mechanism of peduncular hallucinosis. The authors report a 13-year-old female presenting peduncular hallucinosis due to brainstem compression by a pineocytoma. The patient had a 3-month history of complex visual hallucination and slight somnolence. The hallucination mainly consisted of TV game characters, animals, and vegetables which were colorful and vivid. She was well oriented and realized that the hallucination was not real. MRI showed a pineal mass compressing the quadrigeminal plate inferiorly. There was mild obstructive hydrocephalus due to aqueduct stenosis. The tumor was totally removed and was pathologically diagnosed as pineocytoma. After the surgery, the hallucination ameliorated remarkably. Although the administration of benzodiazepine exacerbated the hallucination and sleep disorder, oral carbamazepine was clearly effective and produced nearly complete disappearance of hallucination. To the best of our knowledge, this is the first report of peduncular hallucinosis caused by quadrigeminal plate compression by a pineal tumor. PMID:19621778

  6. Transformation products and reaction pathways of carbamazepine during photocatalytic and sonophotocatalytic treatment.

    Science.gov (United States)

    Jelic, A; Michael, I; Achilleos, A; Hapeshi, E; Lambropoulou, D; Perez, S; Petrovic, M; Fatta-Kassinos, D; Barcelo, D

    2013-12-15

    This study examines the degradation of the antiepileptic carbamazepine (CBZ) by sonolysis, TiO2-based heterogeneous photocatalysis under UV-A and simulated solar irradiation, and by the combined use of UV-A and ultrasound irradiation (i.e. sonophotocatalysis) in demineralized water, ground water and effluent wastewater. The processes were compared with respect to substrate conversion rate and the extent of DOC reduction as a measure of mineralization. CBZ was degraded following a pseudo-first order kinetics. Sonophotocatalysis provided the highest rate of CBZ transformation over the time-course of the experiment while the degree of DOC removal in pure water was similar for all the studied treatments (around 40%), and always lower than CBZ conversion. This indicated that a considerable organic load remained in the treated solutions that could also be attributed to the presence of persistent oxidation products. UPLC-(+ESI)-QToF-MS was employed to determine major CBZ-related transformation products. Several recalcitrant hydroxy- and keto-derivatives of CBZ were tentatively identified. A Daphnia magna bioassay was used to evaluate the potential toxicity of the samples collected at different time points showing that the mixtures were highly toxic to D. magna. PMID:23972790

  7. Comparative study of the degradation of carbamazepine in water by advanced oxidation processes.

    Science.gov (United States)

    Dai, Chao-Meng; Zhou, Xue-Fei; Zhang, Ya-Lei; Duan, Yan-Ping; Qiang, Zhi-Min; Zhang, Tian C

    2012-06-01

    Degradation of carbamazepine (CBZ) using ultraviolet (UV), UV/H2O2, Fenton, UV/Fenton and photocatalytic oxidation with TiO2 (UV/TiO2) was studied in deionized water. The five different oxidation processes were compared for the removal kinetics of CBZ. The results showed that all the processes followed pseudo-first-order kinetics. The direct photolysis (UV alone) was found to be less effective than UV/H2O2 oxidation for the degradation of CBZ. An approximate 20% increase in the CBZ removal efficiency occurred with the UV/Fenton reaction as compared with the Fenton oxidation. In the UV/TiO2 system, the kinetics of CBZ degradation in the presence of different concentrations of TiO2 followed the pseudo-first order degradation, which was consistent with the Langmuir-Hinshelwood (L-H) model. On a time basis, the degradation efficiencies ofCBZ were in the following order: UV/Fenton (86.9% +/- 1.7%) > UV/TiO2 (70.4% +/- 4.2%) > Fenton (67.8% +/- 2.6%) > UV/H2O2 (40.65 +/- 5.1%) > UV (12.2% +/- 1.4%). However, the lowest cost was obtained with the Fenton process. PMID:22856279

  8. Recrystallization of Commercial Carbamazepine Samples—A Strategy to Control Dissolution Variability

    Directory of Open Access Journals (Sweden)

    Felicia Flicker

    2012-01-01

    Full Text Available Physical properties of commercial carbamazepine (CBZ samples can significantly influence drug release and thereby jeopardize bioequivalence of the final dosage form. The aim of this study was to reduce variability in commercial CBZ samples by recrystallization. CBZ samples of four different suppliers were recrystallized in ethanol solution containing 1% polyvinylpyrrolidone (PVP. CBZ samples were analyzed by disk intrinsic dissolution rate (DIDR, X-ray powder diffraction (XRPD, differential scanning calorimetry (DSC, and scanning electron microscopy (SEM. Recrystallized CBZ samples showed strongly reduced variability in DIDR compared to the untreated CBZ samples. Moreover, transformation process to CBZ dihydrate was inhibited; no dihydrate crystals were visible on compact surfaces after 8 h intrinsic dissolution measurement. Recrystallized CBZ samples showed no change in polymorphic form, however, particle size and shape was inhomogenous. In binary mixtures with microcrystalline cellulose, recrystallized CBZ samples again showed difference in drug release. This difference was associated with the inhomogenous particle size in the recrystallized CBZ samples. The results show that a controlled grinding step is required after recrystallization. We suggest the recrystallization in presence of 1% PVP followed by a controlled grinding step as a strategy to reduce dissolution variability in commercial CBZ samples.

  9. Effect of HPMC on solubility and dissolution of carbamazepine form III in simulated gastrointestinal fluids

    Directory of Open Access Journals (Sweden)

    Bhise S

    2008-01-01

    Full Text Available The effect of HPMC on solubility and dissolution of carbamazepine form III (CBZ was investigated in 50% w/w of CBZ form III in HPMC solid dispersion and physical mixture. Powdered samples of CBZ form III, physical mixture, and solid dispersion were characterized for thermal behavior (DSC, crystallinity (PXRD, and compatibility (FT-IR. Solubility and dissolution studies were carried out in different simulated gastrointestinal fluids and de-ionized water. Solubility studies in simulated gastric fluid (SGF revealed that acidic pH favors formation of CBZ dihydrate. Triton X 100 in blank fast-state simulated gastric fluid (FaSSGF prevents the formation of CBZ dihydrate in acidic pH. A maximum solubility of 268.77 µg/mL was achieved with fed-state simulated intestinal fluid (FeSSIF. Correlation between solubility and pH could not be established. Both solubility and dissolution studies revealed that HPMC had a profound effect of enhancement of solubility and dissolution of CBZ form III in both physical mixtures and solid dispersions. HPMC prevents the formation of CBZ dihydrate and thereby improves the solubility and dissolution. This was further correlated with results obtained from DSC and XRD. There was no drastic difference in solubility and dissolution of CBZ form III with different media. It was observed that there was no existing relationship between solubility and dissolution of CBZ form III in different media.

  10. Factors influencing plasma level/dose ratios of carbamazepine and its major metabolites in epileptic children.

    Science.gov (United States)

    Hartley, R; Lucock, M D; Ng, P C; Forsythe, W I; McLain, B; Bowmer, C J

    1990-09-01

    The relationship between daily dose and plasma concentrations of carbamazepine (CBZ), CBZ-10,11-epoxide (CBZ-EP), and 10,11-dihydro-10,11-trans-dihydroxy-CBZ (CBZ-DIOL) was investigated in 21 children aged 7-16 years who received CBZ monotherapy, twice daily in equally divided doses. Significant linear correlations between CBZ dose and plasma levels were obtained for CBZ and its metabolites (p less than 0.01). In addition, the effects of daily dose and patients' age on the plasma level/dose ratios for CBZ, CBZ-EP, and CBZ-DIOL were evaluated. A significant negative correlation was observed between the daily dose of CBZ and the CBZ plasma level/dose ratio (p less than 0.01). By contrast, plasma level/dose ratios for CBZ-EP and CBZ-DIOL were independent of dose (p greater than 0.1). On the basis of these observations, we consider that the decrease in CBZ plasma level/dose ratio with increasing CBZ dose appears to be due to dose-dependent metabolic clearance of CBZ. The influence of age on plasma level/dose ratios for CBZ and its metabolites was not significant (p greater than 0.05). However, there was considerable interdose and diurnal variation in the plasma level/dose ratios, particularly for CBZ (28-41%); this must be taken into account when making dose adjustments based on plasma level/dose ratios. PMID:2293405

  11. Pharmacogenetic potential biomarkers for carbamazepine adverse drug reactions and clinical response.

    Science.gov (United States)

    Jaramillo, Nancy Monroy; Galindo, Ingrid Fricke; Vázquez, Alberto Ortega; Cook, Helgi Jung; LLerena, Adrián; López, Marisol López

    2014-01-01

    Carbamazepine (CBZ) is a first-line widely used anticonvulsant. It has a narrow therapeutic index and exhibits considerable interindividual and interethnic variability in clinical efficacy and adverse drug reactions including potentially life-threatening hypersensitivity reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. The most important pharmacogenetic finding is related to the association of CBZ-induced hypersensitivity with human leukocyte antigens (HLA class I and II alleles). Moreover, genotyping for HLA-B*15:02 allele is required prior to initiating CBZ in Asians and Asian ancestry patients, demonstrating the usefulness of biomarkers to avoid adverse drug reactions. On the other hand, in order to explain the differences in the clinical response to CBZ, genetic polymorphisms in phase I (CYP3A4, CYP3A5 and EPHX1) and phase II (UGT2B7) metabolising enzymes have been assessed; additionally, the influence of transporters (ABCB1 and ABCC2), receptors (PXR) and other drug targets (voltage- gated Na+ channels) in CBZ clinical response has been evaluated. To date, these studies are controversial and require further investigations to clarify the functional role of these polymorphisms as potential biomarkers in regard to CBZ therapy. PMID:24406279

  12. ATHEROSCLEROTIC RISK AMONG EPILEPTIC PATIENTS TAKING CARBAMAZEPINE, PHENYTOIN TREATMENT: BRIEF REVIEW

    Directory of Open Access Journals (Sweden)

    S. S. Khot*, Md. Hanif Shaikh and Lalitkumar Gupta

    2013-03-01

    Full Text Available ABSTRACT: Epilepsy is a common chronic neurological disorder that requires long-term or sometimes lifetime therapy. Anticonvulsant drugs are used in large quantities during long-term antiepileptic therapy and the treatment may be associated with various metabolic abnormalities in connective tissues, endocrine system and the liver. Recent evidence indicates that prolonged use of antiepileptic drugs (AEDs particularly carbamazepine (CBZ, phenytoin (PHT might modify some vascular risk factors; however, the influence of AED therapy on the development of atherosclerosis has been the subject of controversy and pretty unclear. Some epidemiological studies have reported a higher prevalence of ischemic vascular disease among epileptic patients on AEDs, while in other studies the mortality due to atherosclerosis-related cardiovascular disease in treated epileptics has been observed to be lower than in the general population. The etiology of atherosclerosis-related vascular diseases in epileptic patients has not been fully clarified. Atherosclerotic vascular alterations may start early in life, this review focuses on major atherogenic risk, including disordered lipid profiles, and increased lipoprotein (a serum levels among epileptic patients.

  13. Hepatoprotective and antioxidant activity of N-acetyl cysteine in carbamazepine-administered rats

    Directory of Open Access Journals (Sweden)

    Eswaran Maheswari

    2014-01-01

    Full Text Available Objectives: The present study evaluates the hepatoprotective activity of N-acetyl cysteine (NAC against carbamazepine (CBZ-induced hepatotoxicity. Materials and Methods: Rats were treated with CBZ (50 mg/kg p.o. and CBZ supplemented with NAC 50, 100 and 200 mg/kg for 45 days, after which blood samples were collected and subjected to liver function tests. Animals were killed, liver was separated, weighed and the levels of antioxidants and liver enzymes were estimated. In addition, histopathological investigation was also performed. Results: Serum glutamate pyruvate transaminase (SGPT, serum glutamate oxaloacetate (SGOT transaminase, alkaline phosphatase (ALP, bilirubin, lipid peroxidation, absolute and relative liver weights were significantly (P < 0.05 elevated, whereas serum levels of albumin, total protein and body weight were decreased in the CBZ-treated animals. CBZ also produced vacuolar degeneration, centrilobular congestion and hepatic necrosis as evidenced from histopathological report. NAC significantly reduced the levels of serum transaminase, ALP, bilirubin and liver weight and increased the levels of total protein, albumin and body weight. Conclusion: It was observed that NAC increased the glutathione (GSH content, reduced lipid peroxidation and reversed the CBZ-induced histopathological abnormalities. CBZ-induced hepatotoxicity may be due its toxic epoxide metabolite-induced oxidative stress.

  14. Evaluation of cytochrome P450 inductions by anti-epileptic drug oxcarbazepine, 10-hydroxyoxcarbazepine, and carbamazepine using human hepatocytes and HepaRG cells.

    Science.gov (United States)

    Sugiyama, Ikuo; Murayama, Norie; Kuroki, Ayaka; Kota, Jagannath; Iwano, Shunsuke; Yamazaki, Hiroshi; Hirota, Takashi

    2016-09-01

    Anti-epileptic drug oxcarbazepine is structurally related to carbamazepine, but has reportedly different metabolic pathway. Auto-induction potentials of oxcarbazepine, its pharmacologically active metabolite 10-hydroxyoxcarbazepine and carbamazepine were evaluated by cytochrome P450 (CYP) 1A2, CYP2B6 and CYP3A4 mRNA levels and primary metabolic rates using human hepatocytes and HepaRG cells. For the CYP1A2 the induction potential determined as the fold change in mRNA levels was 7.2 (range: 2.3-11.5) and 10.0 (6.2-13.7) for oxcarbazepine and carbamazepine, respectively, while 10-hydroxyoxcarbazepine did not induce. The fold change in mRNA levels for CYP2B6 was 11.5 (3.2-19.3), 7.0 (2.5-10.8) and 14.8 (3.1-29.1) for oxcarbazepine, 10-hydroxyoxcarbazepine and carbamazepine, respectively. The fold change for CYP3A4 induction level by oxcarbazepine, 10-hydroxyoxcarbazepine and carbamazepine was 3.5 (1.2-7.4), 2.7 (0.8-5.7) and 8.3 (3.5-14.5), respectively. The data suggest lower induction potential of oxcarbazepine and 10-hydroxyoxcarbazepine relative to carbamazepine. The results in HepaRG cells showed similar trend as the human hepatocytes. After incubation for 72 h in hepatocytes and HepaRG cells, auto-induction was evident for only carbamazepine metabolism. The 10-keto group instead of double bond at C10 position is evidently a determinant factor for limited auto-induction of P450 enzymes by oxcarbazepine. PMID:26711482

  15. Effect of carbamazepine on viscoelastic properties and hot melt extrudability of Soluplus ®.

    Science.gov (United States)

    Gupta, Simerdeep Singh; Parikh, Tapan; Meena, Anuprabha K; Mahajan, Nidhi; Vitez, Imre; Serajuddin, Abu T M

    2015-01-15

    The purpose of this study was to apply viscoelastic properties of polymer and drug-polymer mixtures to determine processing conditions for the preparation of amorphous solid dispersion by melt extrusion. A poorly water-soluble drug, carbamazepine (CBZ), was mixed with Soluplus(®) as the carrier. Torque analysis using a melt extruder was performed at 10, 20 and 30% w/w drug concentrations and the effect of barrel temperature was studied. Viscosity of the mixtures either at fixed temperatures with different angular frequencies or as a function of temperature with the same frequency was studied using a rheometer. The viscosity of Soluplus(®) and the torque exerted on the twin screws decreased with the increase in CBZ concentration. The viscosity versus temperature plots for different CBZ concentrations were parallel to each other, without the drug melting transition, indicating complete drug-polymer miscibility. Thus, the drug-polymer mixtures could be extruded at temperature as low as 140°C with 10% w/w drug load, 135°C with 20% w/w drug and 125°C with 30% w/w drug, which were, respectively, ∼ 50°C, 55°C and 65°C below the melting point of 191°C for CBZ. The differential scanning calorimetry (DSC) and powder X-ray diffraction (XRD) analyses of the binary mixtures extruded at 125-150°C showed absence of crystalline drug. A systematic study of miscibility and extrudability of drug-polymer mixtures by rheological and torque analysis as a function of temperature will help formulators select optimal melt extrusion processing conditions to develop solid dispersions. PMID:25448585

  16. Transformation products and reaction pathways of carbamazepine during photocatalytic and sonophotocatalytic treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jelic, A. [Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Jordi Girona 18-26, 08034 Barcelona (Spain); Michael, I.; Achilleos, A.; Hapeshi, E. [Department of Civil and Environmental Engineering, University of Cyprus, 1 Panepistimiou Avenue, P.O. Box 20537, 1678 Nicosia (Cyprus); Nireas, International Water Research Centre, University of Cyprus, 1 Panepistimiou Avenue, P.O. Box 20537, 1678 Nicosia (Cyprus); Lambropoulou, D. [Department of Chemistry, Aristotle University of Thessaloniki, Thessaloniki 54124 (Greece); Perez, S., E-mail: spsqam@idaea.csic.es [Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Jordi Girona 18-26, 08034 Barcelona (Spain); Petrovic, M. [Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, 101-E-17003 Girona (Spain); Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluis Companys 23, 08010 Barcelona (Spain); Fatta-Kassinos, D. [Department of Civil and Environmental Engineering, University of Cyprus, 1 Panepistimiou Avenue, P.O. Box 20537, 1678 Nicosia (Cyprus); Nireas, International Water Research Centre, University of Cyprus, 1 Panepistimiou Avenue, P.O. Box 20537, 1678 Nicosia (Cyprus); Barcelo, D. [Catalan Institute for Water Research (ICRA), H2O Building, Scientific and Technological Park of the University of Girona, 101-E-17003 Girona (Spain); Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluis Companys 23, 08010 Barcelona (Spain)

    2013-12-15

    Highlights: • Degradation of CBZ during US, TiO{sub 2}/UV and TiO{sub 2}/UV/US processes has been evaluated. • The combined TiO{sub 2}/UV/US oxidation resulted in significant enhancement of the CBZ degradation rate. • Transformation products were identified and the transformation pathways were proposed. • An acute toxicity test showed an increase in toxicity over the time-course of the studied processes. -- Abstract: This study examines the degradation of the antiepileptic carbamazepine (CBZ) by sonolysis, TiO{sub 2}-based heterogeneous photocatalysis under UV-A and simulated solar irradiation, and by the combined use of UV-A and ultrasound irradiation (i.e. sonophotocatalysis) in demineralized water, ground water and effluent wastewater. The processes were compared with respect to substrate conversion rate and the extent of DOC reduction as a measure of mineralization. CBZ was degraded following a pseudo-first order kinetics. Sonophotocatalysis provided the highest rate of CBZ transformation over the time-course of the experiment while the degree of DOC removal in pure water was similar for all the studied treatments (around 40%), and always lower than CBZ conversion. This indicated that a considerable organic load remained in the treated solutions that could also be attributed to the presence of persistent oxidation products. UPLC–(+ESI)-QToF-MS was employed to determine major CBZ-related transformation products. Several recalcitrant hydroxy- and keto-derivatives of CBZ were tentatively identified. A Daphnia magna bioassay was used to evaluate the potential toxicity of the samples collected at different time points showing that the mixtures were highly toxic to D. magna.

  17. Transformation products and reaction pathways of carbamazepine during photocatalytic and sonophotocatalytic treatment

    International Nuclear Information System (INIS)

    Highlights: • Degradation of CBZ during US, TiO2/UV and TiO2/UV/US processes has been evaluated. • The combined TiO2/UV/US oxidation resulted in significant enhancement of the CBZ degradation rate. • Transformation products were identified and the transformation pathways were proposed. • An acute toxicity test showed an increase in toxicity over the time-course of the studied processes. -- Abstract: This study examines the degradation of the antiepileptic carbamazepine (CBZ) by sonolysis, TiO2-based heterogeneous photocatalysis under UV-A and simulated solar irradiation, and by the combined use of UV-A and ultrasound irradiation (i.e. sonophotocatalysis) in demineralized water, ground water and effluent wastewater. The processes were compared with respect to substrate conversion rate and the extent of DOC reduction as a measure of mineralization. CBZ was degraded following a pseudo-first order kinetics. Sonophotocatalysis provided the highest rate of CBZ transformation over the time-course of the experiment while the degree of DOC removal in pure water was similar for all the studied treatments (around 40%), and always lower than CBZ conversion. This indicated that a considerable organic load remained in the treated solutions that could also be attributed to the presence of persistent oxidation products. UPLC–(+ESI)-QToF-MS was employed to determine major CBZ-related transformation products. Several recalcitrant hydroxy- and keto-derivatives of CBZ were tentatively identified. A Daphnia magna bioassay was used to evaluate the potential toxicity of the samples collected at different time points showing that the mixtures were highly toxic to D. magna

  18. Effects of sodium valproate and carbamazepine on food competition aggression in pigeons

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    C. Fachinelli

    2007-06-01

    Full Text Available Valproate and carbamazepine (CAR have been proposed as adjunct alternatives for the control of aggression in psychiatric patients, although no definite conclusions have been reached. We examined the effects of these drugs on food competition offensive aggression and other behaviors in high- and low-aggression food-restricted pigeons. These were divided into pairs containing previously ranked high-aggression (N = 10 pairs and low-aggression females (N = 10 pairs. In Experiment 1, a pigeon in each pair of high- and low-aggression subjects was treated daily with an oral dose of sodium valproate (50 mg kg-1 mL saline-1 for 15 days. The other animal received the vehicle. On days 1, 7, and 15, food competition trials (10 min were performed 60 min after treatment. In Experiment 2, one pigeon in each pair was treated daily with an oral dose of CAR (20 mg kg-1 mL saline-1 for 15 days. Each pair was submitted to a food competition trial on days 1, 7, and 15 of treatment. Valproate (15 days of treatment selectively decreased the time spent in offensive aggression (control: 102.7 ± 9.3 vs valproate: 32.7 ± 9.2 s; P < 0.001, ANOVA-2-TAU of high-aggression pigeons. This was also the case for 7 and 15 days of CAR treatment (control: 131.5 ± 8.9 vs CAR: 60.4 ± 5.3, P < 0.01, and control: 122.7 ± 7.1 vs CAR: 39.1 ± 5.2; P < 0.001, ANOVA-2-TAU, respectively. Thus, the two anticonvulsive drugs have a similar effect on food competition aggression in pigeons.

  19. Human health risk assessment of pharmaceuticals in water: an uncertainty analysis for meprobamate, carbamazepine, and phenytoin.

    Science.gov (United States)

    Kumar, Arun; Xagoraraki, Irene

    2010-01-01

    This study presents a step-wise development of a quantitative pharmaceutical risk assessment (QPhRA, hereafter) framework, including Monte Carlo uncertainty analysis for meprobamate, carbamazepine, and phenytoin during (1) accidental exposures of stream water and fish consumption and (2) direct ingestion of finished drinking water for children and adults. Average hazard quotients of these pharmaceuticals (i.e., the ratio of values of chronic daily intake to acceptable daily intake) were found to lie between 1x10(-10) and 3x10(-5) and 99 th percentile values of hazard quotients were found to be less than 1x10(-4) for both sub-populations, indicating no potential risks of adverse effects due to pharmaceuticals exposures. In addition, pharmaceutical concentrations were also observed to be lower than their respective calculated acceptable daily intake-equivalent drinking water levels, indicating no potential human health risks. To the authors' knowledge, for the first time in QPhRA studies, this study has attempted to characterize and quantify effects of factors, such as considerations for sensitive sub-populations using subpopulation-specific toxic endpoints and use of pharmaceutical concentrations in stream and finished drinking waters on risk estimates. Acceptable daily intake was observed to be the primary contributor (>93% variance contribution) in the overall uncertainties of estimates of hazard quotients, followed by fish consumptions and pharmaceutical concentrations in water. Further research efforts are required to standardize use of acceptable daily intake values to reduce large variability in estimation of hazard quotients. PMID:20152876

  20. Electrochemical removal of carbamazepine in water with Ti/PbO2 cylindrical mesh anode.

    Science.gov (United States)

    García-Espinoza, J D; Gortáres-Moroyoqui, P; Orta-Ledesma, M T; Drogui, P; Mijaylova-Nacheva, P

    2016-01-01

    Carbamazepine (CBZ) is one of the most frequently detected organic compounds in the aquatic environment. Due to its bio-persistence and toxicity for humans and the environment its removal has become an important issue. The performance of the electrochemical oxidation process and in situ production of reactive oxygen species (ROS), such as O3 and H2O2, for CBZ removal have been studied using Ti/PbO2 cylindrical mesh anode in the presence of Na2SO4 as supporting electrolyte in a batch electrochemical reactor. In this integrated process, direct oxidation at anode and indirect oxidation by in situ electrogenerated ROS can occur simultaneously. The effect of several factors such as electrolysis time, current intensity, initial pH and oxygen flux was investigated by means of an experimental design methodology, using a 2(4) factorial matrix. CBZ removal of 83.93% was obtained and the most influential parameters turned out to be electrolysis time, current intensity and oxygen flux. Later, the optimal experimental values for CBZ degradation were obtained by means of a central composite design. The best operating conditions, analyzed by Design Expert(®) software, are the following: 110 min of electrolysis at 3.0 A, pH = 7.05 and 2.8 L O2/min. Under these optimal conditions, the model prediction (82.44%) fits very well with the experimental response (83.90 ± 0.8%). Furthermore, chemical oxygen demand decrease was quantified. Our results illustrated significant removal efficiency for the CBZ in optimized condition with second order kinetic reaction. PMID:26942539

  1. Reproductive performance and embriotoxicity of rats exposed to carbamazepine Performance reprodutiva e embriotoxicidade de ratos expostos à carbamazepina

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    Marli Gerenutti

    2008-09-01

    Full Text Available To study the possible effects of carbamazepine in rats during pregnancy and fetuses' physical development, carbamazepine solubilized in propilenglycol was orally administered (20 and 40 mg/kg to the female rats from the 2nd to the 19th days of pregnancy. Propilenglycol was administered to the control group. The animals were sacrificed on the 20th day, when 50% of the offspring were fixed in Bouin's solution and the remaining 50% were submitted to diaphanization. The carbamazepine administration caused reduction on weight gain of pregnant rats and did not damage the females' reproductive performance. In the fetuses' physical development, it was observed a flattening on the skull soft tissues and bones; delay in the skull bone development; cartilage calcification increase between hip and femur and reduction in the number of the sternum ossifications. Although carbamazepine has not caused general changes over female rats' reproductive performance, it produced significant alterations in the development of the fetuses' skeletal parameters.Este trabalho teve como objetivo estudar os possíveis efeitos da administração da carbamazepina na gestação de ratas. A solução glicólica de carbamazepina foi administrada por via oral (20 mg/kg e 40 mg/kg, às ratas do 2º ao 19º dia de gestação. O grupo controle recebeu solução de propilenoglicol. Após a realização da cesária, no 20º dia, 50% dos filhotes foram fixados em Bouin e os outros 50% passaram por processo de diafanização. Estes estudos mostraram que embora a administração de carbamazepina tenha promovido redução do ganho de peso de ratas prenhes, não prejudicou a performance reprodutiva de fêmeas. Nos fetos, observou-se achatamento de tecidos moles e ossos do crânio, retardo no desenvolvimento ósseo do crânio, aumento da calcificação da cartilagem entre o quadril e o fêmur e redução no número de ossificações do esterno. Estes dados, tomados em conjunto, indicam que a

  2. Removal of ibuprofen, naproxen and carbamazepine in aqueous solution onto natural clay: equilibrium, kinetics, and thermodynamic study

    Science.gov (United States)

    Khazri, Hassen; Ghorbel-Abid, Ibtissem; Kalfat, Rafik; Trabelsi-Ayadi, Malika

    2016-04-01

    This study aimed to describe the adsorption of three pharmaceuticals compounds (ibuprofen, naproxen and carbamazepine) onto natural clay on the basis of equilibrium parameters such as a function of time, effect of pH, varying of the concentration and the temperature. Adsorption kinetic data were modeled using the Lagergren's first-order and the pseudo-second-order kinetic equations. The kinetic results of adsorption are described better using the pseudo-second order model. The isotherm results were tested in the Langmuir, Freundlich and Dubinin-Radushkevich models. The thermodynamic parameters obtained indicate that the adsorption of pharmaceuticals on the clay is a spontaneous and endothermic process.

  3. Influence of carbamazepin and diclofenac on the radio-T3/T4-distribution and the maximal binding capacity of thyroid hormone binding proteins

    International Nuclear Information System (INIS)

    Marked changes in plasma thyroid function parameters due to medication have been described in literature. We, therefore, studied the influence of routine administration of carbamazepine and diclofenac upon the radio T3/T4 distribution to specific thyroid transport proteins as well as their maximal binding capacity (MBC) for T4. Both drugs have been found to lead to changes in T3 and T4 distribution but not to any influence upon MBC. The parameters of thyroid function mostly revealed reduced FT3 and FT4 values while bTSH was affected only by carbamazepine administration. (authors)

  4. Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate in adult males with epilepsy

    Directory of Open Access Journals (Sweden)

    Ghaydaa A Shehata

    2009-10-01

    Full Text Available Ghaydaa A Shehata,1 Abd El-aziz M Bateh,2 Sherifa A Hamed,1 Tarek A Rageh,1 Yaser B Elsorogy11Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Egypt; 2Department of Psychology, Faculty of Arts, Banha University, EgyptPurpose: To evaluate the effect of antiepileptic drugs (AEDs on cognition and behavior in adult epileptic males controlled on treatment with conventional antiepileptic medications. Methods: Cognitive, mood, behavior and personality traits were assessed in 45 epileptic patients treated with carbamazepine and/or valproate and free of seizures for ≥1 year. Thirty-four newly diagnosed or untreated patients with epilepsy and 58 matched healthy subjects were also included for comparison. A battery of psychometric tests was utilized including Stanford-Binet (4th edition, Beck Inventory for Depression, Aggressive Scale and Eysenck Personality Questionnaire.Results: Compared to matched control subjects, treated and untreated epileptic patients had poor performance in different cognitive and behavioral functions testing. Treated patients had worse scores in memory for digits forward and backward, total short-term memory, extroversion and psychosis. The duration of AEDs intake was correlated with memory of objects (r = -0.323; P = 0.030, bead memory (r = -0.314; P = 0.036 and total nonverbal short-term memory (r = -0.346; P = 0.020. Treated and untreated epileptic patients had poor performance of similar extent in behavioral functions testing (depression, aggression and neurosis. The dose of AEDs was correlated with testing scores for neurosis (r = 0.307; P = 0.040, verbal aggression (r = 0.483; P = 0.001 and nonverbal aggression (r = 0.526; P = 0.000, and duration of drug intake was correlated with scores for depression (r = 0.384; P = 0.009, psychosis (r = 0.586; P = 0.0001 and nonverbal aggression (r = 0.300; P = 0.045.Conclusions: This study provides support for the notion that AEDs can impair performance

  5. Carbamazepine potentiates the effectiveness of morphine in a rodent model of neuropathic pain.

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    Michael R Due

    Full Text Available Approximately 60% of morphine is glucuronidated to morphine-3-glucuronide (M3G which may aggravate preexisting pain conditions. Accumulating evidence indicates that M3G signaling through neuronal Toll-like receptor 4 (TLR4 may be central to this proalgesic signaling event. These events are known to include elevated neuronal excitability, increased voltage-gated sodium (NaV current, tactile allodynia and decreased opioid analgesic efficacy. Using an in vitro ratiometric-based calcium influx analysis of acutely dissociated small and medium-diameter neurons derived from lumbar dorsal root ganglion (DRG, we observed that M3G-sensitive neurons responded to lipopolysaccharide (LPS and over 35% of these M3G/LPS-responsive cells exhibited sensitivity to capsaicin. In addition, M3G-exposed sensory neurons significantly increased excitatory activity and potentiated NaV current as measured by current and voltage clamp, when compared to baseline level measurements. The M3G-dependent excitability and potentiation of NaV current in these sensory neurons could be reversed by the addition of carbamazepine (CBZ, a known inhibitor of several NaV currents. We then compared the efficacy between CBZ and morphine as independent agents, to the combined treatment of both drugs simultaneously, in the tibial nerve injury (TNI model of neuropathic pain. The potent anti-nociceptive effects of morphine (5 mg/kg, i.p. were observed in TNI rodents at post-injury day (PID 7-14 and absent at PID21-28, while administration of CBZ (10 mg/kg, i.p. alone failed to produce anti-nociceptive effects at any time following TNI (PID 7-28. In contrast to either drug alone at PID28, the combination of morphine and CBZ completely attenuated tactile hyperalgesia in the rodent TNI model. The basis for the potentiation of morphine in combination with CBZ may be due to the effects of a latent upregulation of NaV1.7 in the DRG following TNI. Taken together, our observations demonstrate a

  6. Effects of carbamazepine on cortisol levels and behavioral responses to stress in the fish Jenynsia multidentata.

    Science.gov (United States)

    Calcagno, Emilia; Durando, Patricia; Valdés, M Eugenia; Franchioni, Liliana; Bistoni, María de Los Ángeles

    2016-05-01

    Carbamazepine (CBZ) is an anticonvulsant drug, prescribed worldwide for the treatment of epilepsy, bipolar disorder and trigeminal neuralgia, which has been frequently detected in aquatic environments. The objective of this study was to analyze if CBZ modifies scototaxis and shoaling behaviors and/or whole-body cortisol levels of the one-sided livebearing fish Jenynsia multidentata under stress condition. Female adults of J. multidentata were exposed to 0, 10, 50 and 200μgCBZ/L during 14days. After CBZ exposure, fish were subjected to restraint stress during 15min. Control animals were not exposed to CBZ or stress. In the light/dark preference test (scototaxis), the individuals under acute restraint stress (without CBZ) exhibited a significant increase in the mean speed and in the time spent both in the light compartment and in the bottom of the tank with respect to controls. They also showed a tendency to stay longer frozen in the light compartment. Fish exposed to 10 and 50μgCBZ/L showed a significant reduction in mean speed compared to stressed fish without CBZ. A reduction in the time spent in the bottom of the tank was also observed in fish exposed to 10μgCBZ/L. Fish exposed to 200μgCBZ/L showed a decreasing tendency in all behavioral endpoints (time spent in the light compartment, mean speed, time spent at the bottom and freezing) in comparison to stressed fish not exposed to CBZ. Considering whole-body cortisol results, fish under acute restraint stress (without CBZ) significantly increased their hormone levels with respect to the control group, while fish exposed to CBZ and acute restraint stress, significantly decreased their whole-body cortisol levels. There were no significant changes in shoaling behavior due to either stress or CBZ exposure and no significant differences in whole-body cortisol levels between experimental groups. Considering that the light/dark and shoaling tests measure different stress response behaviors regulated by different

  7. Carbamazepine treatment of bipolar disorder: a retrospective evaluation of naturalistic long-term outcomes

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    Chen Chia-Hui

    2012-05-01

    Full Text Available Abstract Background Carbamazepine (CBZ has been used in the treatment of bipolar disorder, both in acute mania and maintenance therapy, since the early 1970s. Here, we report a follow-up study of CBZ-treated bipolar patients in the Taipei City Psychiatric Centre. Methods Bipolar patients diagnosed according to the DSM-IV system and treated with CBZ at the Taipei City Psychiatric Centre had their charts reviewed to evaluate the efficacy and side effects of this medication during an average follow-up period of 10 years. Results A total of 129 bipolar patients (45 males, mean age: 45.7 ± 10.9 year were included in the analysis of CBZ efficacy used alone (n = 63 or as an add-on after lithium (n = 50 or valproic acid (n = 11, or the both of them (n = 5. The mean age of disease onset was 24.6 ± 9.5 years. The mean duration of CBZ use was 10.4 ± 5.2 year. The mean dose used was 571.3 ± 212.6 mg/day with a mean plasma level of 7.8 ± 5.9 μg/mL. Mean body weight increased from 62.0 ± 13.4 kg to 66.7 ± 13.1 kg during treatment. The frequencies of admission per year before and after CBZ treatment were 0.33 ± 0.46 and 0.14 ± 0.30, respectively. The most common side effects targeted the central nervous system (24%, including dizziness, ataxia and cognitive impairment. Other common side effects were gastrointestinal disturbances (3.6%, tremor (3.6%, skin rash (2.9%, and blurred vision (2.9%. Eighty-eight patients (68.2% were taking antipsychotics concomitantly. Ninety-six patients (74.4% needed to use benzodiazepines concomitantly. Sixty-three (48.8% patients had zero episodes in a 10-year follow-up period, compared to all patients having episodes prior to treatment. Using variable analysis, we found better response to CBZ in males than in females. Conclusions CBZ is efficacious in the maintenance treatment of bipolar disorder in naturalistic clinical practice, either as monotherapy

  8. Carbamazepine degradation using a N-doped TiO2 coated photocatalytic membrane reactor: Influence of physical parameters.

    Science.gov (United States)

    Horovitz, Inna; Avisar, Dror; Baker, Mark A; Grilli, Rossana; Lozzi, Luca; Di Camillo, Daniela; Mamane, Hadas

    2016-06-01

    Commercial α-Al2O3 photocatalytic membranes with a pore size of 200 and 800-nm were coated with N-doped TiO2 photocatalytic film using a sol-gel technique for concurrent bottom-up filtration and photocatalytic oxidation. X-ray diffraction confirmed that the deposited N-doped TiO2 films are in the form of anatase with 78-84% coverage of the membrane surface. The concentration of N found by X-ray photoelectron spectroscopy was in the range of 0.3-0.9 atomic percentage. Membrane permeability after coating decreased by 50% and 12% for the 200- and 800-nm membrane substrates, respectively. The impact of operational parameters on the photocatalytic activity (PCA) of the N-doped TiO2-coated membranes was examined in a laboratory flow cell based on degradation of the model micropollutant carbamazepine, using a solar simulator as the light source. The significant gap in degradation rate between flow through the membrane and flow on the surface of the membrane was attributed both to the hydraulic effect and in-pore PCA. N-doped TiO2-coated membranes showed enhanced activity for UV wavelengths, in addition to activity under visible light. Experiments of PCA under varying flow rates concluded that the process is in the mass-transfer control regime. Carbamazepine removal rate increased with temperature, despite the decrease in dissolved oxygen concentration. PMID:26900981

  9. Production method of carbamazepine/saccharin cocrystal particles by using two solution mixing based on the ternary phase diagram

    Science.gov (United States)

    Kudo, Shoji; Takiyama, Hiroshi

    2014-04-01

    In the pharmaceutical field, improvement of drug solubility is required, and an interest in cocrystals is growing. Crystallization methods for industrial production of cocrystals have not been developed enough whereas many cocrystals have been prepared in order to find a new crystal form by screening in the laboratory. The objective of this study was the development of the crystallization method which is useful for the industrial production of cocrystal particles based on the phase diagram. A cocrystal of carbamazepine and saccharin was selected as a model substance. The ternary phase diagram of carbamazepine and saccharin in methanol at 303 K was measured. A cocrystallization method of mixing two kinds of different eutectic solutions was designed based on the ternary phase diagram. In order to adjust the cocrystallization conditions, the determination method of the driving force for cocrystal deposition such as supersaturation based on mass balance was proposed. The cocrystal particles were obtained under all the conditions of the five mixing ratios. From these experimental results, the relationship between the supersaturation and the induction time for nucleation was confirmed as well as conventional crystallization. In conclusion, the crystallization method for industrial production of cocrystal particles including the determination of the supersaturation was suggested.

  10. Modelling total suspended solids, E. coli and carbamazepine, a tracer of wastewater contamination from combined sewer overflows

    Science.gov (United States)

    Pongmala, Khemngeun; Autixier, Laurène; Madoux-Humery, Anne-Sophie; Fuamba, Musandji; Galarneau, Martine; Sauvé, Sébastien; Prévost, Michèle; Dorner, Sarah

    2015-12-01

    Urban source water protection requires knowledge of sources of fecal contamination upstream of drinking water intakes. Combined and sanitary sewer overflows (CSOs and SSOs) are primary sources of microbiological contamination and wastewater micropollutants (WWMPs) in urban water supplies. To quantify the impact of sewer overflows, predictive simulation models are required and have not been widely applied for microbial contaminants such as fecal indicator bacteria and pathogens in urban drainage networks. The objective of this study was to apply a simulation model to estimate the dynamics of three contaminants in sewer overflows - total suspended solids, Escherichia coli (E. coli) and carbamazepine, a WWMP. A mixed combined and pseudo-sanitary drainage network in Québec, Canada was studied and modelled for a total of 7 events for which water quality data were available. Model results were significantly correlated with field water quality data. The model confirmed that the contributions of E. coli from runoff and sewer deposits were minor and their dominant source was from sewage. In contrast, the main sources of total suspended solids were stormwater runoff and sewer resuspension. Given that it is not present in stormwater, carbamazepine was found to be a useful stable tracer of sewage contributions to total contaminant loads and also provided an indication of the fraction of total suspended solids originating from sewer deposits because of its similar response to increasing flowrates.

  11. Long-term exposure to caffeine and carbamazepine: Impacts on the regenerative capacity of the polychaete Diopatra neapolitana.

    Science.gov (United States)

    Pires, Adília; Almeida, Ângela; Correia, Joana; Calisto, Vânia; Schneider, Rudolf J; Esteves, Valdemar I; Soares, Amadeu M V M; Figueira, Etelvina; Freitas, Rosa

    2016-03-01

    The toxicity induced in non-target organisms by pharmaceutical drugs has been the focus of several studies. In the aquatic environment, most of the studies have been devoted to fish and bivalves, while little is known on the impacts induced in polychaetes. The present study evaluated the impacts of carbamazepine and caffeine on the regenerative capacity of Diopatra neapolitana, a polychaete species with high ecological and economic relevance. Under laboratory controlled conditions polychaetes were exposed, during 28 days, to carbamazepine (Ctl-0.0; 0.3; 3.0; 6.0; 9.0 μg/L) and caffeine (Ctl-0.0; 0.5; 3.0; 18.0 μg/L). During the experiment, at days 11, 18, 25, 32, 39 and 46 after amputation, for each specimen, the percentage of the body width regenerated was determined and the number of new segments was counted. The regenerative capacity was assessed considering the number of days needed to achieve full regeneration and the total number of new segments. The obtained results revealed that with the increase of drugs concentrations organisms regenerated less new segments and took longer to completely regenerate. PMID:26745385

  12. How life history influences the responses of the clam Scrobicularia plana to the combined impacts of carbamazepine and pH decrease

    International Nuclear Information System (INIS)

    In the present study, the bivalve Scrobicularia plana, collected from two contrasting areas (pristine location and mercury contaminated area), was selected to assess the biochemical alterations imposed by pH decrease, carbamazepine (an antiepileptic) and the combined effect of both stressors. The effects on oxidative stress related biomarkers after 96 h exposure revealed that pH decrease and carbamazepine induced alterations on clams, with greater impacts on individuals from the contaminated area which presented higher mortality, higher lipid peroxidation and higher glutathione S-transferase activity. These results emphasize the risk of extrapolating results from one area to another, since the same species inhabiting different areas may be affected differently when exposed to the same stressors. Furthermore, the results obtained showed that, when combined, the impact of pH decrease and carbamazepine was lower than each stressor acting alone, which could be related to the defence mechanism of valves closure when bivalves are under higher stressful conditions. - Highlights: • Environmentally relevant concentrations of CBZ and pH 7.1 impacted the performance of Scrobicularia plana. • The combination of CBZ and pH 7.1 did not induce higher impacts compared with stressors acting alone. • Clams from a polluted area showed greater alterations than clams collected from an unpolluted area. - pH decrease and carbamazepine induced biochemical alterations on clams (Scrobicularia plana), with greater impacts on individuals from the contaminated area

  13. Increasing the oral bioavailability of poorly water-soluble carbamazepine using immediate-release pellets supported on SBA-15 mesoporous silica [Erratum

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    Wang Z

    2013-02-01

    Full Text Available Increasing the oral bioavailability of poorly water-soluble carbamazepine using immediate-release pellets supported on SBA-15 mesoporous silica Wang Z, Chen B, Quan G, et al. International Journal of Nanomedicine. 2012;7:5807–5818.This paper was published without the Supplementary materials.Read the original article

  14. Four Spectrophotometric Methods For Simultaneous Determination Of Carbamazepine And Lamotrigine In Binary Mixtures And Urine Samples

    International Nuclear Information System (INIS)

    In this work four different UV-spectrophotometric methods are described for simultaneous determination of antiepileptic drugs; carbamazepine (CBZ) and lamotrigine (LMT) in binary synthetic mixtures and urine samples without separation. First method was by solving the two simultaneous equations (SEQ) based on total absorbance according to Beers law. Second was Dual wavelength (DWSP) method; Absorbance difference between 304 and 313 nm was measurable for CBZ but was zero for LMT. Likewise the absorbance difference between 282 and 290 nm was significant for LMT, and zero for CBZ. Third involved the use of zero- crossing first derivative method (ZCDSP) using the amplitudes at 308.9 and 286.6 nm for CBZ and LMT respectively. Ratio Derivative Spectrophotometry (RDSP) was the last. Here, the absorbance at different concentrations of CBZ or LMT, was divided, wavelength by wavelength, by the absorbance of a divisor, which was LMT standard for the analyte CBZ, and vice versa for LMT, (Divisor=2.0 μg.mL-1) in both cases. The amplitude of the derivative ratio spectra at 290 nm with wavelength interval (Δλ=6.0nm) and 328 nm (Δλ=4.0 nm) were selected for the determination of CBZ and LMT respectively. CBZ and LMT were simultaneously determined in synthetic mixtures and urine samples by the four methods giving good linearity, r2 ranged between 0.9990 - 0.9997. Detection Limit (D.L) was mostly less than 0.4 μg.mL-1,while in case of ZCDSP and RDSP were between 0.01-0.2 μg.mL-1 with wider linearity range (1-50 for CBZ and 1 - 80 μg.mL-1 for LMT). A slightly lower sensitivity was observed when suppressing solution for urine analysis was used to remove interferences. The recoveries of CBZ and LMT in samples of urine of a healthy person spiked with the drugs and using urine of a healthy person as a blank were, in most cases, around (101.0 % - 103.33 %) and (98.33 % - 102.16 %) with RSD≤3.61 and 3.63 % for CBZ and LMT respectively. The recoveries using suppressing solution were

  15. Properties of human brain sodium channel α-subunits expressed in HEK293 cells and their modulation by carbamazepine, phenytoin and lamotrigine

    Science.gov (United States)

    Qiao, Xin; Sun, Guangchun; Clare, Jeffrey J; Werkman, Taco R; Wadman, Wytse J

    2014-01-01

    Background and purpose Voltage-activated Na+ channels contain one distinct α-subunit. In the brain NaV1.1, NaV1.2, NaV1.3 and NaV1.6 are the four most abundantly expressed α-subunits. The antiepileptic drugs (AEDs) carbamazepine, phenytoin and lamotrigine have voltage-gated Na+ channels as their primary therapeutic targets. This study provides a systematic comparison of the biophysical properties of these four α-subunits and characterizes their interaction with carbamazepine, phenytoin and lamotrigine. Experimental approach Na+ currents were recorded in voltage-clamp mode in HEK293 cells stably expressing one of the four α-subunits. Key results NaV1.2 and NaV1.3 subunits have a relatively slow recovery from inactivation, compared with the other subunits and NaV1.1 subunits generate the largest window current. Lamotrigine evokes a larger maximal shift of the steady-state inactivation relationship than carbamazepine or phenytoin. Carbamazepine shows the highest binding rate to the α-subunits. Lamotrigine binding to NaV1.1 subunits is faster than to the other α-subunits. Lamotrigine unbinding from the α-subunits is slower than that of carbamazepine and phenytoin. Conclusions and implications The four Na+ channel α-subunits show subtle differences in their biophysical properties, which, in combination with their (sub)cellular expression patterns in the brain, could contribute to differences in neuronal excitability. We also observed differences in the parameters that characterize AED binding to the Na+ channel subunits. Particularly, lamotrigine binding to the four α-subunits suggests a subunit-specific response. Such differences will have consequences for the clinical efficacy of AEDs. Knowledge of the biophysical and binding parameters could be employed to optimize therapeutic strategies and drug development. PMID:24283699

  16. Increasing the oral bioavailability of poorly water-soluble carbamazepine using immediate-release pellets supported on SBA-15 mesoporous silica

    Directory of Open Access Journals (Sweden)

    Li G

    2012-11-01

    Full Text Available Zhouhua Wang,1,2 Bao Chen,1 Guilan Quan,1 Feng Li,1 Qiaoli Wu,1 Linghui Dian,1 Yixuan Dong,1 Ge Li,2 Chuanbin Wu1,21School of Pharmaceutical Sciences, 2Research and Development Center of Pharmaceutical Engineering, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaBackground and methods: The aim of this study was to develop an immediate-release pellet formulation with improved drug dissolution and adsorption. Carbamazepine, a poorly water-soluble drug, was adsorbed into mesoporous silica (SBA-15-CBZ via a wetness impregnation method and then processed by extrusion/spheronization into pellets. Physicochemical characterization of the preparation was carried out by scanning electron microscopy, transmission electron microscopy, nitrogen adsorption, small-angle and wide-angle x-ray diffraction, and differential scanning calorimetry. Flowability and wettability of the drug-loaded silica powder were evaluated by bulk and tapped density and by the angle of repose and contact angle, respectively. The drug-loaded silica powder was formulated into pellets to improve flowability.Results: With maximum drug loading in SBA-15 matrices determined to be 20% wt, in vitro release studies demonstrated that the carbamazepine dissolution rate was notably improved from both the SBA-15 powder and the corresponding pellets as compared with the bulk drug. Correspondingly, the oral bioavailability of SBA-15-CBZ pellets was increased considerably by 1.57-fold in dogs (P < 0.05 compared with fast-release commercial carbamazepine tablets.Conclusion: Immediate-release carbamazepine pellets prepared from drug-loaded silica provide a feasible approach for development of a rapidly acting oral formulation for this poorly water-soluble drug and with better absorption.Keywords: ordered mesoporous silica, poorly water-soluble drug, carbamazepine, extrusion, spheronization, pellets, bioavailability

  17. Biodegradation of ibuprofen, diclofenac and carbamazepine in nitrifying activated sludge under 12 °C temperature conditions

    International Nuclear Information System (INIS)

    Pharmaceuticals constitute a well-known group of emerging contaminants with an increasing significance in water pollution. This study focuses on three pharmaceuticals extensively used in Finland and which can be found in environmental waters: ibuprofen, diclofenac and carbamazepine. Biodegradation experiments were conducted in a full-scale Wastewater Treatment Plant (WWTP) and in laboratory-scale Sequencing Batch Reactors (SBRs). The SBRs were operated at 12 °C, with a sludge retention time (SRT) 10–12 d and organic loading rates (OLRs) of 0.17, 0.27 and 0.33 kg BOD7 m-3d-1. Ibuprofen was found to biodegrade up to 99%. The biodegradation rate constants (kbiol) for ibuprofen were calculated for full-scale and laboratory processes as well as under different laboratory conditions and found to differ from 0.9 up to 5.0 l gSS−1 d−1. Diclofenac demonstrated an unexpected immediate drop of concentration in three SBRs and partial recovery of the initial concentration in one of the reactors. High fluctuating in diclofenac concentration was presumably caused by removal of this compound under different concentrations of nitrites during development of nitrifying activated sludge. Carbamazepine showed no biodegradation in all the experiments. - Highlights: • The biodegradation of three pharmaceuticals examined under 12 °C conditions. • kbiol constants for ibuprofen proposed for full-scale and laboratory-scale processes. • Influence of OLR on ibuprofen biodegradation was studied. • Removal followed by recovery of diclofenac detected in nitrifying activated sludge

  18. Biodegradation of ibuprofen, diclofenac and carbamazepine in nitrifying activated sludge under 12 °C temperature conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kruglova, Antonina; Ahlgren, Pia; Korhonen, Nasti; Rantanen, Pirjo; Mikola, Anna; Vahala, Riku

    2014-11-15

    Pharmaceuticals constitute a well-known group of emerging contaminants with an increasing significance in water pollution. This study focuses on three pharmaceuticals extensively used in Finland and which can be found in environmental waters: ibuprofen, diclofenac and carbamazepine. Biodegradation experiments were conducted in a full-scale Wastewater Treatment Plant (WWTP) and in laboratory-scale Sequencing Batch Reactors (SBRs). The SBRs were operated at 12 °C, with a sludge retention time (SRT) 10–12 d and organic loading rates (OLRs) of 0.17, 0.27 and 0.33 kg BOD{sub 7} m{sup -3}d{sup -1}. Ibuprofen was found to biodegrade up to 99%. The biodegradation rate constants (k{sub biol}) for ibuprofen were calculated for full-scale and laboratory processes as well as under different laboratory conditions and found to differ from 0.9 up to 5.0 l g{sub SS}{sup −1} d{sup −1}. Diclofenac demonstrated an unexpected immediate drop of concentration in three SBRs and partial recovery of the initial concentration in one of the reactors. High fluctuating in diclofenac concentration was presumably caused by removal of this compound under different concentrations of nitrites during development of nitrifying activated sludge. Carbamazepine showed no biodegradation in all the experiments. - Highlights: • The biodegradation of three pharmaceuticals examined under 12 °C conditions. • k{sub biol} constants for ibuprofen proposed for full-scale and laboratory-scale processes. • Influence of OLR on ibuprofen biodegradation was studied. • Removal followed by recovery of diclofenac detected in nitrifying activated sludge.

  19. Second-order advantage with excitation–emission photoinduced fluorimetry for the determination of the antiepileptic carbamazepine in environmental waters

    Energy Technology Data Exchange (ETDEWEB)

    Lozano, Valeria A.; Escandar, Graciela M., E-mail: escandar@iquir-conicet.gov.ar

    2013-06-11

    Graphical abstract: -- Highlights: •A simple and safe method for the emerging contaminant carbamazepine is developed. •MCR-ALS algorithm allows us the quantification in very interfering media. •Determination is accomplished in natural waters using green-chemistry principles. -- Abstract: A photochemically induced fluorescence system combined with second-order chemometric analysis for the determination of the anticonvulsant carbamazepine (CBZ) is presented. CBZ is a widely used drug for the treatment of epilepsy and is included in the group of emerging contaminant present in the aquatic environment. CBZ is not fluorescent in solution but can be converted into a fluorescent compound through a photochemical reaction in a strong acid medium. The determination is carried out by measuring excitation–emission photoinduced fluorescence matrices of the products formed upon ultraviolet light irradiation in a laboratory-constructed reactor constituted by two simple 4 W germicidal tubes. Working conditions related to both the reaction medium and the photoreactor geometry are optimized by an experimental design. The developed approach enabled the determination of CBZ at trace levels without the necessity of applying separation steps, and in the presence of uncalibrated interferences which also display photoinduced fluorescence and may be potentially present in the investigated samples. Different second-order algorithms were tested and successful resolution was achieved using multivariate curve resolution-alternating least-squares (MCR-ALS). The study is employed for the discussion of the scopes and yields of each of the applied second-order chemometric tools. The quality of the proposed method is probed through the determination of the studied emerging pollutant in both environmental and drinking water samples. After a pre-concentration step on a C18 membrane using 50.0 mL of real water samples, a prediction relative error of 2% and limits of detection and

  20. Second-order advantage with excitation–emission photoinduced fluorimetry for the determination of the antiepileptic carbamazepine in environmental waters

    International Nuclear Information System (INIS)

    Graphical abstract: -- Highlights: •A simple and safe method for the emerging contaminant carbamazepine is developed. •MCR-ALS algorithm allows us the quantification in very interfering media. •Determination is accomplished in natural waters using green-chemistry principles. -- Abstract: A photochemically induced fluorescence system combined with second-order chemometric analysis for the determination of the anticonvulsant carbamazepine (CBZ) is presented. CBZ is a widely used drug for the treatment of epilepsy and is included in the group of emerging contaminant present in the aquatic environment. CBZ is not fluorescent in solution but can be converted into a fluorescent compound through a photochemical reaction in a strong acid medium. The determination is carried out by measuring excitation–emission photoinduced fluorescence matrices of the products formed upon ultraviolet light irradiation in a laboratory-constructed reactor constituted by two simple 4 W germicidal tubes. Working conditions related to both the reaction medium and the photoreactor geometry are optimized by an experimental design. The developed approach enabled the determination of CBZ at trace levels without the necessity of applying separation steps, and in the presence of uncalibrated interferences which also display photoinduced fluorescence and may be potentially present in the investigated samples. Different second-order algorithms were tested and successful resolution was achieved using multivariate curve resolution-alternating least-squares (MCR-ALS). The study is employed for the discussion of the scopes and yields of each of the applied second-order chemometric tools. The quality of the proposed method is probed through the determination of the studied emerging pollutant in both environmental and drinking water samples. After a pre-concentration step on a C18 membrane using 50.0 mL of real water samples, a prediction relative error of 2% and limits of detection and

  1. The role of sorption and biodegradation in the removal of acetaminophen, carbamazepine, caffeine, naproxen and sulfamethoxazole during soil contact: A kinetics study.

    Science.gov (United States)

    Martínez-Hernández, Virtudes; Meffe, Raffaella; Herrera López, Sonia; de Bustamante, Irene

    2016-07-15

    In countries like Spain, where water is a limited resource, reusing effluents from wastewater treatment plants may imply the introduction of incompletely eliminated pollutants into the environment. Therefore, this work identified the role of sorption and biodegradation in attenuating pharmaceutical compounds (acetaminophen, carbamazepine, caffeine, naproxen and sulfamethoxazole) in natural soil. It also determined which sorption and removal ("sorption+biodegradation") kinetics models describe the behaviour of these substances in the water-soil system. Presence of potential transformation products (TPs) as a result of pharmaceuticals biodegradation was also studied. To this end, serial batch-type experiments were performed with a soil:water ratio of 1:4 and an initial pharmaceutical concentration of 100μgL(-1). Despite results are dependent on soil characteristics, they revealed that, for those substances with a higher affinity to the soil used (loamy sand), sorption seems to play a key role during the first 48h of contact with soil, and gives way to biodegradation afterwards. The sorption of the pharmaceuticals studied follows a pseudo second-order kinetics. Caffeine and sulfamethoxazole displayed the fastest initial sorption velocities (h=2055 and h=228μgkg(-1)h(-1), respectively). The removal kinetics experiments, satisfactorily simulated by the first-order kinetics model, indicated the presence of potential microbial adaptation to degradation. Indeed, half-lives decreased from 1.6- to 11.7-fold with respect to initial values. The microbial capacity to degrade sulfamethoxazole could be a matter of concern if bacteria have developed resistance to this antibiotic. Caffeine, acetaminophen and sulfamethoxazole were mitigated to a greater extent, whereas the removal of naproxen and carbamazepine was more limited. The appearance of epoxy-carbamazepine and N4-acetyl-sulfamethoxazole as possible TPs of carbamazepine and sulfamethoxazole, respectively, indicated that

  2. The association of C3435T single-nucleotide polymorphism, Pgp-glycoprotein gene expression levels and carbamazepine maintenance dose in patients with epilepsy

    Directory of Open Access Journals (Sweden)

    Sterjev Z

    2012-04-01

    Full Text Available Zoran Sterjev1, Gordana Kiteva Trencevska2, Emilija Cvetkovska2, Igor Petrov2, Igor Kuzmanovski2, Jasmina T Ribarska3, Aleksandra K Nestorovska1, Nadica Matevska1, Zorica Naumovska1, Suzana Jolevska-Trajkovic3, Aleksandar Dimovski1, Ljubica Suturkova11Institute of Pharmaceutical Chemistry, Faculty of Pharmacy Skopje, Republic of Macedonia; 2Clinic of Neurology, Faculty of Medicine, Skopje, Republic of Macedonia; 3Institute of Pharmaceutical Analysis, Faculty of Pharmacy Skopje, Republic of MacedoniaAbstract: The ABCB1 gene encodes the P-glycoprotein (Pgp protein, which is thought to transport various antiepileptic drugs. The single nucleotide polymorphism (SNP (C3435T in exon 26 of this gene correlates with the altered expression levels of P-glycoprotein, range of drug response and clinical conditions. In order to investigate the influence of this polymorphism on the susceptibility to and efficacy of carbamazepine therapy, we evaluated the allelic frequency and genotype distribution of this variant in 162 epilepsy patients from the Republic of Macedonia. Statistically significant differences were detected neither in the allelic frequency and genotype distribution between carbamazepine-resistant and carbamazepine-responsive epilepsy patients nor between the subgroups of carbamazepine (CBZ-responsive patients treated with different CBZ doses. However, the T-allele was enriched in CBZ-responsive patients who required higher maintenance CBZ doses, This observation was substantiated by the findings that the median total plasma levels were the lowest in patients with CC (20 µmol/L followed by CT (23 µmol/L and TT (29 µmol/L genotypes. Patients with a CC genotype also had a higher likelihood of response compared to patients with CT or TT genotypes over a wide range (400–1000 mg/day of initial doses of CBZ. The T allele showed a reduced expression of ~5% compared to the C allele in peripheral blood mononuclear cells in heterozygotes for the variant

  3. Acute toxicity of carbamazepine to juvenile rainbow trout (Oncorhynchus mykiss): effects on antioxidant responses, hematological parameters and hepatic EROD.

    Science.gov (United States)

    Li, Zhi-Hua; Zlabek, Vladimir; Velisek, Josef; Grabic, Roman; Machova, Jana; Kolarova, Jitka; Li, Ping; Randak, Tomas

    2011-03-01

    Awareness of residual pharmaceutically active compounds (PhACs) in the aquatic environment is growing as investigations into these pollutants are increasing and analytical detection techniques are improving. However, the toxicological effects of PhACs have not been adequately researched. In this study, the toxic effects of carbamazepine (CBZ), an anticonvulsant drug commonly present in surface and groundwater, was studied in juvenile rainbow trout, Oncorhynchus mykiss, by acute semi-static bioassay. Blood parameters, liver xenobiotic-metabolizing response and tissue antioxidant status were evaluated. Compared to the control group, fish exposed to CBZ (96 h LC50) showed significantly higher Er, Hb, MCHC, monocytes, neutrophil granulocytes and plasma enzymes activity, and significantly lower MCV and lymphocytes. CF and HSI were not significantly different among groups such as hepatic EROD. SOD, CAT, GPx and GR activity was significantly higher in liver of experimental groups, but decreased significantly in brain and gill. In general, antioxidant enzyme activity in intestine and muscle was less evident than in liver. Oxidative stress indices (levels of LPO and CP) were significantly higher in gill and brain, despite a trend to increased values were manifested in the remaining tissues. In short, CBZ-induced stress responses in different tissues were reflected in the oxidant stress indices and hematological parameters. However, before those parameters are used as special biomarkers for monitoring residual pharmaceuticals in aquatic environment, more detailed experiments in laboratory need to be performed in the future. PMID:20971511

  4. Kinetic changes and modulation by carbamazepine on voltage-gated sodium channels in rat CA1 neurons after epilepsy

    Institute of Scientific and Technical Information of China (English)

    Guang-chun SUN; Taco WERKMAN; Wytse J WADMAN

    2006-01-01

    Aim: To study whether the functional properties of sodium channels, and subsequently the channel modulation by carbamazepine (CBZ) in hippocampal CA1 neurons can be changed after epileptic seizures. Methods: We used the acutely dissociated hippocampal CA1 pyramidal cells from epilepsy model rats 3 weeks and 3 months respectively after kainate injection, and whole-cell voltage-clamp techniques. Results: After long-term epileptic seizures, both sodium channel voltage-dependence of activation and steady-state inactivation shifted to more hyperpolarizing potentials, which resulted in the enlarged window current; the membrane density of sodium current decreased and the time constant of recovery from inactivation increased. CBZ displayed unchanged efficacy on sodium channels, with a similar binding rate to them, except that at higher concentrations, the voltage shift of inactivation was reduced. For the short-term kainate model rats, no differences were detected between the control and epilepsy groups. Conclusion: These results indicate that the properties of sodium channels in acutely dissociated hippocampal neurons could be changed following long-term epilepsy, but the alternation might not be enough to induce the channel resistance to CBZ.

  5. Carbamazepine is effective in the treatment of 21-day-old Wistar rats injected with Tityus serrulatus crude venom.

    Science.gov (United States)

    Guidine, Patrícia Alves Maia; Moraes-Santos, Tasso; Massensini, André Ricardo; Moraes, Márcio Flávio Dutra

    2008-11-01

    The scorpion-envenoming syndrome has an incidence of approximately 8000 accidents/year in Brazil; with most severe cases occurring during childhood and elderly. Previous results from our laboratory suggest that the effects of scorpion toxins on the central nervous system play a major role on the lethality induced by scorpion envenoming. Our group has shown that the pre-treatment with carbamazepine (CBZ) is able to increase the latency-to-death in developing animals inoculated with tityustoxin, a toxic fraction of the Tityus serrulatus crude venom. Nevertheless, in order to perceive CBZ as potentially useful in clinical practice, the efficiency of CBZ against crude venom inoculation and the pharmacological treatment introduced after envenomation must be addressed. Thus, the objective of this work was to evaluate CBZ therapeutic efficiency against scorpion envenomation in developing rats. Animals were treated with i.p. injections of either vehicle or CBZ (50 mg/kg or 100 mg/kg) 10 min after injected with a s.c. fixed volume of either saline or crude T. serrulatus venom extract (48 mg/kg). The dose chosen for venom inoculation was 16 times its DL50 for 21-day-old Wistar rats, invariably inducing death within 2 h. Although CBZ did not significantly reduce the pulmonary edema, it was effective in increasing survival rate by approximately 75% in treated rats. In conclusion, CBZ was effective in the treatment of T. serrulatus envenomation even though not blocking the pulmonary edema. PMID:18760265

  6. Interactions of valproic acid with carbamazepine and its metabolites' concentrations, concentrations ratios, and level/dose ratios in epileptic children.

    Science.gov (United States)

    Liu, H; Delgado, M R; Browne, R H

    1995-02-01

    In two groups of epileptic children receiving carbamazepine (CBZ) therapy with or without valproic acid (VPA) comedication, we investigate the drug interactions of VPA on serum CBZ and its metabolites' concentrations, concentration ratios, and level/dose ratios. Serum total and free CBZ-10, 11-epoxide (CBZ-E) concentrations are significantly increased in patients taking CBZ plus VPA, together with higher CBZ-E/CBZ concentration ratios and CBZ-E level/dose ratios. These results reflect the accumulation of CBZ-E. The decreased concentration ratios of trans-10, 11-dihydroxy-10, 11-dihydro-CBZ (CBZ-H)/CBZ-E observed in patients taking CBZ plus VPA suggest an inhibition in the biotransformation from CBZ-E to CBZ-H. Significant negative correlations are found between serum VPA level and CBZ-H/CBZ-E concentration ratios, indicating that the inhibition of CBZ-E hydrolysis by VPA may depend on the concentration of VPA (total or free CBZ-H/CBZ-E concentration ratio = [formula: see text], respectively). VPA concentration also shows significant positive correlations with CBZ-E and CBZ level/dose ratios. Patients taking CBZ plus VPA have significant higher free fractions of CBZ and CBZ-E than do patients on CBZ alone, suggesting a protein-binding displacement by VPA. PMID:8665529

  7. Sorption of carbamazepine, 17α-ethinylestradiol, iopromide and trimethoprim to biomass involves interactions with exocellular polymeric substances.

    Science.gov (United States)

    Khunjar, Wendell O; Love, Nancy G

    2011-02-01

    The sorption of carbamazepine (CBZ), iopromide (IOP), trimethoprim (TMP) and 17α-ethinylestradiol (EE2) was evaluated using four biomass types (pure ammonia oxidizing bacterial culture, two heterotrophic enrichment cultures with varying levels of oxygenase activity, and a full-scale nitrifying activated sludge (NAS) culture). CBZ and IOP did not sorb to the four biomass types. EE2 did not sorb to the pure culture but sorbed significantly to the heterotrophic cultures and NAS. TMP sorbed to the heterotrophic cultures and NAS, and was not evaluated for the pure culture. Three floc characteristics (hydrophobicity, median particle size, organic matter content) correlated moderately well with the EE2 organic matter sorption coefficient (KOM,EE2). Zeta potential did not correlate well with KOM,EE2 but did with KOM,TMP, indicating that TMP sorption is more influenced by electrostatic factors than EE2. Once divalent cation-linked exocellular polymeric substances (EPS) were removed from flocs, EE2 and TMP sorption to the non-EPS (cellular) fraction decreased by approximately 50%. The correlation between KOM,EE2 for the non-EPS cellular fraction deteriorated while the correlation between KOM,TMP improved. EE2 seemed to sorb more strongly to EPS protein whereas TMP sorbed equally to polysaccharide and protein EPS. Attempts to develop predictive models were not successful. Pharmaceuticals that sorbed to biomass samples underwent biodegradation whereas those that did not sorb were not biodegraded, suggesting a relationship between sorption and pharmaceutical biotransformation. PMID:21111443

  8. Efficient degradation of carbamazepine by easily recyclable microscaled CuFeO2 mediated heterogeneous activation of peroxymonosulfate.

    Science.gov (United States)

    Ding, Yaobin; Tang, Hebin; Zhang, Shenghua; Wang, Songbo; Tang, Heqing

    2016-11-01

    Microscaled CuFeO2 particles (micro-CuFeO2) were rapidly prepared via a microwave-assisted hydrothermal method and characterized by scanning electron microscopy, X-ray powder diffraction and X-ray photoelectron spectroscopy. It was found that the micro-CuFeO2 was of pure phase and a rhombohedral structure with size in the range of 2.8±0.6μm. The micro-CuFeO2 efficiently catalyzed the activation of peroxymonosulfate (PMS) to generate sulfate radicals (SO4-), causing the fast degradation of carbamazepine (CBZ). The catalytic activity of micro-CuFeO2 was observed to be 6.9 and 25.3 times that of micro-Cu2O and micro-Fe2O3, respectively. The enhanced activity of micro-CuFeO2 for the activation of PMS was confirmed to be attributed to synergistic effect of surface bonded Cu(I) and Fe(III). Sulfate radical was the primary radical species responsible for the CBZ degradation. As a microscaled catalyst, micro-CuFeO2 can be easily recovered by gravity settlement and exhibited improved catalytic stability compared with micro-Cu2O during five successive degradation cycles. Oxidative degradation of CBZ by the couple of PMS/CuFeO2 was effective in the studied actual aqueous environmental systems. PMID:27329789

  9. Effect of carbamazepine or phenytoin therapy on blood level of intravenously administered midazolam: a prospective cohort study.

    Science.gov (United States)

    Hayashi, Tomoko; Higuchi, Hitoshi; Tomoyasu, Yumiko; Ishii-Maruhama, Minako; Maeda, Shigeru; Miyawaki, Takuya

    2016-02-01

    Dental treatment of intellectually disabled patients is frequently performed under general anesthesia or sedation. Many of these patients have epilepsy and are medicated with antiepileptic drugs (AEDs). Carbamazepine (CBZ) and phenytoin (PHT) are known to promote the metabolism of midazolam, and the blood levels of midazolam in patients medicated with CBZ or PHT may be different from those in healthy individuals. In this study, we clarified the influences of CBZ and PHT on the blood level of intravenously administered midazolam in patients medicated with CBZ or PHT. The subjects were divided into the following groups: not medicated with AEDs (control group), medicated with only CBZ or PHT (mono CBZ/PHT group), and medicated with CBZ or PHT or both and other AEDs (poly CBZ/PHT group). General anesthesia was achieved using midazolam, propofol, and remifentanil, and then the blood midazolam level was measured at 10, 30, and 60 min after intravenous midazolam administration. According to the results, the blood midazolam level was significantly lower in the mono and poly CBZ/PHT groups than in the control group. This finding suggests that intravenously administered midazolam may have a weaker effect in patients medicated with CBZ or PHT. PMID:26272251

  10. The automatic use of capillary isoelectric focusing with whole column imaging detection for carbamazepine binding to human serum albumin.

    Science.gov (United States)

    Maciążek-Jurczyk, Małgorzata; Pawliszyn, Janusz

    2016-08-01

    The binding of the anticonvulsant drug carbamazepine (CBZ) to human serum albumin, both without (dHSA) and in the presence of fatty acids (HSA) was studied in real time by capillary isoelectric focusing with whole column imaging detection (cIEF-WCID). Reaction mixtures at different CBZ:HSA and CBZ:dHSA molar ratios (0:1/25:1) were prepared in phosphate buffer saline (PBS) solution at a physiological pH (7.4), and incubated for 0-72h at 37°C in a water bath. Application of the cIEF-WCID method allowed for observations on the impact of increasing CBZ:serum albumin molar ratios on isoelectric point (pI) shifts, as well as changes in peak area and absorbance, which serve as evidence of structural alterations occurring in the protein in the presence of CBZ. The obtained cIEF-WCID results indicated that the dynamic process of complex formation is not dependent on incubation time. The presented work allowed for recognition of different types of interactions, as well as for the calculation of association constants that demonstrate the stability of the complex. This study was also designed to examine the possible impact of fatty acids (FAs) on protein stability and drug delivery in blood. PMID:26809616

  11. Structural modeling of HLA-B*1502/peptide/carbamazepine/T-cell receptor complex architecture: implication for the molecular mechanism of carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis.

    Science.gov (United States)

    Zhou, Peng; Zhang, Shilei; Wang, Yewang; Yang, Chao; Huang, Jian

    2016-08-01

    Drug-induced adverse reactions are a significant problem in healthcare worldwide and are estimated to cost billions of dollars annually in the United States. A portion of such reactions is observed to strongly associate with certain human leukocyte antigen (HLA) alleles; one of the strongest associations is the HLA-B*1502 protein with carbamazepine (CBZ)-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) - the odds ratio value can even be higher than one thousand. The particularly strong association in CBZ-induced SJS/TEN suggests that the HLA-B*1502 is not only a genetic marker but also a participant in the pathogenesis of the disease. In the current study, we attempt to computationally model the atomic-level structure of the complete HLA-B*1502/peptide/CBZ/T-cell receptor (TCR) complex architecture based on prior knowledge obtained from epidemiological investigations as well as in vitro and in vivo assays. The model tells a different story about the molecular mechanism of CBZ-induced SJS/TEN from that previously reported for abacavir (ABC)-induced hypersensitivity (HSR); the CBZ molecule is located at the interface between HLA-B*1502/peptide and TCR, directly contacts the P3-P6 residues of antigen peptide, and bound within a pocket region encompassed by two TCR CDR3 fingers. Molecular dynamics simulation and binding energy analysis further reveal that the CBZ shows considerably high affinity to TCR over HLA-B*1502/peptide, which can tightly interact with the former rather than the latter. From the model, two hypotheses are proposed that can well explain most previous observations and are expected to guide next wet-lab experiments. This study could help to promote our understanding of the molecular mechanism and pathological implication underlying CBZ-induced SJS/TEN. PMID:26488421

  12. Carbamazepine-Induced Liver Injury Requires CYP3A-Mediated Metabolism and Glutathione Depletion in Rats.

    Science.gov (United States)

    Iida, Azumi; Sasaki, Eita; Yano, Azusa; Tsuneyama, Koichi; Fukami, Tatsuki; Nakajima, Miki; Yokoi, Tsuyoshi

    2015-07-01

    Carbamazepine (CBZ) is widely used as an antiepileptic agent and causes rare but severe liver injury in humans. It has been generally recognized that reactive metabolites formed via the metabolic activation reaction contribute to the onset of liver injuries by several drugs. However, the role of CBZ metabolism in the development of liver injury is not fully understood. In this study, we developed a novel rat model of CBZ-induced liver injury and attempted to elucidate the associated mechanisms by focusing on the metabolism of CBZ. The repeated administration of CBZ for 5 days in combination with l-buthionine sulfoximine (BSO), a glutathione (GSH) synthesis inhibitor, resulted in increases in the plasma alanine aminotransferase (ALT) levels and centrilobular necrosis in the liver that were observed in various degrees. The CBZ and 2-hydroxy-CBZ concentrations in the plasma after the last CBZ administration were lower in the rats with high plasma ALT levels compared with those with normal plasma ALT levels, showing the possibility that the further metabolism of CBZ and/or 2-hydroxy-CBZ is associated with the liver injury. Although a single administration of CBZ did not affect the plasma ALT levels, even when cotreated with BSO, pretreatment with dexamethasone, a CYP3A inducer, increased the plasma ALT levels. In addition, the rats cotreated with troleandomycin or ketoconazole, CYP3A inhibitors, suppressed the increased plasma ALT levels. In conclusion, reactive metabolite(s) of CBZ produced by CYP3A under the GSH-depleted condition might be involved in the development of liver injury in rats. PMID:25870103

  13. Prophylactic efficacy of lithium, valproic acid, and carbamazepine in the maintenance phase of bipolar disorder: a naturalistic study.

    Science.gov (United States)

    Peselow, Eric D; Clevenger, Steven; IsHak, Waguih W

    2016-07-01

    Mood stabilizers are used clinically for the management of bipolar disorder. Prophylactic therapy with mood stabilizers is the primary treatment for preventing depressive and manic relapses in bipolar patients once they are stabilized. In this study, we examined the relative efficacy of the three most commonly used mood-stabilizing agents: lithium (Li), valproic acid (VPA), and carbamazepine (CBZ), in preventing relapse episodes. A total of 225 patients with bipolar disorder were included in the present analysis. Patients taking Li, VPA, or CBZ were followed up for up to 124 months, until suffering a manic, mixed, or depressive episode (relapse), or until the end of the study/study termination (no relapse), whichever came first. The median unadjusted survival time was 36 months for patients taking VPA, 42 months for patients taking CBZ, and 81 months for patients taking Li. These results indicate that patients stayed longer on Li, suggesting that it might have been better tolerated than either CBZ or VPA. χ-Analysis showed that patients taking Li were significantly less likely to experience relapse during the observational period than patients taking either VPA or CBZ (P<0.05). A Cox regression model showed that the hazard of experiencing relapse was significantly predicted by the total number of depressive (P=0.007) and manic symptoms (P=0.02) assessed before the observation period. In addition, after controlling for symptom covariates, the hazard of experiencing relapse was 1.66 times (95% confidence interval 1.03-2.67) or 66% higher for patients taking VPA compared with patients taking Li (P=0.037). Although the hazard of experiencing relapse was higher for patients taking CBZ compared with those taking Li, the risk was not elevated by a significant amount. Notwithstanding the limitations of the naturalistic design of this study, the differences in relapse prevention and survival time observed in these medications show Li fairing relatively better in

  14. Intravenous immunoglobulin in the treatment of primary trigeminal neuralgia refractory to carbamazepine: a study protocol[ISRCTN33042138

    Directory of Open Access Journals (Sweden)

    Roewer Norbert

    2003-01-01

    Full Text Available Abstract Background We have recently reported successful treatment of patients with chronic pain syndromes using human pooled intravenous immunoglobulin (IVIG in a prospective, open-label cohort study. A randomised, placebo controlled, double blinded study is needed to confirm these results. We chose to study patients with carbamazepine resistant primary Trigeminal Neuralgia (rpTN, as these had responded particularly well to IVIG. A protocol involving the use of IVIG in rpTN is complex for three reasons: 1. The effect of IVIG does not follow simple dose-response rules; 2. The response pattern of patients to IVIG was variable and ranged between no effect at all and pain free remission between two weeks and >1 year; 3. TN is characterized by extremely severe pain, for which operative intervention is (if temporarily helpful in most patients. Design A placebo controlled, parallel, add-on model was developed and the primary outcome variable defined as the length of time during which patients remain in the study. Study groups are compared using Kaplan-Maier survival analysis. Patients record their response to treatment ("severe, moderate, slight, no pain". The study coordinator monitors pain diaries. Severe or moderate pain of three days duration will result in termination of the study for that patient. Conclusions This study design utilizes a method of survival analysis and is novel in chronic pain research. It allows for both early departure from the study and voluntary crossover upon non-response. It may be applicable to the analysis of IVIG efficacy in other chronic pain syndromes.

  15. Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate--Expert opinion.

    Science.gov (United States)

    Peltola, Jukka; Holtkamp, Martin; Rocamora, Rodrigo; Ryvlin, Philippe; Sieradzan, Kasia; Villanueva, Vicente

    2015-09-01

    There is currently a lack of guidance on methodology and special considerations for transitioning patients from oxcarbazepine (OXC) or carbamazepine (CBZ) to eslicarbazepine acetate (ESL), if deemed clinically necessary. An advisory panel of epilepsy experts was convened to share their experience on the use of adjunctive ESL in clinical practice and to provide practical recommendations to help address this gap. When changing over from OXC to ESL, an OXC:ESL dose ratio of 1:1 should be employed to calculate the ESL target dose, and the changeover can take place overnight. No changes to comedication are required. Since CBZ has a different mechanism of action to ESL and is a stronger inducer of cytochrome P450 (CYP) enzymes, the transitioning of patients from CBZ to ESL requires careful consideration on a patient-by-patient basis. In general, a CBZ:ESL dose ratio of 1:1.3 should be employed to calculate the ESL target dose, and patients should be transitioned over a minimum period of 1-2weeks. Special considerations include adjustment of titration schedule and target dose in elderly patients and those with hepatic or renal impairment and potential adjustment of comedications metabolized by CYP enzymes. In summary, due to structural distinctions between ESL, OXC, and CBZ, which affect mechanism of action and tolerability, there are clinical situations in which it may be appropriate to consider transitioning patients from OXC or CBZ to ESL. Changing patients over from OXC to ESL is generally more straightforward than transitioning patients from CBZ to ESL, which requires careful consideration. PMID:26114438

  16. Histidine enhances carbamazepine action against seizures and improves spatial memory deficits induced by chronic transauricular kindling in rats

    Institute of Scientific and Technical Information of China (English)

    Qing LI; Chun-lei JIN; Li-sha XU; Zheng-bin ZHU-GE; Li-xia YANG; Lu-ying LIU; Zhong CHEN

    2005-01-01

    Aim: To investigate whether histidine can enhance the anticonvulsant efficacy of carbamazepine (CBZ) and simultaneously improve the spatial memory impairment induced by transauricular kindled seizures in Sprague-Dawley rats. Methods:Chronic transauricular kindling was induced by repeated application of initially subconvulsive electrical stimulation through ear-clip electrodes once every 24 h until the occurrence of 3 consecutive clonic-tonic seizures. An 8-arm radial maze (4 arms baited) was used to measure spatial memory, and histamine and γ-aminobutyric acid levels were measured by high performance liquid chromatography (HPLC). Results: Chronic transauricular kindling produced a significant impairment of spatial memory and a marked decrease in histamine content in the hypothalamus, the brainstem, and the hippocampus. Injection of histidine (1000 mg/kg or 1500 mg/kg, ip) significantly inhibited transauricular kindled seizures. Injection of histidine at lower doses (200 mg/kg or 500 mg/kg, ip) had no appreciable anticonvulsant effect when administered alone, whereas it significantly potentiated the protective effects of CBZ against kindled seizures. CBZ had no meliorative effect on memory deficit, but, in contrast, histidine (200 mg/kg or 500 mg/kg, ip) alone or co-administered with CBZ significantly ameliorated the memory deficits induced by the seizures. Conclusion: Chronic transauricular kindling is a very useful animal model for evaluating memory deficits associated with epilepsy, and histidine has both a potentiate effect on the anticonvulsant efficacy of CBZ and an ameliorative effect on the spatial memory deficits induced in this model. Histidine at a specific dosage range might serve as a beneficial adjuvant for the clinical treatment of epilepsy, especially when accompanied by impaired spatial memory.

  17. Carbamazepine behaviour and effects in an urban wastewater MBR working with high sludge and hydraulic retention time.

    Science.gov (United States)

    González-Pérez, Daniel María; Pérez, Jorge Ignacio; Nieto, Miguel Ángel Gómez

    2016-08-23

    The behaviour and fate of carbamazepine (CBZ) in urban wastewater treatment by a membrane bioreactor (MBR) and its possible effects on the system's efficiency, and on mixed microbial communities, has been studied. The experimental microfiltration MBR system, with capacity to treat 10.8 m(3) d(-1) of urban wastewater, operated with a pre-denitrification configuration with high sludge and hydraulic retention time. The CBZ concentration assayed was higher than in the usual urban wastewater, in order to provoke a strong biomass reaction. Influent, effluent, and all bioreactors of the MBR system were analysed in order to calculate a CBZ balance. Bench-scale experiments and respirometric analyses were performed, with and without the presence of CBZ, to evaluate its influence on the bacterial activity. The respirometric assays showed variations in the oxygen uptake rate (OUR) in the presence of CBZ. Negative effects were detected in the MBR bacterial community during the initial period of dosing. However, the effects were not permanent and the biomass spiked with CBZ had behaviour similar to that of the biomass without CBZ after a few hours. Biodegradation was not detected during the MBR treatment. The system showed an inefficient elimination of CBZ (less than 10%) with a high concentration in the effluent. The small percentage of CBZ removal was associated with the sludge retention and eliminated by the purge. All CBZ present in the influent was accounted for, and even an increase in the total amount of CBZ was registered in the permeate. During and after the experimental process, CBZ did not significantly affect the efficiency of the MBR system, and the quality of the effluent was not affected by the dosing of CBZ in terms of COD and nitrogen removal. PMID:27230859

  18. Regenerable granular carbon nanotubes/alumina hybrid adsorbents for diclofenac sodium and carbamazepine removal from aqueous solution.

    Science.gov (United States)

    Wei, Haoran; Deng, Shubo; Huang, Qian; Nie, Yao; Wang, Bin; Huang, Jun; Yu, Gang

    2013-08-01

    A novel granular carbon nanotubes (CNTs)/alumina (Al2O3) hybrid adsorbent with good sorption and regeneration properties was successfully prepared by mixing CNTs with surfactant Brij 35 and pseudo boehmite, followed by calcining to remove surfactant and form porous granules. Alumina binder increased the mechanical strength, hydrophilicity and porosity of the granular adsorbent, while the dispersed CNTs in the granular adsorbent were responsible for the sorption of diclofenac sodium (DS) and carbamazepine (CBZ). Scanning electron microscopy (SEM) showed that the CNTs and Al2O3 were mixed well and the porous structure was formed in the granular adsorbent. The high surface area and appropriate pore size of granular CNTs/Al2O3 adsorbent were favorable for sorption. The sorption of DS decreased with increasing solution pH, while pH had little effect on CBZ sorption. The maximum sorption capacities of CBZ and DS on the CNTs/Al2O3 adsorbent were 157.4 and 106.5 μmol/g according to the Langmuir fitting. Moreover, the spent CNTs/Al2O3 adsorbent can be thermally regenerated at 400 °C in air due to the thermal stability of CNTs. The removal of CBZ and DS changed a little in the initial reuse cycles and then kept relatively constant until tenth cycles. The adsorbed CBZ and DS were decomposed in the regeneration process. This regenerable adsorbent may find potential application in water or wastewater treatment for the removal of some micropollutants such as pharmaceuticals. PMID:23579087

  19. Entwicklung und Validierung eines Enzyme-linked Immunosorbent Assays (ELISA) für die Quantifizierung von Carbamazepin in Abwasser, Oberflächenwasser und Trinkwasser

    OpenAIRE

    Bahlmann, Arnold

    2013-01-01

    Ein kompetitiver ELISA (Enzyme-linked Immunosorbent Assay) für den Nachweis von Carbamazepin (CBZ) mit einer Bestimmungsgrenze von ca. 30 ng/L wurde entwickelt und validiert. Dieser in Gewässern häufig auftretende anthropogene Marker wurde anschließend in einer Vielzahl an Proben aus Abwässern, Oberflächengewässern und Trinkwässern nachgewiesen. Der ELISA zeigte eine exzellente Präzision und erbrachte in allen Matrizes geringfügig höhere Analysenergebnisse als die Referenzmethode HPLC-MS/MS. ...

  20. Clinical Validation and Implications of Dried Blood Spot Sampling of Carbamazepine, Valproic Acid and Phenytoin in Patients with Epilepsy

    Science.gov (United States)

    Kong, Sing Teang; Lim, Shih-Hui; Lee, Wee Beng; Kumar, Pasikanthi Kishore; Wang, Hwee Yi Stella; Ng, Yan Lam Shannon; Wong, Pei Shieen; Ho, Paul C.

    2014-01-01

    To facilitate therapeutic monitoring of antiepileptic drugs (AEDs) by healthcare professionals for patients with epilepsy (PWE), we applied a GC-MS assay to measure three AEDs: carbamazepine (CBZ), phenytoin (PHT) and valproic acid (VPA) levels concurrently in one dried blood spot (DBS), and validated the DBS-measured levels to their plasma levels. 169 PWE on either mono- or polytherapy of CBZ, PHT or/and VPA were included. One DBS, containing ∼15 µL of blood, was acquired for the simultaneous measurement of the drug levels using GC-MS. Simple Deming regressions were performed to correlate the DBS levels with the plasma levels determined by the conventional immunoturbimetric assay in clinical practice. Statistical analyses of the results were done using MedCalc Version 12.6.1.0 and SPSS 21. DBS concentrations (Cdbs) were well-correlated to the plasma concentrations (Cplasma): r = 0.8381, 0.9305 and 0.8531 for CBZ, PHT and VPA respectively, The conversion formulas from Cdbs to plasma concentrations were [0.89×CdbsCBZ+1.00]µg/mL, [1.11×CdbsPHT−1.00]µg/mL and [0.92×CdbsVPA+12.48]µg/mL respectively. Inclusion of the red blood cells (RBC)/plasma partition ratio (K) and the individual hematocrit levels in the estimation of the theoretical Cplasma from Cdbs of PHT and VPA further improved the identity between the observed and the estimated theoretical Cplasma. Bland-Altman plots indicated that the theoretical and observed Cplasma of PHT and VPA agreed well, and >93.0% of concentrations was within 95% CI (±2SD); and similar agreement (1∶1) was also found between the observed Cdbs and Cplasma of CBZ. As the Cplasma of CBZ, PHT and VPA can be accurately estimated from their Cdbs, DBS can therefore be used for drug monitoring in PWE on any of these AEDs. PMID:25255292

  1. Synergistic effect between UV and chlorine (UV/chlorine) on the degradation of carbamazepine: Influence factors and radical species.

    Science.gov (United States)

    Wang, Wen-Long; Wu, Qian-Yuan; Huang, Nan; Wang, Ting; Hu, Hong-Ying

    2016-07-01

    For successful wastewater reclamation, advanced oxidation processes have attracted attention for elimination of emerging contaminants. In this study, the synergistic treatment with UV irradiation and chlorine (UV/chlorine) was used to degrade carbamazepine (CBZ). Neither UV irradiation alone nor chlorination alone could efficiently degraded CBZ. UV/chlorine oxidation showed a significant synergistic effect on CBZ degradation through generation of radical species (OH and Cl), and this process could be well depicted by pseudo first order kinetic. The degradation rate constants (kobs,CBZ) of CBZ increased linearly with increasing UV irradiance and chlorine dosage. The degradation of CBZ by UV/chlorine in acidic solutions was more efficient than that in basic solutions mainly due to the effect of pH on the dissociation of HOCl and OCl(-) and then on the quantum yields and radical species quenching of UV/chlorine. When pH was increased from 5.5 to 9.5, the rate constants of degradation of CBZ by OH decreased from 0.65 to 0.14 min(-1) and that by Cl decreased from 0.40 to 0.11 min(-1). The rate constant for the reaction between Cl and CBZ was 5.6 ± 1.6 × 10(10) M(-1) s(-1). Anions of HCO3(-) (1-50 mM) showed moderate inhibition of CBZ degradation by UV/chlorine, while Cl(-) did not. UV/chlorine could efficiently degrade CBZ in wastewater treatment plant effluent, although the degradation was inhibited by about 30% compared with that in ultrapure water with chlorine dosage of 0.14-0.56 mM. Nine main oxidation products of the CBZ degradation by UV/chlorine were identified using the HPLC-QToF MS/MS. Initial oxidation products arose from hydroxylation, carboxylation and hydrogen atom abstraction of CBZ by OH and Cl, and were then further oxidized to generate acylamino cleavage and decarboxylation products of acridine and acridione. PMID:27105033

  2. Biodegradation of carbamazepine and clarithromycin by Trichoderma harzianum and Pleurotus ostreatus investigated by liquid chromatography - high-resolution tandem mass spectrometry (FTICR MS-IRMPD).

    Science.gov (United States)

    Buchicchio, Alessandro; Bianco, Giuliana; Sofo, Adriano; Masi, Salvatore; Caniani, Donatella

    2016-07-01

    In this study, the capability of pharmaceutical biodegradation of fungus Trichoderma harzianum was evaluated through the comparison with the well-known biodegradation capability of white-rot fungus Pleurotus ostreatus. The study was performed in aqueous phase under aerobic conditions, using two of the most frequently detected drugs in water bodies: carbamazepine and clarithromycin, with concentrations commonly found in treated wastewater (4μg/l and 0.03μg/l respectively). For the first time, we demonstrated that T. harzianum is able to remove carbamazepine and clarithromycin. The analyses were performed by reversed-phase liquid chromatography/mass spectrometry, using high-resolution Fourier-transform ion cyclotron resonance mass spectrometry upon electrospray ionization in positive ion mode. The high selectivity and mass accuracy provided by high-resolution mass spectrometry, allowed us to identify some unknown metabolites. On the basis of our study, the major metabolites detected in liquid culture treated by T. harzianum were: 14-hydroxy-descladinosyl- and descladinosyl-clarithromycin, which are pharmacologically inactive products not dangerous for the environment. PMID:27039063

  3. Entalpías de Inmersión de Carbones Activados en Soluciones Séricas de Carbamazepina Immersion Enthalpies of Activated Carbon in Carbamazepine Serum Solutions

    Directory of Open Access Journals (Sweden)

    Natalia Bohórquez

    2008-01-01

    Full Text Available Se determinan la entalpía de inmersión y la capacidad de adsorción de carbones activados en soluciones séricas de carbamazepina. Los carbones activados se modifican con soluciones de ácido nítrico de 40% y 65% a 303 K, aumentando el contenido de sitios ácidos totales en la superficie. Se establecen relaciones entre el área superficial y la variación en la entalpía de inmersión en función del tratamiento de modificación y la cantidad adsorbida de carbamazepina. Se observa que para los sólidos obtenidos a partir de carbón mineral, la interacción está influenciada por características físicas y químicas de la superficie, en tanto que para los sólidos obtenidos a partir del carbón activado comercial se aprecia mayor interacción al aumentar el contenido de grupos ácidos. Los carbones activados con mayor absorción de carbamazepina son: los de origen mineral modificado, CAmi40 CAmi65, y carbón comercial modificado con ácido nítrico de mayor concentración, CAmk65.The immersion enthalpy and the adsorption capacity of activated carbon in carbamazepine serum solutions are determined in this study. The activated carbon were modified with nitric acid solutions of 40 and 65% at 303 K, increasing the content of the total acid sites on the surface. ¶Relations between the superficial area and the immersion enthalpy variation in function of modification treatment and the adsorbed amount of carbamazepine. It was observed that for solids obtained from mineral coal, the interaction is influenced by the physical and chemical surface characteristics, while for solids obtained from the commercial activated carbon it was observed a greater interaction as the content of acid groups increases. ¶The activated carbons with higher carbamazepine adsorption are: the modified mineral activated carbons, CAmi40, CAmi65 and the commercial carbon modified with nitric acid with a higher concentration, CAmk65.

  4. Estudio de bioequivalencia de dos formulaciones de tabletas de carbamazepina de liberación retardada Study of bioequivalence of two carbamazepine retard-release tablet formulations

    Directory of Open Access Journals (Sweden)

    2000-03-01

    Full Text Available En 12 voluntarios sanos se efectuó un estudio de bioequivalencia de dos preparados comerciales de carbamazepina en tabletas de liberación retardada. Este estudio permitió comparar la biodisponibilidad de la formulación de referencia Tegretol® Retard de Ciba Geigy elaborado en Colombia por Novartis, y la formulación de prueba Carbamazepina MK Retard, de Tecnoquímicas. Para evaluar la bioequivalencia se determinaron las curvas de concentración plasmática vs tiempo de las dos formulaciones y se calcularon las áreas bajo la curva (AUC y las concentraciones máximas (Cmáx. Para la formulación de prueba el intervalo de confianza del 90% para el AUC estuvo entre 95.7 y 100.7% y para el C(máx entre el 88.6 y el 106.1%. Para ambas determinaciones el rango de aceptación, según normas internacionales, está entre 80 y 125% de la formulación de referencia. Esto demuestra la bioequivalencia de las dos formulaciones. A study of the bioequivalence of two comercial carbamazepine retard-release formulations was carried out in 12 healthy volunteers. Studies of bioequivalence allow to compare the bioavailability of the innovator formulation with generic, alternative or branch formulations. In order to evaluate the bioequivalence, plasma carbamazepine concentration/time curves were obtained for the Tegretol® Retard Tablets –reference formulationand for the test formulation; the area under each curve and the maximum concentration were calculated. After the calculation, statistical analysis of data for the area under the curve of the Carbamazepine Retard Tablets –test formulation, was between 95.7% and 100.7 % and the maximum concentration of the test formulation was between 88.6% and 106.1%; both parameters with the 90% confidence interval. Since the acceptance range was determined to be between 80.0% and 125.0% of the reference formulation, we concluded from this study that the two formulations are bioequivalent.

  5. High doses of carbamazepine for refractory partial epilepsy Altas doses de carbamazepina para epilepsia parcial refratária

    Directory of Open Access Journals (Sweden)

    Cristiana Borges Pereira

    1996-03-01

    Full Text Available Forty-eight patients with partial seizures were analysed during treatment with 1200 mg/d or more of carbamazepine (CBZ. Thirty-three were on monotherapy and fifteen on polytherapy. The other drugs were kept unchanged in the patients on polytherapy. The dose of CBZ was increased if no control was observed and the patient had no side effects. The doses used ranged between 1200 and 1900 mg/day (1200 mg/day, n=18; 1300mg/day, n=1; 1400 mg/day, n=7; 1600 mg/day, n=9; 1700 mg/day, n=4; 1800 mg/day, n=8; 1900 mg/day, n=1. Anticonvulsant plasma levels were taken to confirm patient compliance. The average plasma level was 9.6 ug/mL. The period of follow up varied from 3 to 96 months (M=25.6. Seizure's control was observed in 7 (14.48% patients taking 1200 mg/day and in 2 (4.16% patients taking 1400 mg/day of CBZ. Thirty-nine patients did not show any control (81.21%. Ten patients (20.81% had signs of intoxication. When patients have no improvement with 1400 mg/day, it is difficult to obtain any control despite the use of higher doses of CBZ, which frequently expose the patient to significant side effects.Foram analisados 48 pacientes epilépticos com crises parciais que faziam uso de carbamazepina (CBZ em doses iguais ou superiores a 1200 mg por dia. Trinta e três estavam em monoterapia e 15 em politerapia. As outras medicações foram mantidas constantes durante a manipulação da dose de CBZ nos pacientes em politerapia. O critério utilizado para o aumento da dose de CBZ foi a falta de controle clínico e a ausência de efeitos colaterais (independente da dosagem sérica. A dose máxima variou de 1200 a 1900 mg/dia (1200 mg, n=18; 1300 mg/dia, n=1; 1400 mg/dia, n=7; 1600 mg/dia, n=9; 1700 mg/dia, n=4; 1800 mg/dia, n=8 ; 1900 mg/dia, n=1. Dosagens séricas de anticonvulsivantes eram utilizadas no sentido de confirmar a aderência ao tratamento. A média das dosagens disponíveis foi de 9,6 ug/mL. O tempo de seguimento variou de 3 a 96 meses (M=25

  6. Anhydrate to hydrate solid-state transformations of carbamazepine and nitrofurantoin in biorelevant media studied in situ using time-resolved synchrotron X-ray diffraction

    DEFF Research Database (Denmark)

    Boetker, Johan P.; Rantanen, Jukka; Arnfast, Lærke;

    2016-01-01

    in water was shorter than for DOPC/SDS but still faster than the conversion seen in fed and fasted state micellar media. The conversion of CBZ anhydrate to hydrate was the slowest in the solution containing bile salt alone. In contrast, the solution-mediated phase transformations of NF did only show...... with different biorelevant media, simulated fasted and fed state intestinal fluids containing bile salt and dioleoylphosphatidylcholine (DOPC) micelles, DOPC/sodium dodecyl sulfate (SDS) mixture, bile salt solution and water. Two anhydrate compounds (carbamazepine, CBZ and nitrofurantoin, NF) with...... component analysis, PCA) and compared to those for nitrofurantoin (NF). The study showed that the solution-mediated phase transformation of CBZ anhydrate was remarkably faster in the DOPC/SDS medium compared to transformation in all the other aqueous dispersion media. The conversion time for CBZ anhydrate...

  7. Simultaneous Detection of Sulfamethoxazole, Diclofenac, Carbamazepine, and Bezafibrate by Solid Phase Extraction and High Performance Liquid Chromatography with Diode Array Detection

    Science.gov (United States)

    Zhou, Z.; Jiang, J.-Q.

    2014-05-01

    A method of solid phase extraction (SPE) coupled with high performance liquid chromatography and diode array detection (HPLC-DAD) was studied for the simultaneous determination of sulfamethoxazole (SMX), diclofenac (DCF), carbamazepine (CBZ), and bezafi brate (BZF) in test solutions. The target compounds were extracted by SPE from samples, and the resulting elutes were analyzed using a HPLC-DAD system at wavelengths of 270, 280, 290, and 230 nm for SMX, DCF, CBZ, and BZF, respectively. This method shows good recoveries for SMX, DCF, CBZ, and BZF with mean recoveries of 89.7 ± 9.3%, 86.1 ± 7.6%, 95.0 ± 6.5%, and 94.0 ± 5.4%, respectively.

  8. Dissipation of triclosan, triclocarban, carbamazepine and naproxen in agricultural soil following surface or sub-surface application of dewatered municipal biosolids

    International Nuclear Information System (INIS)

    In many jurisdictions land application of municipal biosolids is a valued source of nutrients for crop production. The practice must be managed to ensure that crops and adjacent water are not subject to contamination by pharmaceuticals or other organic contaminants. The broad spectrum antimicrobial agents triclosan (TCS) and triclocarban (TCC), the anti-epileptic drug carbamazepine (CBZ), and the nonsteroidal anti-inflammatory drug naproxen (NAP) are widely used and are carried in biosolids. In the present study, the effect of biosolids and depth of placement in the soil profile on the rates of TCS, TCC, CBZ, and NAP dissipation were evaluated under semi-field conditions. Aggregates of dewatered municipal biosolids (DMBs) supplemented with 14C-labeled residues were applied either on the soil surface or in the subsurface of the soil profile, and incubated over several months under ambient outdoor conditions. The dissipation of TCS, TCC and NAP was significantly faster in sub-surface than surface applied biosolid aggregates. In contrast the dissipation rate for CBZ was the same in surface applied and incorporated aggregates. Overall, the present study has determined a significant effect of depth of placement on the dissipation rate of biodegradable molecules. - Highlights: • We characterized the soil fate of four organic contaminants carried in biosolids. • Biosolids were placed on the soil surface or incorporated within the soil profile. • Naproxen, triclosan and triclocarban were dissipated more rapidly when incorporated. • Depth of placement did not influence the rate of carbamazepine dissipation. • Soil incorporation of biosolids will result in more rapid dissipation of contaminants

  9. Dissipation of triclosan, triclocarban, carbamazepine and naproxen in agricultural soil following surface or sub-surface application of dewatered municipal biosolids

    Energy Technology Data Exchange (ETDEWEB)

    Al-Rajab, Abdul Jabbar; Sabourin, Lyne [Agriculture and Agri-Food Canada, London, ON N5V 4T3 (Canada); Lapen, David R. [Agriculture and Agri-Food Canada, Ottawa, ON K1A 0C6 (Canada); Topp, Edward, E-mail: ed.topp@agr.gc.ca [Agriculture and Agri-Food Canada, London, ON N5V 4T3 (Canada); Department of Biology, Western University, London, ON N6A 5B7 (Canada)

    2015-04-15

    In many jurisdictions land application of municipal biosolids is a valued source of nutrients for crop production. The practice must be managed to ensure that crops and adjacent water are not subject to contamination by pharmaceuticals or other organic contaminants. The broad spectrum antimicrobial agents triclosan (TCS) and triclocarban (TCC), the anti-epileptic drug carbamazepine (CBZ), and the nonsteroidal anti-inflammatory drug naproxen (NAP) are widely used and are carried in biosolids. In the present study, the effect of biosolids and depth of placement in the soil profile on the rates of TCS, TCC, CBZ, and NAP dissipation were evaluated under semi-field conditions. Aggregates of dewatered municipal biosolids (DMBs) supplemented with {sup 14}C-labeled residues were applied either on the soil surface or in the subsurface of the soil profile, and incubated over several months under ambient outdoor conditions. The dissipation of TCS, TCC and NAP was significantly faster in sub-surface than surface applied biosolid aggregates. In contrast the dissipation rate for CBZ was the same in surface applied and incorporated aggregates. Overall, the present study has determined a significant effect of depth of placement on the dissipation rate of biodegradable molecules. - Highlights: • We characterized the soil fate of four organic contaminants carried in biosolids. • Biosolids were placed on the soil surface or incorporated within the soil profile. • Naproxen, triclosan and triclocarban were dissipated more rapidly when incorporated. • Depth of placement did not influence the rate of carbamazepine dissipation. • Soil incorporation of biosolids will result in more rapid dissipation of contaminants.

  10. The safety and effectiveness of open-label extended-release carbamazepine in the treatment of children and adolescents with bipolar I disorder suffering from a manic or mixed episode

    OpenAIRE

    Findling RL; Ginsberg LD

    2014-01-01

    Robert L Findling,1,2 Lawrence D Ginsberg31Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 2Kennedy Krieger Institute, Baltimore, MD, USA; 3Red Oak Psychiatry Associates, PA, Houston, TX, USAObjective: To assess the safety and effectiveness of open-label treatment with extended-release carbamazepine (ERC) in pediatric subjects suffering from bipolar I disorder.Method: Medically healthy youths aged 10–17&nbs...

  11. A comprehensive study of the relation between serum concentrations, concentration ratios, and level/dose ratios of carbamazepine and its metabolites with age, weight, dose, and clearances in epileptic children.

    Science.gov (United States)

    Liu, H; Delgado, M R

    1994-01-01

    We made a comprehensive study of the relation between age, weight, carbamazepine (CBZ) dose, total clearance (TC), and intrinsic clearance (IC) and concentrations, concentration ratios, and level/dose ratios of CBZ, carbamazepine-10,11-epoxide (CBZ-E) and trans-10,11-dihydroxy-10,11- dihydro-carbamazepine (CBZ-H) in a group of epileptic children receiving CBZ monotherapy. Body weight and age showed negative correlations with TC, IC, CBZ dose, and CBZ-E/CBZ and CBZ-H/CBZ concentration ratios, and had positive relation with CBZ, CBZ-E, and CBZ-H level/dose ratios. These results indicate decreased CBZ metabolism with patient maturity. Correlations between CBZ dose with TC, IC, and the concentration ratios of CBZ-E/CBZ, CBZ-H/CBZ-E, and CBZ-H/CBZ were positive. CBZ dose also had negative associations with CBZ and CBZ-E level/dose ratios, indicating dose-dependent autoinduction of CBZ metabolism. Our data suggest that weight, age, and CBZ dose have less influence on epoxide-hydrolase activities than on epoxidase activities. The CBZ-E/CBZ concentration ratio can be used as an indicator of the degree of autoinduction of CBZ metabolism, even in patients receiving CBZ monotherapy. PMID:7988515

  12. The impacts of pharmaceutical drugs under ocean acidification: New data on single and combined long-term effects of carbamazepine on Scrobicularia plana.

    Science.gov (United States)

    Freitas, Rosa; Almeida, Ângela; Calisto, Vânia; Velez, Cátia; Moreira, Anthony; Schneider, Rudolf J; Esteves, Valdemar I; Wrona, Frederick J; Figueira, Etelvina; Soares, Amadeu M V M

    2016-01-15

    Ocean acidification and increasing discharges of pharmaceutical contaminants into aquatic systems are among key and/or emerging drivers of environmental change affecting marine ecosystems. A growing body of evidence demonstrates that ocean acidification can have direct and indirect impacts on marine organisms although combined effects with other stressors, namely with pharmaceuticals, have received very little attention to date. The present study aimed to evaluate the impacts of the pharmaceutical drug Carbamazepine and pH 7.1, acting alone and in combination, on the clam Scrobicularia plana. For this, a long-term exposure (28 days)was conducted and a set of oxidative stress markers was investigated. The results obtained showed that S. plana was able to develop mechanisms to prevent oxidative damage when under low pH for a long period, presenting higher survival when exposed to this stressor compared to CBZ or the combination of CBZ with pH 7.1. Furthermore, the toxicity of CBZ on S. plana was synergistically increased under ocean acidification conditions (CBZ + pH 7.1): specimens survival was reduced and oxidative stress was enhanced when compared to single exposures. These findings add to the growing body of evidence that ocean acidification will act to increase the toxicity of CBZ to marine organisms,which has clear implications for coastal benthic ecosystems suffering chronic pollution from pharmaceutical drugs. PMID:26473700

  13. Using lysosomal membrane stability of haemocytes in Ruditapes philippinarum as a biomarker of cellular stress to assess contamination by caffeine, ibuprofen, carbamazepine and novobiocin.

    Science.gov (United States)

    Aguirre-Martínez, Gabriela V; Buratti, Sara; Fabbr, Elena; DelValls, Angel T; Martín-Díaz, M Laura

    2013-07-01

    Although pharmaceuticals have been detected in the environment only in the range from ng/L to microg/L, it has been demonstrated that they can adversely affect the health status of aquatic organisms. Lysosomal membrane stability (LMS) has previously been applied as an indicator of cellular well-being to determine health status in bivalve mussels. The objective of this study is to evaluate LMS in Ruditapes philippinarum haemolymph using the neutral red retention assay (NRRA). Clams were exposed in laboratory conditions to caffeine (0.1, 5, 15, 50 microg/L), ibuprofen (0.1, 5, 10, 50 microg/L), carbamazepine and novobiocin (both at 0.1, 1, 10, 50 microg/L) for 35 days. Results show a dose-dependent effect of the pharmaceuticals. The neutral red retention time measured at the end of the bioassay was significantly reduced by 50% after exposure to environmental concentrations (p Measurement of the alteration of LMS has been found to be a sensitive technique that enables evaluation of the health status of clams after exposure to pharmaceuticals under laboratory conditions, thus representing a robust Tier-1 screening biomarker. PMID:24218854

  14. Carbamazepine transbuccal delivery: the histo-morphological features of reconstituted human oral epithelium and buccal porcine mucosae in the transmucosal permeation.

    Science.gov (United States)

    Campisi, G; Paderni, C; Saccone, R; Siragusa, M G; Lo Muzio, L; Tripodo, C; Giannola, L I; Florena, A M

    2008-01-01

    Transbuccal drug delivery is an attractive way of administration since several well-known advantages are provided, especially with respect to peroral management. Carbamazepine (CBZ) is an anticonvulsant which is useful in controlling neuropathic pain, and it is currently administered by peroral route, although its absorption and bioavailability is limited due to various factors. The oral cavity could be an interesting site for transbuccal CBZ delivery due to two properties: slow administration of constant low drug doses and less dose-related side effects. However, in transbuccal absorption a major limitation could be the low permeability of the mucosa which results in low drug bioavailability; thus the aptitude of the drug to penetrate the buccal mucosa has to be assessed by using tissue models resembling human normal mucosa. In our experience, CBZ well permeates mucosal membranes. In order to assess the efficacy of CBZ transbuccal delivery and to verify the reliability of these tissues in permeability testing before and after the passage of CBZ, the histo-morphological features of reconstituted human oral (RHO) epithelium (E) and buccal porcine mucosae were investigated. Significant histological changes due to CBZ passage were observed both in RHO-E and porcine mucosa. The main findings detected in RHO samples were cellular swellings with a signet ring-like appearance, nuclear swelling, prominent nucleoli lined against the nuclear membrane and the presence of keratohyalin granules. The most striking finding regarding porcine buccal mucosa was a cytoplasmic vacuolization, mainly involving the basal layer. PMID:19144275

  15. Carbamazepine in municipal wastewater and wastewater sludge: ultrafast quantification by laser diode thermal desorption-atmospheric pressure chemical ionization coupled with tandem mass spectrometry.

    Science.gov (United States)

    Mohapatra, D P; Brar, S K; Tyagi, R D; Picard, P; Surampalli, R Y

    2012-09-15

    In this study, the distribution of the anti-epileptic drug carbamazepine (CBZ) in wastewater (WW) and aqueous and solid phases of wastewater sludge (WWS) was carried out. A rapid and reliable method enabling high-throughput sample analysis for quicker data generation, detection, and monitoring of CBZ in WW and WWS was developed and validated. The ultrafast method (15s per sample) is based on the laser diode thermal desorption-atmospheric pressure chemical ionization (LDTD-APCI) coupled to tandem mass spectrometry (MS/MS). The optimization of instrumental parameters and method application for environmental analysis are presented. The performance of the novel method was evaluated by estimation of extraction recovery, linearity, precision and detection limit. The method detection limits was 12 ng L(-1) in WW and 3.4 ng g(-1) in WWS. The intra- and inter-day precisions were 8% and 11% in WW and 6% and 9% in WWS, respectively. Furthermore, three extraction methods, ultrasonic extraction (USE), microwave-assisted extraction (MAE) and accelerated solvent extraction (ASE) with three different solvent condition such as methanol, acetone and acetonitrile:ethyle acetate (5:1, v/v) were compared on the basis of procedural blank and method recovery. Overall, ASE showed the best extraction efficiency with methanol as compared to USE and MAE. Furthermore, the quantification of CBZ in WW and WWS samples showed the presence of contaminant in all stages of the treatment plant. PMID:22967548

  16. Dissipation of triclosan, triclocarban, carbamazepine and naproxen in agricultural soil following surface or sub-surface application of dewatered municipal biosolids.

    Science.gov (United States)

    Al-Rajab, Abdul Jabbar; Sabourin, Lyne; Lapen, David R; Topp, Edward

    2015-04-15

    In many jurisdictions land application of municipal biosolids is a valued source of nutrients for crop production. The practice must be managed to ensure that crops and adjacent water are not subject to contamination by pharmaceuticals or other organic contaminants. The broad spectrum antimicrobial agents triclosan (TCS) and triclocarban (TCC), the anti-epileptic drug carbamazepine (CBZ), and the nonsteroidal anti-inflammatory drug naproxen (NAP) are widely used and are carried in biosolids. In the present study, the effect of biosolids and depth of placement in the soil profile on the rates of TCS, TCC, CBZ, and NAP dissipation were evaluated under semi-field conditions. Aggregates of dewatered municipal biosolids (DMBs) supplemented with (14)C-labeled residues were applied either on the soil surface or in the subsurface of the soil profile, and incubated over several months under ambient outdoor conditions. The dissipation of TCS, TCC and NAP was significantly faster in sub-surface than surface applied biosolid aggregates. In contrast the dissipation rate for CBZ was the same in surface applied and incorporated aggregates. Overall, the present study has determined a significant effect of depth of placement on the dissipation rate of biodegradable molecules. PMID:25644844

  17. Hydrothermal Synthesis of Hydrangea-Like F-Doped Titania Microspheres for the Photocatalytic Degradation of Carbamazepine under UV and Visible Light Irradiation

    Directory of Open Access Journals (Sweden)

    Miaomiao Ye

    2012-01-01

    Full Text Available Hydrangea-like F-doped TiO2 microspheres have been synthesized on a large scale by a simple hydrothermal process using potassium titanium oxalate as the titanium source, ammonium fluoride and hydrogen peroxide as the etchant. The photocatalytic activities were evaluated using carbamazepine as the target organic molecule under UV and visible light irradiation. Structural characterization indicates that the hydrangea-like TiO2 microspheres, with an average diameter of 2.80 μm, are composed of numerous anatase TiO2 petals. Moreover, it is found that both the NH4F and H2O2 dosages have important effects on the formation of the hydrangea-like structures. In addition, photocatalytic experiments show that the hydrangea-like TiO2 microspheres calcined at 500°C exhibit high photocatalytic efficiency under both UV and visible light irradiation. The enhanced photocatalytic activity can be attributed to the successful fluorine doping, good crystallinity, and the unique nanostructures.

  18. Immediate and delayed treatment with gabapentin, carbamazepine and CNQX have almost similar impact on cognitive functions and behavior in the lithium-pilocarpine model in rats.

    Science.gov (United States)

    Gulec Suyen, Guldal; Isbil-Buyukcoskun, Naciye; Kahveci, Nevzat; Sengun, Ece; Ozluk, Kasim

    2016-09-01

    In the present study, we aimed to investigate the effects of immediate and delayed treatment with intracerebroventricular (i.c.v.) gabapentin (GBP), carbamazepine (CBZ) and 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) on learning and memory, anxiety, and locomotor activity in rats with lithium-pilocarpine-induced status epilepticus (SE). SE was induced by intraperitoneal injections of 3mEq/kg LiCl followed by 45mg/kg pilocarpine 24h later. In the first series of experiments, rats were divided into four groups three hours after the onset of SE and received GBP (100μg/10μl, two times a day; i.c.v.), CBZ (200μg/10μl; i.c.v.), CNQX (25nmol/10μl; i.c.v.) or saline (10μl; i.c.v.) for 7days. Six weeks after SE, cognitive and behavioral performances were evaluated by Morris water maze, elevated plus maze, and open field tests. In the second series, rats received no treatment for six weeks following SE. On the seventh week the same treatment with the previous rats was given and six weeks later the cognitive and behavioral tests were applied. SE significantly impaired spatial learning and memory in the Morris water maze. GBP treatment improved the acqusition and memory performance. CNQX worsened the acqusition but improved the memory performance, while CBZ worsened both parameters. In the elevated plus maze, epileptic rats which received saline showed significantly lower anxiety levels with respect to the naive rats. Only CBZ led to further anxiolysis, while the other drugs had no effect. Locomotor activity significantly increased due to SE, which was augmented by GBP and CNQX. The impact of immediate and delayed treatment with these drugs on cognition and behavior seems to be quite similar. PMID:27426469

  19. Effects of Levetiracetam, Carbamazepine, Phenytoin, Valproate, Lamotrigine, Oxcarbazepine, Topiramate, Vinpocetine and Sertraline on Presynaptic Hippocampal Na(+) and Ca(2+) Channels Permeability.

    Science.gov (United States)

    Sitges, María; Chiu, Luz María; Reed, Ronald C

    2016-04-01

    Ion channels are targets of various antiepileptic drugs. In cerebral presynaptic nerve endings Na(+) and Ca(2+) channels are particularly abundant, as they control neurotransmitter release, including the release of glutamate (Glu), the most concentrated excitatory amino acid neurotransmitter in the brain. Several pre-synaptic channels are implicated in the mechanism of action of the pro-convulsive agent, 4-aminopyridine (4-AP). In the present study the effects of levetiracetam and other established and newer (vinpocetine) anti-epileptic drugs, as well as of the anti-depressant, sertraline on the increase in Ca(2+) induced by 4-AP in hippocampal isolated nerve endings were investigated. Also the effects of some of the anti-seizure drugs on the selective increase in Ca(2+) induced by high K(+), or on the selective increase in Na(+) induced by veratridine were tested. Sertraline and vinpocetine effectively inhibited the rise in Ca(2+) induced by 4-AP, which was dependent on the out-in Na(+) gradient and tetrodotoxin sensitive. Carbamazepine, phenytoin, lamotrigine and oxcarbazepine inhibited the rise in Ca(2+) induced by 4-AP too, but at higher concentrations than sertraline and vinpocetine, whereas levetiracetam, valproic acid and topiramate did not. The three latter antiepileptic drugs also failed in modifying other responses mediated by the activation of brain presynaptic Na(+) or Ca(2+) channels, including Glu release. This indicates that levetiracetam, valproic acid and topiramate mechanisms of action are unrelated with a decrease in presynaptic Na(+) or Ca(2+) channels permeability. It is concluded that depolarized cerebral isolated nerve endings represent a useful tool to unmask potential antiepileptic drugs targeting presynaptic Na(+) and/or Ca(2+) channels in the brain; such as vinpocetine or the anti-depressant sertraline, which high effectiveness to control seizures in the animal in vivo has been demonstrated. PMID:26542150

  20. Carbamazepine solubility enhancement in tandem with swellable polymer osmotic pump tablet: A promising approach for extended delivery of poorly water-soluble drugs

    Directory of Open Access Journals (Sweden)

    Hadjira Rabti

    2014-06-01

    Full Text Available Elementary osmotic pump (EOP is a unique extended release (ER drug delivery system based on the principle of osmosis. It has the ability to minimize the amount of the drug, accumulation and fluctuation in drug level during chronic uses. Carbamazepine (CBZ, a poorly water-soluble antiepileptic drug, has serious side effects on overdoses and chronic uses. The aim of the present study was to design a new EOP tablet of CBZ containing a solubility enhancers and swellable polymer to reduce its side effects and enhance the patient compliance. Firstly, a combination of solubilizing carriers was selected to improve the dissolution of the slightly soluble drug. Then, designing the new EOP tablet and investigating the effect of different variables of core and coat formulations on drug release behavior by single parameter optimization and by Taguchi orthogonal design with analysis of variance (ANOVA, respectively. The results showed that CBZ solubility was successfully enhanced by a minimum amount of combined polyvinyl pyrrolidone (PVP K30 and sodium lauryl sulfate (SLS. The plasticizer amount and molecular weight (MW together with the osmotic agent amount directly affect the release rate whereas the swellable polymer amount and viscosity together with the semi-permeable membrane (SPM thickness inversely influence the release rate. In addition, the tendency of following zero order kinetics was mainly affected by the coat components rather than those of the core. Further, orifice size does not have any significant effect on the release behavior within the range of 0.1 mm to 0.8 mm. In this study we report the successful formulation of CBZ-EOP tablets, which were similar to the marketed product Tegretol CR 200 and able to satisfy the USP criterion limits and to deliver about 80% of CBZ at a rate of approximately zero order for up to 12 h.

  1. Visualizing the conversion of carbamazepine in aqueous suspension with and without the presence of excipients: a single crystal study using SEM and Raman microscopy.

    Science.gov (United States)

    Tian, F; Sandler, N; Gordon, K C; McGoverin, C M; Reay, A; Strachan, C J; Saville, D J; Rades, T

    2006-11-01

    Visual observations of the hydration process of single carbamazepine (CBZ) crystals in water and in various excipient solutions [(1% w/v) - hydroxypropyl cellulose (HPC), poly(vinyl pyrrolidone) (PVP), sodium carboxymethylcellulose (CMC) at pH 7.5 and 3.0, and polyethylene glycol (PEG)] using scanning electron microscopy (SEM) are reported in this paper. Raman microscopy was used to confirm the chemical structures of the unconverted CBZ and the CBZ dihydrate (DH) needles. It was found that defect structures were a more important driving force than the nature of crystal faces for the initiation of the hydration, but face differences became obvious after 6 h immersion. The biggest crystal face grown from methanol, (100), was the slowest one to be covered with DH needles. A comparison of the molecular arrangements along the three crystal faces [(100), (010) and (001)] was carried out using crystal structure visualization software, and fewer polar groups exposed on the (100) face than on the (001) and (010) faces were found, explaining the comparatively weak interaction of the (100) face with water during hydration. Furthermore, investigation of the influence of excipients on the hydration of CBZ showed that both HPC and PVP strongly inhibited conversion, and no conversion of CBZ to DH was found after 18 h immersion in water. PEG and CMC (pH 7.5) were less potent inhibitors than HPC and PVP, and DH needles were observed on all the faces except the (100) face after 18 h immersion. No conversion was detected for the crystal immersed in CMC solution at pH 3.0. This is likely to be caused by the decreased polarity of CMC in water at pH 3.0 (pKa,cmc = 4.3), and thus a higher surface adsorption of CMC to the CBZ crystals in dispersion. The influence of excipients on the conversion of CBZ observed in this study agreed well with our previous quantitative studies using Raman spectroscopy. In this study, visual observation using electron microscopy has been demonstrated to be a

  2. Extracorporeal treatment for carbamazepine poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Yates, Christopher; Galvao, Tais F;

    2014-01-01

    mg/L (42 the μ in μmol/L looks weird.) (2D). Intermittent hemodialysis is the preferred ECTR (1D), but both intermittent hemoperfusion (1D) or continuous renal replacement therapies (3D) are alternatives if hemodialysis is not available. MDAC therapy should be continued during ECTR (1D). CONCLUSION...

  3. Preparation and Quality Evaluation of Carbamazepine Orally Disintegrating Tablets%卡马西平口腔速崩片的制备及质量评价

    Institute of Scientific and Technical Information of China (English)

    卫晓晓; 焦海胜

    2011-01-01

    OBJECTIVE: To prepare Carbamazepine (CBZ) orally disintegrating tablets and to evaluate the quality standard of it.METHODS: The tablets were prepared by directly powder compression method using microcrystaline cellulose (MCC) and croscarmellose sodium (CCNa) as disintegrants.The preparation method was optimized by orthogonal test using amount of MCC,CCNa and lactose as factors and with disintegrating time as index.The content of main components was determined by UV spectrophotometry, and the properties of the tablets were evaluated using dissolution rate and stability as index.The dissolution rate of CBZ orally disintegrating tablets was compared with common tablet, and the stability of CBZ orally disintegrating tablets was compared with raw material.RESULTS: The optimal formula was as follows: MCC 75 mg, CCNa 9 mg, lactose 30 mg.The quality of prepared tablets was in line with the standard.The disintegration time was (21 ± 3) s and the accumulative dissolution rate was 81.46% within 2 min.The accumulative dissolution rate was 71.46% within 90 min.Compared with raw material, the absorption peak of prepared tablets changed slightly.CONCLUSION: The preparation technology of orally disintegrating tablets is simple, controllable in quality.It should be kept in drug and cold environment.%目的:制备卡马西平(CBZ)口腔速崩片并评价其质量.方法:选用CBZ为主药,微晶纤维素(MCC)、交联羧甲基纤维素钠(CCNa)为崩解剂,以直接粉末压片法制备片剂;以MCC、CCNa、乳糖用量为考察因素,崩解时间为考察指标设计正交试验筛选处方;采用紫外分光光度法测定制剂中主药的含量,同时以崩解时间、溶出度及稳定性等指标进行质量评价,并与普通片剂比较溶出度,与原料药比较稳定性.结果:优选处方为MCC 75mg、CCNa 9mg、乳糖30mg.所制制剂含量均匀度符合规定,崩解时间为(21±3)s.溶出迅速,2 min内累积溶出率达81.46%;普通片剂90 min

  4. 卡马西平联合巴氯芬治疗三叉神经痛的临床分析%Clinical analysis of carbamazepine combined with baclofen treating trigeminal neuralgia

    Institute of Scientific and Technical Information of China (English)

    程福璋

    2015-01-01

    Objective To explore the clinical effect of carbamazepine combined with baclofen treating trigeminal neu-ralgia. Methods 82 patients with trigeminal neuralgia meeting clinical diagnostic criteria and received in our hospital from February 2013 to February 2015 were selected as study object.Patients were divided into control group and treat-ment group by random number table method,and each group was 41 cases.Patients in control group were treated simply with carbamazepine,while patients in treatment group were given carbamazepine combined with baclofen.Disappear time of trigeminal neuralgia symptom,the total time of medicine treatment plan implement,treatment effect and incidence rate of adverse reaction and so on in patients between two groups was compared respectively. Results The disappear time of trigeminal neuralgia symptom and the total time of medicine treatment plan implement in treatment group [(7.32±1.08) d and (10.75±1.68) d] was obviously shorter than that of control group [(10.68±2.15) d and (14.79±2.53) d] respectively (P<0.05).The total effective rate in treatment group (90.3%) was obviously higher than that of control group (68.3%) (P<0.05).The incidence rate of adverse reaction in treatment group (2.4%) obviously lower than that of control group (17.1%) (P<0.05). Conclusion The clinical effect is very obvious by using carbamazepine combined with baclofen treat-ing trigeminal neuralgia.%目的:探讨卡马西平联合巴氯芬治疗三叉神经痛的临床效果。方法选择2013年2月~2015年2月我院收治的符合临床诊断标准的三叉神经痛患者82例作为研究对象,采取随机数字表法将其分成对照组和治疗组,每组41例。对照组患者给予单纯卡马西平治疗;治疗组患者给予卡马西平联合巴氯芬治疗。比较两组患者的三叉神经痛症状消失时间和用药治疗计划实施总时间、治疗效果、不良反应发生率等。结果治疗组患者的三

  5. A chiral HPLC-UV method for the quantification of dibenz[b,f]azepine-5-carboxamide derivatives in mouse plasma and brain tissue: eslicarbazepine acetate, carbamazepine and main metabolites.

    Science.gov (United States)

    Fortuna, Ana; Bicker, Joana; Alves, Gilberto; Falcão, Amílcar; Soares-da-Silva, Patrício

    2011-06-01

    For the first time, a selective and sensitive chiral HPLC-UV method was developed and fully validated for the simultaneous quantification of eslicarbazepine acetate (ESL), carbamazepine (CBZ), S-licarbazepine (S-Lic), R-licarbazepine (R-Lic), oxcarbazepine (OXC) and carbamazepine-10,11-epoxide (CBZ-E), in mouse plasma and brain homogenate supernatant. After the addition of chloramphenicol as the internal standard, samples were processed using an SPE procedure. The chiral chromatographic analysis was carried out on a LiChroCART 250-4 ChiraDex column, employing a mobile phase of water and methanol (88:12, v/v) pumped at 0.9 mL/min and the UV detector set at 235 nm. The assay was linear (r(2) ≥0.995) for ESL, CBZ, OXC, S-Lic, R-Lic and CBZ-E in the range of, respectively, 0.2-4, 0.4-30, 0.1-60, 0.2-60, 0.2-60 and 0.2-30 μg/mL, in plasma, and of 0.06-1.5 μg/mL for ESL, 0.12-15 μg/mL for CBZ and CBZ-E and 0.06-15 μg/mL for OXC and both licarbazepine (Lic) enantiomers in brain homogenate supernatant. The overall precision was within 8.71% and accuracy ranged from -7.55 to 8.97%. The recoveries of all the compounds were over 92.1%. Afterwards, the application of the method was demonstrated using real plasma and brain samples obtained from mice administered simultaneously with ESL and CBZ. PMID:21557472

  6. The safety and effectiveness of open-label extended-release carbamazepine in the treatment of children and adolescents with bipolar I disorder suffering from a manic or mixed episode

    Directory of Open Access Journals (Sweden)

    Findling RL

    2014-08-01

    Full Text Available Robert L Findling,1,2 Lawrence D Ginsberg31Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 2Kennedy Krieger Institute, Baltimore, MD, USA; 3Red Oak Psychiatry Associates, PA, Houston, TX, USAObjective: To assess the safety and effectiveness of open-label treatment with extended-release carbamazepine (ERC in pediatric subjects suffering from bipolar I disorder.Method: Medically healthy youths aged 10–17 years suffering from an acute manic or mixed episode were eligible. After screening for study eligibility, the youths began a 5-week titration period in which doses of ERC were adjusted in order to optimize benefit whilst minimizing adverse events, at doses between 200–1,200 mg/day. Thereafter, subjects could continue to receive treatment during a subsequent 21-week period. Safety measures included spontaneously reported adverse events (AEs and laboratory assessments. The primary efficacy measure was the Young Mania Rating Scale (YMRS.Results: A total of 60 children (ages 10–12 and 97 adolescents (ages 13–17, with an overall average age of 13.4 years (standard deviation [SD] 2.0 years received ERC. The mean duration of study participation was 109.6 days (SD 70.2 days, with 66 (42% completing the entire study. At end of study participation (end point, the most prevalent dose of ERC was 1,200 mg: 31.7% of children and 24.7% of adolescents reached the 1,200 mg dose. The YMRS decreased from a mean of 28.6 (SD 6.2 at baseline to a mean of 13.8 (SD 9.4 (P<0.0001 at end point. A total of 26 subjects discontinued study participation because of AEs, the most common of which were rash (n=6, white blood cell count decreased (n=5, nausea (n=3, and vomiting (n=3. No deaths were reported. The most commonly reported AEs were headache (n=41, somnolence (n=30, nausea (n=22, dizziness (n=21, and fatigue (n=19.Conclusions: Open-label administration of ERC might be a safe

  7. 卡马西平对癫(痫)患者血浆纤维蛋白原含量的影响%Effect of Carbamazepine on plasma fibrinogen for epilepsy patients

    Institute of Scientific and Technical Information of China (English)

    刘广韬; 潘隆盛; 凌至培; 许百男

    2011-01-01

    目的 分析口服卡马西平(CBZ)对患者血浆纤维蛋白原含量的影响.方法 回顾性分析我院收治的使用卡马西平出现血浆纤维蛋白原含量降低患者的临床资料,对患者的性别,年龄、卡马西平的用法用量、用药时间、停药时间、停药前后纤维蛋白原的含量变化及转归进行分析讨论.结果 12例男性患者均为长期不规则服药,时长与病史年限大致相同.经停用卡马西平,11例患者纤维蛋白原恢复至2.0 g/L以上,1例停药14 d,纤维蛋白原由1.40g/L升至1.92g/L.结论 卡马西平可致患者血浆纤维蛋白原含量降低,用药过程中应监测纤维蛋白原含量,以防引起严重出血.%Objective To analyze the effect of oral administration with Carbamazepine (CBZ) on plasma fibrinogen content for epilepsy patients. Methods The clinical data of patients with CBZ reduced plasma fibrinogen levels in patients were analyzed retrospectively. The patient's sex, age,use of CBZ dosage, administration time, stop medicine time, fibrinogen levels before and after drug withdrawal and the prognosis were analyzed and compared. Results 12 male patients in long-term irregular medication, whose duration and medical history were approximately same. The disabled and symptomatic treatment of CBZ, 11 patients recovered to fibrinogen 2.0 g/L or more, one case of withdrawal 14 d and fibrinogen by the 1. 40 g/L increased to 1.92 g/L. Conclusion CBZ may cause decreased plasma fibrinogen levels, should be monitored during the medication, to prevent serious bleeding.

  8. 128例口服卡马西平导致不良反应文献分析%Literature Analysis of 128 Cases With Carbamazepine Induced Adverse Reactions

    Institute of Scientific and Technical Information of China (English)

    李燕; 赵生芳; 段金菊; 王芳

    2012-01-01

    Objective To explore the general characteristics of adverse drug reactions (ADR) caused by the carbamazepine (CMP), and provide some information for clinical medication . Methods The related reports about ADR caused by CMP were searched and retrospective analyzed in medical and academic journals from China Journal Full-Text Database between January 2000 and October 2009 . At last, a total of 128 cases were include into this study . The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shanxi Medical University . Results Clinical manifestations of ADR caused by the CMP were complex and diverse . The top three incident rate of systemic injury were skin and its appendages injury (58 .60% , 75/128) , central and peripheral nervous system injury (14 .84% , 19/128) and blood disorders (10.16% , 13/128). There had significant difference of incident rate between males and females (P<0 .05) . The ADR can occur in any age stages , and patients older than 60-year-old had the highest incident rate (11 .72% , 5/128). The ADR caused by drug combination may have serious results , such as bullous epidermal necrolysis drug eruption , generalized myoclonic seizures and leukocyte reduction . In 128 patients , the cure rate was 93 .75% (120/128), occurrence rate of sequelae was 0 .78% (1/128) and rate of rescue invalid death was 5 .47% (7/128) . Conclusions Clinicians should pay attention to the ADR caused by CMP, especially guard against the occurrence of serious drug-induced rash , aplastic anemia and acute renal failure. And further knowledge about serious ADR, such as bullous epidermal necrolysis drug eruption, generalized myoclonic seizures and leukocyte reduction caused by drug combination , should be attention .%目的 探讨卡马西平(CMP)导致不良反应(ADR)的一般规律及特点,为临床合理用药提供参考.方法 采用回顾性分析方法,选择2000年1月至2009年10月中国期刊全文数据库收载的国

  9. Comparison of the efficacy of carbamazepine, haloperidol and valproic acid in the treatment of children with Sydenham´s chorea: clinical follow-up of 18 patients Comparación de la eficacia de carbamazepina, haloperidol y acido valproico en el tratamiento de niños con corea de Sydenham: seguimiento clínico de 18 pacientes

    Directory of Open Access Journals (Sweden)

    Joaquín Peña

    2002-06-01

    Full Text Available In order to compare and contrast the efficacy of haloperidol, carbamazepine, and valproic acid in the treatment of Sydenham´s chorea a prospective study including 18 cases of this disorder was undertaken. Age of patients ranged from 7 to 15 years. Ten children were female and 8 were male. All but one had generalized, either symmetric or asymmetric chorea. The patients were divided in three equal groups, and were given a standardized dose of each of the drugs built-up over a week. Following therapy, the six children receiving valproic acid showed remarkable improvement, without side effects. Five patients receiving carbamazepine showed improvement without side effects. Only three of the patients that received haloperidol improved. In the 4 cases that did not show clinical improvement after one week of treatment, therapy with valproic acid led to disappearance of the symptoms in a lapse that ranged from 4 to 7 days. Recurrence related to discontinuation of treatment was observed in two patients. In view of the present results we recommend valproic acid as the first choice drug to treat Sydenham chorea.A fin de comparar y contrastar la eficacia de haloperidol, carbamazepina y ácido valproico en el tratamiento de la corea de Sydenham, se realizó un estudio prospectivo que incluyó 18 casos de esta patología. La edad de los pacientes varió de 7 a 15 años. Diez de los niños eran varones y el resto hembras. A excepción de uno de ellos, todos tenían corea generalizada, simétrica ó asimétrica. Los pacientes fueron divididos en tres grupos iguales, a cada uno de los cuales se le administró una dosis estandarizada de los medicamentos mencionados durante una semana. Luego del tratamiento, los seis pacientes que recibieron ácido valproico mostraron mejoría notable sin efectos colaterales. Cinco de los seis pacientes que recibieron carbamazepina exhibieron mejoría sin efectos colaterales. Solo tres de los pacientes que recibieron haloperidol

  10. 调神活血止痛针刺法与卡马西平治疗丘脑痛作用特点的动态变化观察%Dynamic Observation on Therapeutic Features of Thalamic Pain by Mind Calming, Blood Activating and Pain Relief Acupuncture and Carbamazepine

    Institute of Scientific and Technical Information of China (English)

    樊小农; 张雪; 武连仲; 王海荣

    2011-01-01

    Objective To observe therapeutic features of thalamic pain by mind Calming, blood activating and pain relief acupuncture and Carbamazepine.Methods Crossover trial design was adopted.Eleven patients with confirmed diagnosis of thalamic pain were randomly assigned to two groups according to the minimal unbalance index method, i.e., Group Ⅰ ( Six patients received acupuncture first and then Western medicine.) and Group Ⅱ ( Five patients received Western medicine first and then acupuncture).The therapeutic course for each group was ten days.There was a ten-day elution phase between the two therapeutic methods.The total therapeutic course was thirty days.Eleven patients were enrolled in the two groups for statistical analysis.The therapeutic efficacy was assessed with visual analogue scale (VAS) and the pain assessment scale of Anderson Cancer Center in the USA (MD Pain Evaluation value) respectively.The VAS and MD values of the two groups were recorded every day to get the dynamic curve.Results The VAS and MD values obviously decreased in the two groups after treatment (P<0.05).The pain curves of the two groups showed a declining trend during the treatment.A gradual and stable descending process was shown in the acupuncture group.But a greater decrease first appeared in the Western medicine group, then a comparatively greater decrease occurred after one platform stage, showing ladder-shaped curve.Conclusions Cumulative potency may be the main analgesic effects of acupuncture.Western medicine may possibly play a role by rapid initiate effect.%目的 观察调神活血止痛针刺法与卡马西平治疗丘脑痛的作用特点.方法 采用交叉试验设计,将11例确诊患者按最小不平衡指数法随机分为1组(先针刺治疗后西药治疗6例)和2组(先西药治疗后针刺治疗5例).每种疗法疗程10天,两种方法间有10天洗脱期,总疗程30天.进行统计分析时,针刺组和西药组均为11例.分别应用视觉模拟评分法(VAS)

  11. Determination of the Phenobarbitone(PBB),Carbamazepine(CBM),Estazolam (ETZ),Alprazolam(APZ),Clonazepam(CZP) and Oxazepam (OZP) concentration in the human plasma by HPLC%高效液相色谱法同时测定苯巴比妥、卡马西平、艾司唑仑、阿普唑仑、氯硝西泮、奥沙西泮的血药浓度

    Institute of Scientific and Technical Information of China (English)

    徐晖

    2013-01-01

    目的 建立高效液相色谱法同时测定苯巴比妥(Phenobarbitone PBB)、卡马西平(Carbamazepine CBM)、艾司唑仑(Estazolam ETZ)、阿普唑仑(Alprazolam APZ)、氯硝西泮(Clonazepam CZP)、奥沙西泮(Oxazepam OZP)等血药浓度.方法 取血浆样品在pH=8.0磷酸盐缓冲液条件下用乙酸乙酯和石油醚混合溶剂提取后在55℃水浴氮气中吹干,残渣用甲醇-水(55:45)溶解后进样分析,流动相为甲醇:磷酸盐缓冲液(55:45 pH=3.0),柱温31℃,检测波长230nm,流速0.9mL·min-1.结果 苯巴比妥、卡马西平分别在0.5~100μg·mL-1、0.2~40μg·mL-1,其他组分均在0.02~4.0μg·mL-1范围内浓度与峰面积线性关系良好.日内和日间差均小于5%,回收率均在97.3%~102.8%,最低检测浓度(S/N≥3):苯巴比妥20ng·mL-1,卡马西平5ng·mL-1,其余组分均10ng·mL-1.结论 本法操作简便,结果准确,适用于临床常规血药浓度检测.

  12. Predicted environmental concentrations of carbamazepine, oxcarbazepine and their main metabolites in a coastal system

    OpenAIRE

    Fenet, Helene; Arpin-pont, Lauren; Vanhoutte Brunier, Alice; Munaron, Dominique; Fiandrino, Annie; Hilaire-buys, Dominique; Mathieu, Olivier; BUDZINSKI Helene; Chiron, Serge; Boillot, Clotilde; Gomez, Elena

    2012-01-01

    Pharmaceuticals are widely released in aquatic environment through treated wastewaters. They reach coastal zone indirectly via streams or directly though marine outfalls however data concerning this contamination in coastal waters are scarce. Environmental Risk Assessment (ERA) of pharmaceuticals have been conducted mostly in surface waters and has not been performed in coastal zone. The first step of ERA is to evaluate the exposure through predictive environmental concentration (PEC) valu...

  13. Spatial Distribution of the Human Drug Carbamazepine in a Constructed Wetland Receiving Municipal Sewage Eflluent

    Science.gov (United States)

    Artificially constructed wetlands offer a low cost treatment alternative to remove a number of pollutants found in effluent water from industry, mining, agriculture, and urban areas. Wetlands can be used to mechanically remove suspended solids through sedimentation. Dissolved nutrients, biochemica...

  14. Soil persistence and fate of carbamazepine, lincomycin, caffeine, and iburpofen from wastewater

    Science.gov (United States)

    The reuse of treated wastewater for groundwater recharge is an effective way to provide advanced treatment and water storage in the desert southwest. Contaminants such as human drugs, found in treated effluent, have been identified as a potential problem for use of this water. The town of Gilbert, A...

  15. Anticonvulsant treatments of dysphoric mania: a trial of gabapentin, lamotrigine and carbamazepine in Iran

    OpenAIRE

    Young, Allan,

    2008-01-01

    Naghmeh Mokhber1, Carol J Lane2, Mohamad R Azarpazhooh3, Elham Salari4, Reza Fayazi5, Mohamad T Shakeri6, Allan H Young71Assistant Professor of Psychiatry, 3Assistant Professor of Neurology, 4Mashhad Department of Forensic Psychiatry, 5Assistant Professor of Psychiatry, 6Assistant Professor of Statistics, Mashhad University of Medical Science, Mashhad, Iran; 2Department of Psychiatry, University of British Columbia, Vancouver, Canada7Abstract: The treatment of dysphoric mania is challenging g...

  16. Quantitative bioanalytical and analytical method development of dibenzazepine derivative, carbamazepine: A review

    OpenAIRE

    Datar, Prasanna A.

    2015-01-01

    Bioanalytical methods are widely used for quantitative estimation of drugs and their metabolites in physiological matrices. These methods could be applied to studies in areas of human clinical pharmacology and toxicology. The major bioanalytical services are method development, method validation and sample analysis (method application). Various methods such as GC, LC–MS/MS, HPLC, HPTLC, micellar electrokinetic chromatography, and UFLC have been used in laboratories for the qualitative and qua...

  17. Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate) in adult males with epilepsy

    OpenAIRE

    Shehata, Ghaydaa A; Bateh, Abd El-aziz M; Hamed, Sherifa A; et al

    2009-01-01

    Ghaydaa A Shehata,1 Abd El-aziz M Bateh,2 Sherifa A Hamed,1 Tarek A Rageh,1 Yaser B Elsorogy11Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Egypt; 2Department of Psychology, Faculty of Arts, Banha University, EgyptPurpose: To evaluate the effect of antiepileptic drugs (AEDs) on cognition and behavior in adult epileptic males controlled on treatment with conventional antiepileptic medications. Methods: Cognitive, mood, behavior and personality traits were asse...

  18. Design and start-up of laboratory scale membrane bioreactor for biological degradation of ibuprofen, diclofenac and carbamazepine

    OpenAIRE

    Riska, Mats

    2016-01-01

    Pharmaceuticals and their fate in the wastewater treatment is a growing area of interest among researchers. Some pharmaceuticals are removed during conventional active sludge process, but new advanced methods are needed to improve the effluent quality. MBR (Membrane Bioreactor) technology is one of the fastest growing new technologies that can be used to receive better effluent quality. In this thesis two parallel laboratory scale MBR wastewater treatment plants were designed and built. T...

  19. A comparative pharmacokinetic study in healthy volunteers of the effect of carbamazepine and oxcarbazepine on cyp3a4

    DEFF Research Database (Denmark)

    Andreasen, Astrid-Helene; Brøsen, Kim; Damkier, Per

    2007-01-01

    a 4-week wash-out period. The subjects received 1200 mg oral OXCZ daily for 17 days and 800 mg oral CBZ for 17 days. A single 200 mg oral dose of quinidine was administered at baseline and following administration of CBZ and OXCZ. Outcome parameters were the formation clearance of 3-hydroxyquinidine...... dose and the ratio of the AUCs of 3-hydroxyquinidine to quinidine. RESULTS: Formation clearance of 3-hydroxyquinidine was increased by means of 89% (CI: 36-164; p=0.0022) and 181% (CI: 120-260, p<0.0001) after treatment with OXCZ and CBZ, respectively, compared to baseline. The relative inductive...... effect of CBZ was 46% higher than for OXCZ. AUC ratio increased by means of 161% (CI: 139-187, p<0.0001) (OXCZ) and 222% (CI: 192-257, p<0.0001) (CBZ). Quinidine Cmax decreased by means of 29% (CI: 16-40, p=0.0018) (OXCZ) and 33% (CI: 18-45, p=0.0020) (CBZ). T1/2 decreased by means of 12% (CI: 6-17, p<0...

  20. Entalpías de Inmersión de Carbones Activados en Soluciones Séricas de Carbamazepina Immersion Enthalpies of Activated Carbon in Carbamazepine Serum Solutions

    OpenAIRE

    Natalia Bohórquez; Liliana Giraldo; Juan C Moreno-Piraján

    2008-01-01

    Se determinan la entalpía de inmersión y la capacidad de adsorción de carbones activados en soluciones séricas de carbamazepina. Los carbones activados se modifican con soluciones de ácido nítrico de 40% y 65% a 303 K, aumentando el contenido de sitios ácidos totales en la superficie. Se establecen relaciones entre el área superficial y la variación en la entalpía de inmersión en función del tratamiento de modificación y la cantidad adsorbida de carbamazepina. Se observa que para los sólidos ...

  1. Erythromycin and Sulfisoxazole

    Science.gov (United States)

    ... blood thinners') such as warfarin (Coumadin), astemizole (Hismanal), carbamazepine (Tegretol), clozapine (clozaril), cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), disopyramide (Norpace), ...

  2. 卡马西平口腔速崩片处方筛选和制备工艺研究%The study on orally disintegrating tablets of Carbamazepine

    Institute of Scientific and Technical Information of China (English)

    苏金龙; 马永恒; 焦海胜; 李敏; 卫晓晓

    2010-01-01

    目的 为了方便老人、儿童和吞咽困难的患者服药,提高卡马西平的生物利用度,优化处方制备卡马西平口腔速崩片(CBZ-ODT).方法 筛选恰当的崩解时间测定方法,以崩解时间和口感为主要评价指标,通过实验选择最佳制备工艺及配方,并通过单因素试验选取对崩解时间影响大的成分的含量为变量进行三因素四水平的L16(43)正交试验设计,确定最优处方.结果 采用全粉末直接压片法,用乳糖作为填充剂,硬脂酸镁做为润滑剂,交联羧甲基纤维素钠(CCNa)作为崩解剂,以崩解时间、硬度和口感为评价指标筛选出最佳处方组合压制三批卡马西平口腔速崩片,片面光洁圆整,无斑点,经测试,崩解时间在(21±3)s.结论 采用全粉末直接压片法压片,工艺简单且能满足要求.采用崩解仪改良法测量崩解时间更为接近于人体口腔内的测定结果,所制备的卡马西平口腔崩解片崩解时间短,硬度适中.口感好,具备临床应用价值.

  3. Correlation between adherence of children epilepsy patients and effect of carbamazepine%儿童癫痫患者卡马西平疗效与依从性的关系

    Institute of Scientific and Technical Information of China (English)

    何晓静

    2013-01-01

    目的 评估癫痫患儿卡马西平(CBz)疗效与依从性的关系.方法 通过查阅病历、问卷调查等方式,对2008年1月至今在我院门诊、病房首诊的癫痫患儿383例进行分析,评价CBZ治疗依从性与疗效的关系.结果 CBZ治疗依从性与疗效相关,规律服药和复查的癫痫患儿疗效显著升高(P<0.05);治疗时间延长,CBZ治疗依从性降低;血药浓度监测可提高CBZ治疗依从性,CBZ浓度在治疗窗内的癫痫患儿依从性较高.结论 癫痫患儿CBZ疗效与依从性密切相关.%Objective To evaluate the correlation between adherence of children epilepsy patients and effect of carbamazeping ( CBZ) , and analyze the main reasons. Methods By looking up medical records, sending out questionnaires, and et al, 383 children epilepsy patients were enrolled in our study from Jan 2008 till now. Using retrospective method, the correlation between adherence of children epilepsy patients and effect of CBZ were analyzed. Results There is a significant correlation between adherence of children epilepsy patients and effect of CBZ. Compared with those who don' t take CBZ and re - check regularly, children epilepsy patients who take CBZ and re — check regularly have significant better result ( P < 0. 05 ) . When duration is longer, adherence of children epilepsy patients is decreased. Adherence of children epilepsy patients is increased in those who take therapeutic drug monitoring. Conclusion Effect of CBZ has a significant correlation with adherence of children epilepsy patients. Clinical pharmacists could help parents of children epilepsy patient improve their recognition, boost the effect of CBZ in children epilepsy patients.

  4. A Control Study of Clonazepam and Carbamazepine in the Treatment of Manic Episodes%氯硝西泮与卡马西平治疗躁狂发作临床观察

    Institute of Scientific and Technical Information of China (English)

    高丽红; 路光辉

    2002-01-01

    目的:评价氯硝西泮与卡马西平对锂盐治疗无效的躁狂发作的疗效和副反应.方法:将符合CCMD-2-R躁狂发作诊断标准的72例患者随机分为氯硝西泮组(35例)和卡马西平组(37例),治疗6周.使用Bech-Rafaelsen躁狂量表及临床疗效总评量表评定疗效,用副反应量表及有关实验室检查评定副反应.结果:氯硝西泮与卡马西平均能有效减轻躁狂症状,疗效相近,卡马西平起效时间迟于氯硝西泮.氯硝西泮和卡马西平的副反应均以共济失调、头晕、嗜睡多见.结论:氯硝西泮与卡马西平均可用于锂盐治疗无效的躁狂发作,疗效相当.

  5. Combined application of mixture experimental design and artificial neural networks in the solid dispersion development.

    Science.gov (United States)

    Medarević, Djordje P; Kleinebudde, Peter; Djuriš, Jelena; Djurić, Zorica; Ibrić, Svetlana

    2016-01-01

    This study for the first time demonstrates combined application of mixture experimental design and artificial neural networks (ANNs) in the solid dispersions (SDs) development. Ternary carbamazepine-Soluplus®-poloxamer 188 SDs were prepared by solvent casting method to improve carbamazepine dissolution rate. The influence of the composition of prepared SDs on carbamazepine dissolution rate was evaluated using d-optimal mixture experimental design and multilayer perceptron ANNs. Physicochemical characterization proved the presence of the most stable carbamazepine polymorph III within the SD matrix. Ternary carbamazepine-Soluplus®-poloxamer 188 SDs significantly improved carbamazepine dissolution rate compared to pure drug. Models developed by ANNs and mixture experimental design well described the relationship between proportions of SD components and percentage of carbamazepine released after 10 (Q10) and 20 (Q20) min, wherein ANN model exhibit better predictability on test data set. Proportions of carbamazepine and poloxamer 188 exhibited the highest influence on carbamazepine release rate. The highest carbamazepine release rate was observed for SDs with the lowest proportions of carbamazepine and the highest proportions of poloxamer 188. ANNs and mixture experimental design can be used as powerful data modeling tools in the systematic development of SDs. Taking into account advantages and disadvantages of both techniques, their combined application should be encouraged. PMID:26065534

  6. Influence of Solid Drug Delivery System Formulation on Poorly Water-Soluble Drug Dissolution and Permeability

    Directory of Open Access Journals (Sweden)

    Marko Krstić

    2015-08-01

    Full Text Available The majority of drugs have a low dissolution rate, which is a limiting step for their absorption. In this manuscript, solid dispersions (SD, solid self-microemulsifying drug delivery systems (S-SMEDDS and solid self-nanoemulsifying drug delivery systems (S-SNEDDS were evaluated as potential formulation strategies to increase the dissolution rate of carbamazepine. Influence of increased dissolution rate on permeability of carbamazepine was evaluated using PAMPA test. In S-SMEDDS and S-SNEDDS formulations, the ratio of liquid SMEDDS/SNEDDS and solid carrier (Neusilin® UFL2 was varied, and carbamazepine content was constant. In SD formulations, the ratio of carbamazepine and Neusilin® UFL2, was varied. Formulations that showed the best dissolution rate of carbamazepine (SD_1:6, SMEDDS_1:1, SNEDDS_1:6 were mutually compared, characterization of these formulations was performed by DSC, PXRD and FT-IR analyses, and a PAMPA test was done. All formulations have shown a significant increase in dissolution rate compared to pure carbamazepine and immediate-release carbamazepine tablets. Formulation S-SMEDDS_1:1 showed the fastest release rate and permeability of carbamazepine. DSC, PXRD and FT-IR analyses confirmed that in S-SMEDDS and S-SNEDDS carbamazepine remained in polymorph form III, and that it was converted to an amorphous state in SD formulations. All formulations showed increased permeability of carbamazepine, compared to pure carbamazepine.

  7. Flecainide

    Science.gov (United States)

    ... Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); carbamazepine (Carbatrol, Tegretol); cimetidine (Tagamet); clozapine (Clozaril); dichlorphenamide; digoxin (Lanoxin); diltiazem (Cardizem, Tiazac); disopyramide ( ...

  8. Erythromycin

    Science.gov (United States)

    ... especially other antibiotics, anticoagulants ('blood thinners'), astemizole (Hismanal), carbamazepine (Tegretol), cisapride (Propulsid), clozapine (clozaril), cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), disopyramide (Norpace), ...

  9. Effect of carbamazepineon bioelectric activity of hypothalamus of rats in the conditions of stress reaction development

    OpenAIRE

    T. G. Chaus; V. P. Lyashenko; S. М. Lukashov; G. G. Chaus

    2006-01-01

    The influence of carbamazepine medication on bioelectric activity of the posterior and anterior hypothalamus in rats under stress conditions was studied. It is shown, that carbamazepine changes amplitude of the basic rhythms of electric activity of the hypothalamus posterior zone, which value were less compared with the capacities amplitude of the hypothalamic anterior zone.

  10. 丙戊酸钠、卡马西平对首发躁狂患者体质量及瘦素的影响%Valproate sodium and Carbamazepine induced weight gain and leptin change in first-episode manic patients

    Institute of Scientific and Technical Information of China (English)

    金建烽; 严清章; 巢亚琴; 刘邦令; 丁睿鹰; 顾军

    2011-01-01

    目的:探讨丙戊酸钠、卡马西平对躁狂患者体质量及瘦素的影响.方法:80例未经药物治疗的首发躁狂患者,随机分为丙戊酸钠、卡马西平治疗组各40例.于治疗前,治疗2、4、6、8周,分别测定体重、瘦素.结果:(1)丙戊酸钠组体重、瘦素分别于治疗4,6周开始增高(均P<0.05);卡马西平组体重、瘦素则于治疗6周、8周开始增高(均P<0.05).(2)丙戊酸钠组治疗6周时的体重变化值,8周时的体重、瘦素变化值均高于卡马西平组(均P<0.05).(3)治疗8周时,丙戊酸钠组有55%的患者体重显著增加,高于卡马西平组的32.5%(P<0.05).(4)治疗6、8周时,丙戊酸钠组的体重、瘦素的变化值间有正相关(r=0.337、0.386,均P<0.05).结论:丙戊酸钠、卡马西平均可引起体重及瘦素的增高,但以丙戊酸钠更为显著.

  11. 高效液相色谱法测定血清中苯巴比妥、苯妥英、卡马西平、氯硝基安定的浓度%Determination of phenobarbital, phenytoin, carbamazepine and clonazepam in serum by HPLC

    Institute of Scientific and Technical Information of China (English)

    王增寿; 朱光辉; 李光乾

    2002-01-01

    目的:建立血清中苯巴比妥(PB)、苯妥英(PT)、卡马西平(CBZ)、氯硝基安定(CNZP)浓度测定的高效液相色谱法.方法:以PB、PT互为内标,ODS-Hypersil柱为分析柱,甲醇-水-β环糊精(45:55:0.01)为流动相;流速为0.8ml/min,紫外检测波长254nm.结果:PB、PT、CBZ、CNZP分离良好,最低检测浓度分别为0.25、0.5、0.05、0.015μg/ml;线性范围分别为2.5~40、2.5~40、1.25~20、0.02~0.32μg/ml;相对回收率分别为97.8%、102.1%、102.3%、103.3%;日内、日间RSD均小于10%.结论:该法操作简便,结果可靠,适用于临床开展药物浓度监测.

  12. Transient inhibition of cyp3a in rats by star fruit juice.

    Science.gov (United States)

    Hidaka, Muneaki; Okumura, Manabu; Ogikubo, Tetsuya; Kai, Hirofumi; Fujita, Ken-ichi; Iwakiri, Tomomi; Yamasaki, Keishi; Setoguchi, Nao; Matsunaga, Naoya; Arimori, Kazuhiko

    2006-03-01

    Star fruit juice is a potent in vitro inhibitor of CYP3A; however, few reports are available on the inhibition of CYP3A activities by star fruit juice in vivo. Therefore, in this study, we investigated the CYP3A-mediated star fruit-drug interaction in vivo. The effect of star fruit juice on carbamazepine pharmacokinetics was examined in rats. In comparison with water, the area under the concentration-time curve (AUC) of carbamazepine was approximately 1.3-fold greater when star fruit juice (2 ml) was orally administered 1 h before the oral administration of carbamazepine (50 mg/kg). In contrast, the elimination half-life of carbamazepine and the AUC ratio of carbamazepine 10,11-epoxide to carbamazepine were not altered by the administration of star fruit juice. These results suggest that star fruit juice impairs the function of enteric CYP3A, but not of hepatic CYP3A. In addition, we evaluated the time course of recovery of CYP3A activity that was reduced after the treatment with star fruit juice. The inhibition by star fruit juice was recovered within approximately 24 h. These data suggest that the effect of star fruit juice is mainly reversible and transient. Thus, we discovered that star fruit juice alters the carbamazepine pharmacokinetics in rats. PMID:16326816

  13. Phenelzine

    Science.gov (United States)

    ... U.S.); levodopa (Larodopa, in Sinemet); medications for allergies, cough and cold symptoms, hay fever; anxiety, sinus problems, or weight loss (diet pills, appetite suppressants); medications for seizures such as carbamazepine (Tegretol); narcotic ...

  14. New Drugs for Epilepsy: A Review

    OpenAIRE

    Verret, Simon

    1983-01-01

    Four relatively new drugs used as symptomatic treatment against epileptic seizures—carbamazepine (Tegretol), valproic acid (Depakene), clonazepam (Rivotril) and nitrazepam (Mogadon)—are reviewed from the standpoint of pharmacokinetic parameters, clinical indication, toxicity and practical use.

  15. Antiepileptic drugs in pregnancy and hemorrhagic disease of the newborn: An update

    OpenAIRE

    Kazmin, Aleksey; Wong, Renee C.; Sermer, Mathew; Koren, Gideon

    2010-01-01

    QUESTION What is the current evidence regarding the association between hemorrhagic disease of the newborn and maternal use of hepatic enzyme-inducing antiepileptic drugs (eg, carbamazepine, phenobarbitone, topiramate)?

  16. Analysis of Drugs of Abuse in Anonymously Collected Urine and Soil samples from a Music Festival in Scandinavia

    DEFF Research Database (Denmark)

    Mardal, Marie; Ramin, Pedram; Plósz, Benedek G.;

    -MS Results: In the urine samples, the following compounds (and their metabolites) could be detected: cocaine (in 13 samples), levamisole (11), MDMA (9), amphetamine (2), and methamphetamine (2). Furthermore, therapeutic drugs such as metoprolol, carbamazepine, citalopram, quetiapine, methylphenidate...

  17. Carbamzepine-induced toxic epidermal necrolysis

    Directory of Open Access Journals (Sweden)

    Nithyananda K Chowta

    2011-01-01

    Full Text Available Toxic epidermal necrolysis (TEN, also known as Lyell′s syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane. Many factors involved in the etiology of TEN including adverse drug reactions. Here we are reporting a case of toxic epidermal necrolysis in an adult male patient after receiving carbamazepine in a 38 year old male. On the18th day of carbamazepine, patient developed blisters which first appeared on the trunk, chest and arms. The erythematous rash was covering almost all over the body with epidermal detachment of 70% body surface area. There was loss of eye lashes, congestion of conjunctiva with mucopurulent discharge and exposure keratitis. The clinical impression was TEN induced by carbamazepine. Carbamazepine was stopped immediately. He was treated with high dose intravenous betamethasone and systemic and topical antibiotics. After one month, the progression of the skin lesions halted and he was discharged.

  18. ADH (Antidiuretic Hormone) Test

    Science.gov (United States)

    ... and symptoms are usually those associated with water intoxication and may include: Headache Nausea, vomiting Confusion In ... carbamazepine . Drugs that promote ADH action, such as: acetaminophen , metformin, tolbutamide, aspirin, theophylline , and non-steroidal anti- ...

  19. Antipsychotic Medicines for Schizophrenia and Bipolar Disorder: What You Should Know

    Science.gov (United States)

    ... these four as Consumer Reports Best Buy Drugs: Clozapine (generic) Olanzapine (Zyprexa) Perphenazine (generic) Risperidone (generic) For bipolar disorder: Lithium is the standard treat- ment for bipolar disorder. Carbamazepine and valproic acid are also widely used. An ...

  20. Fate and Uptake of Pharmaceuticals in Soil–Plant Systems

    OpenAIRE

    Carter, Laura J.; Harris, Eleanor; Williams, Mike; Ryan, Jim J; Kookana, Rai S.; Boxall, Alistair B.A.

    2014-01-01

    Pharmaceuticals have been detected in the soil environment where there is the potential for uptake into crops. This study explored the fate and uptake of pharmaceuticals (carbamazepine, diclofenac, fluoxetine, propranolol, sulfamethazine) and a personal care product (triclosan) in soil–plant systems using radish (Raphanus sativus) and ryegrass (Lolium perenne). Five of the six chemicals were detected in plant tissue. Carbamazepine was taken up to the greatest extent in both the radish (52 μg/...

  1. Model-Based Approach To Characterize Efavirenz Autoinduction and Concurrent Enzyme Induction with Carbamazepine▿

    OpenAIRE

    Zhu, Min; Kaul, Sanjeev; Nandy, Partha; Grasela, Dennis M.; Pfister, Marc

    2009-01-01

    Characterization of the time course and magnitude of enzyme induction due to multiple inducers is important for interpretation of clinical data from drug-drug interaction studies. A population interaction model was developed to quantify efavirenz autoinduction and further induction with concurrent carbamazepine coadministration. Efavirenz concentration data in the absence and presence of carbamazepine following single- and multiple-dose oral administrations in healthy subjects were used for m...

  2. Distribúcia štyroch humánnych farmaceutík, karbamazepínu, diklofenaku, gemfibrozilu a ibuprofénu v sústave sediment-voda

    OpenAIRE

    Krascsenits, Z.; Hiller, E.; Bartaľ, M.

    2008-01-01

    Laboratory studies were conducted to characterise the sorption-desorption behavior of four human pharmaceuticals (carbamazepine, diclofenac, gemfibrozil, and ibuprofen) at three initial concentrations in aqueous solution on one river sediment. The results of the experiments showed that distribution coefficients were either relatively low for diclofenac and ibuprofen or higher for gemfibrozil and carbamazepine. Distribution coefficients (mean Kd values for three initial concentrations), as mea...

  3. Stability-enhanced Hot-melt Extruded Amorphous Solid Dispersions via Combinations of Soluplus® and HPMCAS-HF

    OpenAIRE

    Alshahrani, Saad M.; Lu, Wenli; Park, Jun-Bom; Morott, Joseph T.; Alsulays, Bader B.; Majumdar, Soumyajit; Langley, Nigel; Kolter, Karl; Gryczke, Andreas; Repka, Michael A.

    2015-01-01

    The aim of this study was to evaluate a novel combination of Soluplus® and hypromellose acetate succinate (HPMCAS-HF) polymers for solubility enhancement as well as enhanced physicochemical stability of the produced amorphous solid dispersions. This was accomplished by converting the poorly water-soluble crystalline form of carbamazepine into a more soluble amorphous form within the polymeric blends. Carbamazepine (CBZ), a Biopharmaceutics Classification System class II active pharmaceutical ...

  4. Bicuspid aortic valve and severe aortic stenosis in a newborn exposed to carbamazapine during pregnancy

    OpenAIRE

    Karataş, Zehra; Karataş, Ahmet; Özlü, Tülay; Goksugur, Sevil B.; Varan, Birgül

    2014-01-01

    The use of antiepileptic drugs increases the risk of major congenital malformations during pregnancy. Here, we report an infant who had a history of in-utero carbamazepine exposure and who was born with a cardiac malformation. The infant was born at 39 weeks of gestation vaginally to an epileptic mother who had been treated with carbamazepine throughout her pregnancy. He was referred due to cardiac murmur in the second week of his life. The mother had not received folic acid supplementation. ...

  5. Solubilization of active ingredients of different polarity in Pluronic® micellar solutions - Correlations between solubilizate polarity and solubilization site.

    Science.gov (United States)

    Nguyen-Kim, Viet; Prévost, Sylvain; Seidel, Karsten; Maier, Walter; Marguerre, Ann-Kathrin; Oetter, Günter; Tadros, Tharwat; Gradzielski, Michael

    2016-09-01

    The solubilization of two pharmaceutically active ingredients (AI) with significantly different water solubility, namely carbamazepine and fenofibrate (solubility of 150ppm and 10ppm, respectively), has been investigated using a series of Pluronics® (Poloxamers) containing different ethylene oxide and propylene oxide (EO/PO) units in the molecule. The results show largely enhanced solubilization of fenofibrate by Pluronic® micelles that increases with the PPO chain length provided the temperature is above the critical micelle temperature (cmt). In contrast the more water-soluble carbamazepine only shows a moderate increase in solubilization upon addition of Pluronics®. Small angle neutron scattering (SANS) and pulsed field gradient (PFG) NMR experiments show that the solubilization of fenofibrate occurs in the core of the micelles, whereas carbamazepine shows no direct association with the micelles. These clearly different solubilization mechanisms for the two AIs were confirmed by Nuclear Overhauser Enhancement Spectroscopy (NOESY) experiments, which show that fenofibrate interacts only with the PPO core of the micelle, whereas carbamazepine interacts with both PPO and PEO similarly. Accordingly, the large enhancement of the solubilization of fenofibrate is related to the fact that it is solubilized within the PPO core of the Pluronic® micelles, while the much more moderate increase of carbamazepine solubility is attributed to the change of solvent quality due to the presence of the amphiphilic copolymer and the interaction with the EO and PO units in solution. PMID:27244594

  6. Cognitive functions, epileptic syndromes and antiepileptic drugs

    Directory of Open Access Journals (Sweden)

    Paulo R. M. Bittencourt

    1992-03-01

    Full Text Available Cognitive function of patients on monotherapy specific for their epileptic syndrome has been studied infrequently. We evaluated 7 patients with symptomatic localised epilepsies (SEL on phenytoin aged 30±12 (mean±standard deviation years, 8 with idiopathic generalised epilepsies on sodium valproate aged 18±4 years, 16 with SEL on carbamazepine aged 28±11 years, and 35 healthy controls aged 27±11 years. All subjects were of normal intelligence, educated appropriately to age, and led productive lives in the community. Two of the patients on carbamazepine and one on valproate had less than five partial, absence or myoclonic seizures monthly, the remaining were controlled. Carbamazepine serum concentrations were 12±5 ug/ml, phenytoin were 23±7, and valproate were 62±23 (mean±sd. Tests included immediate recall and recognition for pictures, Stroop test, delayed recall and recognition of pictures. Patients on phenytoin and valproate performed significantly worse than controls on immediate recall, and patients on carbamazepine performed significantly worse than controls in Stroop test (p<0,01. The results indicate relatively minor effects of the epileptic syndromes and of phenytoin, carbamazepine and valproate on cognition of patients with controlled epilepsy leading productive lives in the community. We conclude that the cognitive deficit found in chronic epileptic patients on polytherapeutic drug regimen must be multifactorial, and that future studies need to control for all possible variables in order to achieve meaningul results.

  7. Effects of emerging contaminants on neurotransmission and biotransformation in marine organisms - An in vitro approach.

    Science.gov (United States)

    Luis, Luis G; Barreto, Ângela; Trindade, Tito; Soares, Amadeu M V M; Oliveira, Miguel

    2016-05-15

    The effects of gold (ionic form and nanoparticles - AuNPs) and pharmaceuticals (carbamazepine and fluoxetine) on enzymes involved in neurotransmission (acetylcholinesterase - AChE) and biotransformation (glutathione S-transferases - GST) were assessed by their incubation with Mytilus galloprovincialis' hemolymph and subcellular fraction of gills, respectively. AuNPs did not alter enzymatic activities unlike ionic gold that inhibited AChE and GST activities at 2.5 and 0.42mg·L(-1), respectively. Carbamazepine inhibited AChE activity at 500mg·L(-1) and fluoxetine at 1000mg·L(-1). GST was inhibited by carbamazepine at 250mg·L(-1) and by fluoxetine at 125mg·L(-1). Increased AChE activity was found in simultaneous exposures to fluoxetine and bovine serum albumin coated AuNPs (BSA-AuNPs). Concerning GST, in the simultaneous exposures, AuNPs revealed protective effects against carbamazepine (citrate and polyvinylpyrrolidone coated) and fluoxetine (citrate and BSA coated) induced inhibition. However, BSA-AuNPs increased the inhibition caused by carbamazepine. AuNPs demonstrated ability to interfere with other chemicals toxicity justifying further studies. PMID:26988391

  8. Bicuspid aortic valve and severe aortic stenosis in a newborn exposed to carbamazapine during pregnancy.

    Science.gov (United States)

    Karataş, Zehra; Karataş, Ahmet; Özlü, Tülay; Goksugur, Sevil B; Varan, Birgül

    2014-01-01

    The use of antiepileptic drugs increases the risk of major congenital malformations during pregnancy. Here, we report an infant who had a history of in-utero carbamazepine exposure and who was born with a cardiac malformation. The infant was born at 39 weeks of gestation vaginally to an epileptic mother who had been treated with carbamazepine throughout her pregnancy. He was referred due to cardiac murmur in the second week of his life. The mother had not received folic acid supplementation. Transthoracic echocardiography revealed bicuspid aortic valve, mild aortic stenosis, patent ductus arteriosus, patent foramen ovale and the renal ultrasound revealed mild left hydronephrosis. Follow-up echocardiography performed 14 weeks later showed increased severity of aortic stenosis and percutaneous balloon aortic valvuloplasty was performed. To our knowledge, there is only one case report in the literature mentioning the association of a bicuspid aortic valve and aortic stenosis with oxcarbazepine exposure, which is a structural derivative of carbamazepine. However, there are no reports for association with carbamazepine itself. Bicuspid aorta and aortic stenosis may be among the cardiac malformations that result from the teratogenic effect of carbamazepine. PMID:25584038

  9. [Anticonvulsant agents in neuralgic pain.].

    Science.gov (United States)

    Jurna, I; Zenz, M

    1992-06-01

    The anticonvulsants, carbamazepine, clonazepam, phenytoin, and valproic acid are capable of depressing attacks of shooting pain in neuralgia. Shooting pain is perceived in trigeminal, intercostal, and other neuralgias, as a consequence of infectious diseases such as herpes zoster, and in the course of polyneuropathies of various causes. It is due to injury of nociceptive afferents, which generate bursts of activity in response to appropriate environmental changes. The anticonvulsant agents have no analgesic property per se, so that background pain remains unchanged. The depression of shooting pain results from the anticonvulsant action of the compounds. Both carbamazepine and phenytoin block synaptic transmission of neuronal hyperactivity by a direct depressant action that includes reduction of sodium conductance and by activation of inhibitory control. Clonazepam and valproic acid act by enhancing GABA-mediated inhibition of synaptic transmission. Carbamazepine is by far the most widely used compound; phenytoin, clonazepam, and valproic acid are not so popular because of their side effects. PMID:18415623

  10. The removal of microorganisms and organic micropollutants from wastewater during infiltration to aquifers after irrigation of farmland in the Tula Valley, Mexico.

    Science.gov (United States)

    Chávez, Alma; Maya, Catalina; Gibson, Richard; Jiménez, Blanca

    2011-05-01

    The Tula Valley receives untreated wastewater from Mexico City for agricultural irrigation, half of which infiltrates to aquifers from where drinking water is extracted. Samples of wastewater and infiltrated water from three areas of the valley were analyzed for microorganisms, organic micropollutants, and some basic parameters. Concentrations of microorganisms in the infiltrated water were generally very low but the incidence of fecal coliforms (present in 68% of samples), somatic bacteriophages (36%), Giardia spp. (14%), and helminth eggs (8%) suggested a health risk. Organic micropollutants, often present at high concentrations in the wastewater, were generally absent from the infiltrated water except carbamazepine which was in 55% of samples (up to 193 ng/L). There was no correlation between carbamazepine concentrations and the presence of microorganisms but highest concentrations of carbamazepine and boron coincided. A treatment such as nanofiltration would be necessary for the infiltrated water to be a safe potable supply. PMID:21316131

  11. Psychotropic medications and leukopenia.

    Science.gov (United States)

    Sedky, Karim; Lippmann, Steven

    2006-09-01

    Neutropenia and/or agranulocytosis are among the medicinal side-effects induced by many psychotropic drugs. Clozapine and carbamazepine cause the highest incidence of this side-effect and require long-term blood cell monitoring. Bone marrow suppression can have an allergic, hypersensitivity etiology (e.g., clozapine), which mandates the causative drug discontinuation. It can also be a direct, toxic effect (e.g., carbamazepine), which calls for dosage reduction or a medication change. Other treatment options may include filgrastim, sargramostim, or lithium. Blood cell count monitoring is encouraged on patients receiving clozapine as long as the drug is continued. Such evaluation is also advised on those medicated with other psychotropics, especially carbamazepine. PMID:17017894

  12. OXCARBAZEPINE INDUCED HYPONATREMIA: A POTENTIAL EXPLANATION OF ITS PHYSIOPATHOLOGY

    Directory of Open Access Journals (Sweden)

    Musso CG

    2009-01-01

    Full Text Available Carbamazepine and oxcarbazepine are antiepileptic drugs which can induce hyponatremia, being this disorder more frequent with the latter.In this report we present a clinical case regarding an oxcarbazepine induced hyponatremia, and we hypothesized that oxcarbazepine could induce hyponatremia as a consequence of its influence on distal nephron where it could promote free water retention, urinary sodium loss, or both of them.Besides, we proposed that a greater tubular sesitivity to oxcarbazepine than to carbamazepine could explain the different hyponatremia inducing capability between these two drugs

  13. Tear Film Break-Up Time: Comparison between Patients using Psychiatric Drugs and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Parvin Dibajnia

    2014-09-01

    Full Text Available Background: Ocular dryness is a well-recognized adverse side effect of many medications. The purpose of this study was to compare tear film stability between psychiatric patients that use lithium carbonate or carbamazepine and normal cases. Materials and Methods: Tear film break up time test was performed in three groups, 30 patients using lithium carbonate, 30 patients using carbamazepine and 30 normal cases. Values of the TBUTs were compared among groups by the independent t-test. Results: Differences between both of patients and control groups were significant (p<0.0001. Conclusion: The results show that these drugs contribute to decrease of tear film break up time.

  14. Psychoactive pharmaceuticals as environmental contaminants may disrupt highly inter-connected nodes in an Autism-associated protein-protein interaction network

    OpenAIRE

    Kaushik, Gaurav; Thomas, Michael A.; Aho, Ken A.

    2015-01-01

    Background Most cases of idiopathic autism spectrum disorder (ASD) likely result from unknown environmental triggers in genetically susceptible individuals. These triggers may include maternal exposure of a fetus to minute concentrations of pharmaceuticals, such as carbamazepine (CBZ), venlafaxine (VNX) and fluoxetine (FLX). Unmetabolized pharmaceuticals reach drinking water through a variety of routes, including ineffectively treated sewage. Previous studies in our laboratory examined the ex...

  15. Development of an in vitro assay for the investigation of metabolism-induced drug hepatotoxicity

    DEFF Research Database (Denmark)

    Otto, Marie; Hansen, Steen Honore'; Dalgaard, L.;

    2008-01-01

    activity but to G6P, was observed for diclofenac and minocycline. Tacrine and amodiaquine displayed decreased toxicity with S9-mix, and carbamazepine, phenytoin, bromfenac and troglitazone were nontoxic at all tested concentrations, with or without S9-mix. The results show that this method, with...

  16. Cognitive Effects of Topiramate and Valproate

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-06-01

    Full Text Available Cognitive and behavioral effects of topiramate (TPM and valproate (VPA as adjunctive therapy with carbamazepine (CBZ were compared in 62 adults (16 to 55 years old with refractory partial seizures, in a randomized, double-blind trial at the Medical College of Georgia, Augusta.

  17. The removal of microorganisms and organic micropollutants from wastewater during infiltration to aquifers after irrigation of farmland in the Tula Valley, Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Chavez, Alma; Maya, Catalina [Instituto de Ingenieria, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510 D.F. (Mexico); Gibson, Richard [Instituto de Geografia, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510 D.F. (Mexico); Jimenez, Blanca, E-mail: bjimenezc@iingen.unam.mx [Instituto de Ingenieria, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, 04510 D.F. (Mexico)

    2011-05-15

    The Tula Valley receives untreated wastewater from Mexico City for agricultural irrigation, half of which infiltrates to aquifers from where drinking water is extracted. Samples of wastewater and infiltrated water from three areas of the valley were analyzed for microorganisms, organic micropollutants, and some basic parameters. Concentrations of microorganisms in the infiltrated water were generally very low but the incidence of fecal coliforms (present in 68% of samples), somatic bacteriophages (36%), Giardia spp. (14%), and helminth eggs (8%) suggested a health risk. Organic micropollutants, often present at high concentrations in the wastewater, were generally absent from the infiltrated water except carbamazepine which was in 55% of samples (up to 193 ng/L). There was no correlation between carbamazepine concentrations and the presence of microorganisms but highest concentrations of carbamazepine and boron coincided. A treatment such as nanofiltration would be necessary for the infiltrated water to be a safe potable supply. - Highlights: > Wastewater from Mexico City used for crop irrigation infiltrates to aquifers. > Infiltration through the soil removes many contaminants. > Occasional contamination of infiltrated water with microorganisms occurs. > Carbamazepine is widely present in the infiltrated water. > Safe use of this water for drinking would need nanofiltration or another treatment. - Water extracted from aquifers fed by wastewater used for irrigation may contain microorganisms and persistent polar organic micropollutants and requires treatment to be a potable supply.

  18. Pharmaceutical residues in aquatic systems: mode of action and effects on mussel physiology

    OpenAIRE

    Buratti, Sara

    2011-01-01

    Pharmaceutical residues contaminate aquatic ecosystems as a result of their widespread human and veterinary usage. Since continuously released and not efficiently removed, certain pharmaceuticals exhibit pseudo-persistence thus generating concerns for the health of aquatic wildlife. This work aimed at assessing on mussels Mytilus galloprovincialis, under laboratory conditions, the effects of three pharmaceuticals, carbamazepine (antiepileptic), propranolol (β-blocker) and oxytetracycline (...

  19. Drug hypersensitivity syndrome

    OpenAIRE

    Rashmi Kumari; Dependra K Timshina; Devinder Mohan Thappa

    2011-01-01

    Drug hypersensitivity syndrome (DHS) is an adverse drug reaction commonly associated with the aromatic antiepileptic drugs (AEDs), viz., phenytoin (PHT), carbamazepine (CBZ), phenobarbital (PB), lamotrigine, primidone, etc. It can also be caused by other drugs, such as sulfonamides, dapsone, minocycline, gold derivatives, cyclosporine, captopril, diltiazem, terbinafine, azathioprine and allopurinol. Diagnosis of DHS may be difficult because of the variety of clinical and laboratory abnormalit...

  20. The removal of microorganisms and organic micropollutants from wastewater during infiltration to aquifers after irrigation of farmland in the Tula Valley, Mexico

    International Nuclear Information System (INIS)

    The Tula Valley receives untreated wastewater from Mexico City for agricultural irrigation, half of which infiltrates to aquifers from where drinking water is extracted. Samples of wastewater and infiltrated water from three areas of the valley were analyzed for microorganisms, organic micropollutants, and some basic parameters. Concentrations of microorganisms in the infiltrated water were generally very low but the incidence of fecal coliforms (present in 68% of samples), somatic bacteriophages (36%), Giardia spp. (14%), and helminth eggs (8%) suggested a health risk. Organic micropollutants, often present at high concentrations in the wastewater, were generally absent from the infiltrated water except carbamazepine which was in 55% of samples (up to 193 ng/L). There was no correlation between carbamazepine concentrations and the presence of microorganisms but highest concentrations of carbamazepine and boron coincided. A treatment such as nanofiltration would be necessary for the infiltrated water to be a safe potable supply. - Highlights: → Wastewater from Mexico City used for crop irrigation infiltrates to aquifers. → Infiltration through the soil removes many contaminants. → Occasional contamination of infiltrated water with microorganisms occurs. → Carbamazepine is widely present in the infiltrated water. → Safe use of this water for drinking would need nanofiltration or another treatment. - Water extracted from aquifers fed by wastewater used for irrigation may contain microorganisms and persistent polar organic micropollutants and requires treatment to be a potable supply.

  1. CLASSIC ULTRA- RAPID CYCLER BIPOLAR DISORDER : A CASE REPORT

    OpenAIRE

    Garg, P.D.; Singh, Paramjit; Kumar, Nirdosh

    1998-01-01

    A 44 year old man presented with classical pattern of bipolar disorder with a fortnightly cycle of mania and depression for last many years. The patient was not responding to chronic lithium therapy but responded to a combination of carbamazepine and nifedipine

  2. Occipital seizures presenting with bilateral visual loss

    OpenAIRE

    Hadjikoutis S; Sawhney I

    2003-01-01

    Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.

  3. Eslicarbazepine acetate in the management of refractory bipolar disorder.

    Science.gov (United States)

    Nath, Kamal; Bhattacharya, Arnab; Praharaj, Samir Kumar

    2012-01-01

    Eslicarbazepine acetate is a novel third-generation antiepileptic related to carbamazepine and oxcarbazepine with a benign adverse effect profile. We report a patient with bipolar mania with intolerance to multiple antimanic drugs, responding to eslicarbazepine without any serious adverse effect. PMID:23151469

  4. Impaired biotin status in anticonvulsant therapy

    OpenAIRE

    Krause, Klaus-Henning; Berlit, Peter; Bonjour, Jean-Pierre

    1982-01-01

    In 264 epileptics undergoing long-term therapy with anticonvulsants, significantly reduced plasma biotin levels were found compared with a normal control group: 74% of the epileptics had biotin levels for those treated with sodium valproate were higher than for those treated with phenytion, primidone, or carbamazepine. The observed reduction in biotin levels might be a factor influencing the efficacy of these three antionvulsants.

  5. General stress, detoxification pathways, neurotoxicity and genotoxicity evaluated in Ruditapes philippinarum exposed to human pharmaceuticals.

    Science.gov (United States)

    Aguirre-Martínez, Gabriela V; DelValls, T Angel; Martín-Díaz, M Laura

    2016-02-01

    A battery of biomarkers was evaluated on Ruditapes philippinarum exposed during 14 days to caffeine, ibuprofen, carbamazepine and novobiocin (0.1, 1, 5, 10, 15, and 50µgL(-1)). The battery included general stress (lysosomal membrane stability - LMS) analysed in the hemolymph, and biochemical biomarkers analysed in digestive gland tissues including: biomarkers of phase I (etoxyresorufin O-deethylase - EROD, dibenzylfluorescein dealkylase - DBF), phase II (gluthathione-S-transferase - GST), oxidative stress (gluthathione reductase - GR, gluthathione peroxidase - GPX, lipid peroxidation - LPO), neurotoxicity (acetylcholinesterase activity - AChE), and genotoxicity (DNA damage). Pharmaceuticals tested induced the sublethal responses (even at the environmental range 0.1µgL(-1)). At this low concentration; caffeine, ibuprofen and carbamazepine decreased the LMS significantly compared with controls (p<0.05). The four compounds induced significantly the detoxification metabolism and oxidative stress (p<0.05). Neurotoxicity was noticed in clams exposed to caffeine and carbamazepine (p<0.05). Ibuprofen, carbamazepine and novobiocin produced genotoxic effects (p<0.05). Results from this research validate the use of biomarkers when assessing the effects of pharmaceuticals within a marine environmental risk assessment framework, using as a laboratory bioassay model the species R. philippinarum. PMID:26436477

  6. Antiepileptic Drugs with Mood Stabilizing Properties and Their Relation with Psychotropic Drug Use in Institutionalized Epilepsy Patients with Intellectual Disability

    Science.gov (United States)

    Leunissen, C. L. F.; de la Parra, N. M.; Tan, I. Y.; Rentmeester, Th. W.; Vader, C. I.; Veendrick-Meekes, M. J. B. M.; Aldenkamp, A. P.

    2011-01-01

    A large number of patients with epilepsy and intellectual disability take medication, amongst which antiepileptic and psychotropic drugs, often simultaneously. Certain antiepileptic drugs have mood-stabilizing properties, e.g. carbamazepine, valproic acid and lamotrigine. The aim of this study was to investigate whether the use of these…

  7. Bone Mass and Turnover in Women with Epilepsy on Antiepileptic Drug Monotherapy

    OpenAIRE

    Pack, Alison M.; Morrell, Martha J.; Marcus, Robert; Holloway, Leah; Flaster, Edith; Doñe, Silvia; Randall, Alison; Seale, Cairn; Shane, Elizabeth

    2005-01-01

    Antiepileptic drugs, particularly cytochrome P450 enzyme inducers, are associated with disorders of bone metabolism. We studied premenopausal women with epilepsy receiving antiepileptic drug monotherapy (phenytoin, carbamazepine, valproate, and lamotrigine). Subjects completed exercise and nutrition questionnaires and bone mineral density studies. Serum was analyzed for indices of bone metabolism including calcium, 25-hydroxyvitamin D, parathyroid hormone, insulin growth factor I, insulin bin...

  8. Isolation of Bacterial Strains Capable of Sulfamethoxazole Mineralization from an Acclimated Membrane Bioreactor

    OpenAIRE

    Bouju, H.; Ricken, B.; Beffa, T; Corvini, P. F.- X.; Kolvenbach, B.A.

    2011-01-01

    In this study, we isolated five strains capable of degrading 14C-labeled sulfamethoxazole to 14CO2 from a membrane bioreactor acclimatized to sulfamethoxazole, carbamazepine, and diclofenac. Of these strains, two belonged to the phylum Actinobacteria, while three were members of the Proteobacteria.

  9. Antiepileptic drugs targeting sodium channels: subunit and neuron-type specific interactions

    NARCIS (Netherlands)

    X. Qiao

    2013-01-01

    Certain antiepileptic drugs (e.g. carbamazepine and lamotrigine) block sodium channels in an use-dependent manner and this mechanism contributes to the anti-convulsant properties of these drugs. There are, however, subtle differences in sodium current blocking properties of the antiepileptic drugs w

  10. Evaluation of pre-treatments for inhibiting bromate formation during ozonation

    DEFF Research Database (Denmark)

    Antoniou, Maria; Andersen, Henrik Rasmus

    2011-01-01

    This study compared several pre-treatment methods for inhibiting BrO3- formation during ozonation of tap water, from the DTU campus, including H2O2 addition (perozone), pH-depression, NH4+ and Cl2/NH4+ addition. At the same time, the inhibition of atrazine and carbamazepine removal was evaluated...

  11. Interactions between antiepileptic and antipsychotic drugs.

    Science.gov (United States)

    Besag, Frank M C; Berry, David

    2006-01-01

    Antiepileptic and antipsychotic drugs are often prescribed together. Interactions between the drugs may affect both efficacy and toxicity. This is a review of human clinical data on the interactions between the antiepileptic drugs carbamazepine, valproic acid (sodium valproate), vigabatrin, lamotrigine, gabapentin, topiramate, tiagabine, oxcarbazepine, levetiracetam, pregabalin, felbamate, zonisamide, phenobarbital and phenytoin with the antipsychotic drugs risperidone, olanzapine, quetiapine, clozapine, amisulpride, sulpiride, ziprasidone, aripiprazole, haloperidol and chlorpromazine; the limited information on interactions between antiepileptic drugs and zuclopenthixol, periciazine, fluphenazine, flupenthixol and pimozide is also presented. Many of the interactions depend on the induction or inhibition of the cytochrome P450 isoenzymes, but other important mechanisms involve the uridine diphosphate glucuronosyltransferase isoenzymes and protein binding. There is some evidence for the following effects. Carbamazepine decreases the plasma concentrations of both risperidone and its active metabolite. It also decreases concentrations of olanzapine, clozapine, ziprasidone, haloperidol, zuclopenthixol, flupenthixol and probably chlorpromazine and fluphenazine. Quetiapine increases the ratio of carbamazepine epoxide to carbamazepine and this may lead to toxicity. The data on valproic acid are conflicting; it may either increase or decrease clozapine concentrations, and it appears to decrease aripiprazole concentrations. Chlorpromazine possibly increases valproic acid concentrations. Lamotrigine possibly increases clozapine concentrations. Phenobarbital decreases clozapine, haloperidol and chlorpromazine concentrations. Phenytoin decreases quetiapine, clozapine, haloperidol and possibly chlorpromazine concentrations. There are major gaps in the data. In many cases there are no published clinical data on interactions that would be predicted on theoretical grounds. PMID

  12. Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers.

    LENUS (Irish Health Repository)

    Campbell, E

    2014-09-01

    Antiepileptic drug (AED) exposure during pregnancy increases the risk of major congenital malformations (MCMs). The magnitude of this risk varies by AED exposure. Here we provide updated results from the UK Epilepsy and Pregnancy Register of the risk of MCMs after monotherapy exposure to valproate, carbamazepine and lamotrigine.

  13. Simultaneous activated carbon adsorption within a membrane bioreactor for an enhanced micropollutant removal.

    Science.gov (United States)

    Li, Xueqing; Hai, Faisal I; Nghiem, Long D

    2011-05-01

    Significant adsorption of sulfamethoxazole and carbamazepine to powdered activated carbon (PAC) was confirmed by a series of adsorption tests. In contrast, adsorption of these micropollutants to the sludge was negligible. The removal of these compounds in membrane bioreactor (MBR) was dependent on their hydrophobicity and loading as well as the PAC dosage. Sulfamethoxazole exhibited better removal rate during operation under no or low (0.1g/L) PAC dosage. When the PAC concentration in MBR was raised to 1.0 g/L, a sustainable and significantly improved performance in the removal of both compounds was observed - the removal efficiencies of sulfamethoxazole and carbamazepine increased to 82 ± 11% and 92 ± 15% from the levels of 64 ± 7%, and negligible removal, respectively. The higher removal efficiency of carbamazepine at high (1.0 g/L) PAC dosage could be attributed to the fact that carbamazepine is relatively more hydrophobic than sulfamethoxazole, which subsequently resulted in its higher adsorption affinity toward PAC. PMID:21145232

  14. Genome-wide mapping for clinically relevant predictors of lamotrigine- and phenytoin-induced hypersensitivity reactions.

    LENUS (Irish Health Repository)

    McCormack, Mark

    2012-03-01

    An association between carbamazepine-induced hypersensitivity and HLA-A*3101 has been reported in populations of both European and Asian descent. We aimed to investigate HLA-A*3101 and other common variants across the genome as markers for cutaneous adverse drug reactions (cADRs) attributed to lamotrigine and phenytoin.

  15. 8-hydroxy-dipropylaminotetralin promotes neural plasticity in epileptic rats with depression

    Institute of Scientific and Technical Information of China (English)

    Ping Yang; Meizhen Sun; Liang Li; Yihua Shen

    2012-01-01

    Rats with chronic pilocarpine-induced temporal lobe epilepsy complicated with depression were studied. Anti-5-bromodeoxyuridine immunofluorescence staining and Timms staining showed that neurogenesis within the hippocampal dentate gyrus and mossy fiber sprouting were increased in model rats. Neurogenesis within the hippocampal dentate gyrus was further enhanced, while mossy fiber sprouting was decreased in model rats administered carbamazepine alone or in combination with the 5-hydroxytryptamine 1A receptor agonist, 8-hydroxy-dipropylaminotetralin (0.1 and 1 mg/kg). Among the groups, the effect was the most significant in rats receiving carbamazepine in conjunction with 1 mg/kg 8-hydroxy-dipropylaminotetralin. Thus, high dose 8-hydroxy-dipropylaminotetralin can improve neural plasticity in epileptic rats with depression.

  16. [Future direction of pharmacogenomics: identification of genes associated with risk of adverse drug reactions using genome-wide association study].

    Science.gov (United States)

    Mushiroda, Taisei

    2014-01-01

    Drug-induced skin rash characterized by an acute inflammatory reaction of skin and mucous membranes is dose-independent, unpredictable, and sometimes life-threatening. In recent years, the U.S. Food and Drug Administration (FDA) has recommended genotyping of polymorphisms in the human leukocyte antigen (HLA) prior to drug administration for the avoidance of severe skin rash induced by drugs, such as abacavir and carbamazepine. A genome-wide association study (GWAS) is useful for the identification of genomic biomarkers that can predict the efficacy or risk of toxicity of various drugs. We identified novel susceptibility loci associated with the risk of a skin rash induced by nevirapine and carbamazepine in Thai and Japanese populations, respectively, through case-control GWAS with high-throughput single-nucleotide polymorphism (SNP) genotyping technology. In order to apply the genomic biomarkers to clinical therapeutics, prospective clinical trials will be necessary for the evaluation of an intervention based on genetic tests. PMID:24724431

  17. Exposure of the Main Italian River Basin to Pharmaceuticals

    OpenAIRE

    Federico Ferrari; Agata Gallipoli; Matteo Balderacchi; Maria M. Ulaszewska; Ettore Capri; Marco Trevisan

    2011-01-01

    This study give a preliminary survey of pharmaceutical contamination and accumulation in surface waters and sediments along the river Po basin (74,000 km2, the largest in Italy), a strategic region for the Italian economy: it collects sewage from a vast industrialized area of Italy (Autorità di Baciono del fiume Po, 2006, 2009). 10 pharmaceuticals (atenolol, propanolol, metoprolol, nimesulide, furosemide, carbamazepine, ranitidine, metronidazole, paracetamol, and atorvastatin) from several th...

  18. Gene-class analysis of expression patterns induced by psychoactive pharmaceutical exposure in fathead minnow (Pimephales promelas) indicates induction of neuronal systems☆

    OpenAIRE

    Thomas, Michael A.; Joshi, Parag P.; Klaper, Rebecca D.

    2011-01-01

    Psychoactive pharmaceuticals are among the most frequently prescribed drugs, contributing to persistent measurable concentrations in aquatic systems. Typically, it is assumed that such contaminants have no human health implications because they exist in extremely low concentrations. We exposed juvenile fathead minnows (Pimephales promelas) to three pharmaceuticals, fluoxetine, venlafaxine and carbamazepine, individually and in a mixture, and measured their effect on the induction of gene expr...

  19. Effects of Mixture of Pharmaceuticals on Early Life Stages of Tench (Tinca tinca)

    OpenAIRE

    Vlasta Stancova; Lucie Plhalova; Marta Bartoskova; Dana Zivna; Miroslav Prokes; Petr Marsalek; Jana Blahova; Misa Skoric; Zdenka Svobodova

    2014-01-01

    Ubiquitous occurrence of pharmaceuticals in aquatic environment results in concern about potential adverse the effects on nontarget organisms. In water, drugs are present in complex mixtures, in which complicated interactions affect toxicity of single components. The purpose of this study was to examine effect of 35-day-long exposure to mixture of ibuprofen, diclofenac, and carbamazepine on the mortality, growth, early ontogeny, and histopathological changes in tench (Tinca tinca). Early life...

  20. Effects of soil properties on the uptake of pharmaceuticals into earthworms

    OpenAIRE

    Carter, Laura Jayne; Ryan, Jim J; Boxall, Alistair Bruce Alleyne

    2016-01-01

    Pharmaceuticals can enter the soil environment when animal slurries and sewage sludge are applied to land as a fertiliser or during irrigation with contaminated water. These pharmaceuticals may then be taken up by soil organisms possibly resulting in toxic effects and/or exposure of organisms higher up the food chain. This study investigated the influence of soil properties on the uptake and depuration of pharmaceuticals (carbamazepine, diclofenac, fluoxetine and orlistat) in the earthworm Ei...

  1. Levels of pharmaceuticals in Slovene municipal and hospital wastewaters: a preliminary study

    OpenAIRE

    Klančar, Anita; Trontelj, Jurij; Kristl, Albin; Zupančič Justin, Maja; Roškar, Robert

    2016-01-01

    Pharmaceuticals in wastewater have clearly raised concern and a broad range of analytical methods has been used to assess the risk as accurately as possible. The aim of our study was to measure and compare the concentrations of atorvastatin, bisoprolol, carbamazepine, ciprofloxacin, clofibric acid, diclofenac, fluoxetine, metoprolol, and sertraline in wastewater samples taken from one municipal and one hospital wastewater treatment plant in Slovenia and to predict the potential environmental ...

  2. Occurrence of pharmaceuticals in municipal wastewater treatment plants and receiving surface waters in Central and Southern Finland

    OpenAIRE

    Lindholm-Lehto, Petra

    2016-01-01

    The presence of five selected pharmaceuticals, four anti-inflammatory drugs, diclofenac, ibuprofen, ketoprofen, naproxen, and an antiepileptic drug carbamazepine, was determined at four municipal wastewater treatment plants (WWTPs) and in the receiving waterway near the city of Jyväskylä, in central Finland and also in the River Vantaa. First, an analytical method was developed including a pretreatment and purification followed by liquid chromatography coupled to tandem mass spectrometry (LC-...

  3. POCIS passive samplers as a monitoring tool for pharmaceutical residues and their transformation products in marine environment

    OpenAIRE

    Bueno, M. J. M.; Herrera, S.; Munaron, D.; Boillot, C.; Fenet, H.; Chiron, Serge; Gomez, E

    2016-01-01

    In the last years, several scientific studies have shown that carbamazepine (CBZ) is one of the most frequently detected pharmaceutical in aquatic environment. However, little data is available on its detection and its transformation products (TPs) in marine water. The use of polar organic chemical integrative sampling (POCIS) passive samplers as a semi-quantitative and qualitative tool for screening of pharmaceuticals and TPs in seawater has been studied. Furthermore, the uptake rates of the...

  4. Does Uptake of Pharmaceuticals Vary Across Earthworm Species?

    OpenAIRE

    Carter, Laura Jayne; Ryan, Jim J; Boxall, Alistair Bruce Alleyne

    2016-01-01

    This study compared the uptake and depuration of four commonly used pharmaceuticals (carbamazepine, diclofenac, fluoxetine and orlistat) in two earthworm species (Lumbricus terrestris and Eisenia fetida). L. terrestris are a larger species and often found in deep burrows whereas E. fetida prefer to reside near the soil surface. Species burrowing habits and sizes may alter uptake by earthworms. All four pharmaceuticals were taken up into both L. terrestris and E. fetida tissue after 21 days ex...

  5. Population pharmacokinetics of topiramate in adult patients with epilepsy using nonlinear mixed effects modelling

    OpenAIRE

    Vučičević, Katarina; Jovanović, Marija; Vovk, Tomaž; Miljković, Branislava; Sokić, Dragoslav; Grabnar, Iztok; Prostran, Milica

    2015-01-01

    The objective of the study was to develop population pharmacokinetic model of topiramate (TPM) using nonlinear mixed effects modelling approach. Data were collected from 78 adult epilepsy patients on mono- or co-therapy of TPM and other antiepileptic drugs, such as carbamazepine (CBZ), valproic acid, lamotrigine, levetiracetam, phenobarbital and pregabalin. Steady-state TPM concentrations were determined in blood samples by high performance liquid chromatography with fluorescence detection. A...

  6. Comparative Long-Term Effectiveness of a Monotherapy with Five Antiepileptic Drugs for Focal Epilepsy in Adult Patients: A Prospective Cohort Study

    OpenAIRE

    Zeng, Qing-Yi; Fan, Tian-Tian; Zhu, Pan; He, Ru-Qian; Bao, Yi-Xin; Zheng, Rong-Yuan; Xu, Hui-Qin

    2015-01-01

    Objective To evaluate and compare long-term effectiveness of five antiepileptic drugs (AEDs) for monotherapy of adult patients with focal epilepsy in routine clinical practice. Methods Adult patients with focal epilepsy, who were prescribed with carbamazepine (CBZ), valproate (VPA), lamotrigine (LTG), topiramate (TPM), or oxcarbazepine (OXC) as monotherapy, during the period from January 2004 to June 2012 registered in Wenzhou Epilepsy Follow Up Registry Database (WEFURD), were included in th...

  7. Long-term Effectiveness of Antiepileptic Drug Monotherapy in Partial Epileptic Patients: A 7-year Study in an Epilepsy Center in China

    OpenAIRE

    Zhu, Fei; Lang, Sen-Yang; Wang, Xiang-qing; Shi, Xiao-Bing; Ma, Yun-Feng; Zhang, Xu; Chen, Ya-Nan; Zhang, Jia-Tang

    2015-01-01

    Background: It is important to choose an appropriate antiepileptic drug (AED) to manage partial epilepsy. Traditional AEDs, such as carbamazepine (CBZ) and valproate (VPA), have been proven to have good therapeutic effects. However, in recent years, a variety of new AEDs have increasingly been used as first-line treatments for partial epilepsy. As the studies regarding the effectiveness of new drugs and comparisons between new AEDs and traditional AEDs are few, it is determined that these are...

  8. Successful use of stellate ganglion block and a new centrally acting analgesic with dual mode of action in a resistant temporomandibular joint pain

    OpenAIRE

    Jones, Gareth Peter; Tripathi, Shiva Shankar

    2014-01-01

    Stellate ganglion blocks have been shown to provide effective pain relief in a number of different conditions involving the upper body. This was demonstrated in a 65-year-old woman who had experienced severe debilitating pain in her left temporomandibular joint (TMJ) and the surrounding area of her face for over 10 years. The pain was unresponsive to indomethacin, carbamazepine, sodium valproate, gabapentin, lithium, melatonin and amitriptyline. She had also had four surgical procedures to th...

  9. CURRENT APPROACHES TO THERAPY OF RETT’S SYNDROME (A REVIEW OF LITERATURE)

    OpenAIRE

    N. Yu. Borovikova; M. Yu. Bobylova

    2016-01-01

    Antiepileptic therapy is one of the most urgent problems in the treatment of Rett’s syndrome. By taking into account a common concurrence of generalized and focal seizures with diffuse epileptiform activity on the electroencephalogram (EEG) in Rett’s syndrome, there are effective broad-spectrum antiepileptic drugs (AEDs): valproates, topiramate, levetiracetam, lamotrigine. Carbamazepine is effective for focal seizures and in the absence of diffuse EEG changes. For atypical absences, ethosuxim...

  10. A multi-system approach assessing the interaction of anticonvulsants with P-gp.

    Directory of Open Access Journals (Sweden)

    David Dickens

    Full Text Available 30% of epilepsy patients receiving antiepileptic drugs (AEDs are not fully controlled by therapy. The drug transporter hypothesis for refractory epilepsy proposes that P-gp is over expressed at the epileptic focus with a role of P-gp in extruding AEDs from the brain. However, there is controversy regarding whether all AEDs are substrates for this transporter. Our aim was to investigate transport of phenytoin, lamotrigine and carbamazepine by using seven in-vitro transport models. Uptake assays in CEM/VBL cell lines, oocytes expressing human P-gp and an immortalised human brain endothelial cell line (hCMEC/D3 were carried out. Concentration equilibrium transport assays were performed in Caco-2, MDCKII ±P-gp and LLC-PK1±P-gp in the absence or presence of tariquidar, an inhibitor of P-gp. Finally, primary porcine brain endothelial cells were used to determine the apparent permeability (Papp of the three AEDs in the absence or presence of P-gp inhibitors. We detected weak transport of phenytoin in two of the transport systems (MDCK and LLC-PK1 cells transfected with human P-gp but not in the remaining five. No P-gp interaction was observed for lamotrigine or carbamazepine in any of the seven validated in-vitro transport models. Neither lamotrigine nor carbamazepine was a substrate for P-gp in any of the model systems tested. Our data suggest that P-gp is unlikely to contribute to the pathogenesis of refractory epilepsy through transport of carbamazepine or lamotrigine.

  11. Determination of anti-anxiety and anti-epileptic drugs in hospital effluent and a preliminary risk assessment.

    Science.gov (United States)

    de Almeida, Carlos Alberto A; Brenner, Carla G B; Minetto, Luciane; Mallmann, Carlos A; Martins, Ayrton F

    2013-11-01

    In this study, an analytical methodology was developed for the determination of psycho-active drugs in the treated effluent of the University Hospital at the Federal University of Santa Maria, RS - Brazil. Samples were collected from point A (Emergency) and point B (General effluent). The adopted methodology included a pre-concentration procedure involving the use of solid phase extraction and determination by liquid chromatography coupled to mass spectrometry. The limit of detection for bromazepam and lorazepam was 4.9 ± 1.0 ng L(-1) and, for carbamazepine, clonazepam and diazepam was 6.1 ± 1.5 ng L(-1). The limit of quantification was 30.0 ± 1.1 ng L(-1), for bromazepam, clonazepam and lorazepam; for carbamazepine was 50.0 ± 1.8 ng L(-1) and was 40.0 ± 1.0 ng L(-1) for diazepam. The mean concentrations in the Emergency and General effluent treated currents were as follows: for bromazepam, 195 ± 6 ng L(-1) and 137 ± 7 ng L(-1); for carbamazepine, 590 ± 6 ng L(-1) and 461 ± 10 ng L(-1); for diazepam, 645 ± 1 ng L(-1) and 571 ± 10 ng L(-1); for lorazepam, 96 ± 7 ng L(-1) and 42 ± 4 ng L(-1); and for clonazepam, 134 ± 10 ng L(-1) and 57 ± 10 ng L(-1). A preliminary risk assessment was conducted: carbamazepine and diazepam require considerable attention owing to their environmental toxicity. The occurrence of these psychoactive-drugs and the environmental risks that they pose demonstrated the need for a more efficient treatment system. As far we are aware, there have been no comparable studies to this on the hazards of hospital effluents in Brazil, and very few that have carried out a risk assessment of psycho-active drugs in hospital effluent in general. PMID:24034828

  12. Ozone oxidation of antidepressants in wastewater –Treatment evaluation and characterization of new by-products by LC-QToFMS

    OpenAIRE

    Lajeunesse André; Blais Mireille; Barbeau Benoît; Sauvé Sébastien; Gagnon Christian

    2013-01-01

    Abstract Background The fate of 14 antidepressants along with their respective N-desmethyl metabolites and the anticonvulsive drug carbamazepine was examined in a primary sewage treatment plant (STP) and following advanced treatments with ozone (O3). The concentrations of each pharmaceutical compound were determined in raw sewage, effluent and sewage sludge samples by LC-MS/MS analysis. The occurrence of antidepressant by-products formed in treated effluent after ozonation was also investigat...

  13. Some ozone advanced oxidation processes to improve the biological removal of selected pharmaceutical contaminants from urban wastewater

    OpenAIRE

    Espejo, Azahara; Aguinaco, Almudena; Amat Payá, Ana María; Fernando J. Beltrán

    2014-01-01

    Removal of nine pharmaceutical compounds¿acetaminophen (AAF), antipyrine (ANT), caffeine (CAF), carbamazepine (CRB), diclofenac (DCF), hydrochlorothiazide (HCT), ketorolac (KET), metoprolol (MET) and sulfamethoxazole (SMX)¿spiked in a primary sedimentation effluent of a municipal wastewater has been studied with sequential aerobic biological and ozone advanced oxidation systems. Combinations of ozone, UVA black light and Fe(III) or Fe3O4 constituted the chemical systems. During the ...

  14. The place of peripheral neurectomy in the management of trigeminal neuralgia.

    OpenAIRE

    Freemont, A. J.; Millac, P

    1981-01-01

    One hundred and forty-six patients with trigeminal neuralgia were studied. Of 49 patients ultimately maintained pain-free by non-medical means, 26 underwent peripheral neurectomy. Twenty of these achieved excellent pain control in the longer term and 5 of the remaining 6 became more responsive to carbamazepine after operation. Seven patients required repeat neurectomies. Peripheral neurectomy is a useful and simple method of pain control in trigeminal neuralgia.

  15. The high-affinity binding site for tricyclic antidepressants resides in the outer vestibule of the serotonin transporter.

    Science.gov (United States)

    Sarker, Subhodeep; Weissensteiner, René; Steiner, Ilka; Sitte, Harald H; Ecker, Gerhard F; Freissmuth, Michael; Sucic, Sonja

    2010-12-01

    The structure of the bacterial leucine transporter from Aquifex aeolicus (LeuT(Aa)) has been used as a model for mammalian Na(+)/Cl(-)-dependent transporters, in particular the serotonin transporter (SERT). The crystal structure of LeuT(Aa) liganded to tricyclic antidepressants predicts simultaneous binding of inhibitor and substrate. This is incompatible with the mutually competitive inhibition of substrates and inhibitors of SERT. We explored the binding modes of tricyclic antidepressants by homology modeling and docking studies. Two approaches were used subsequently to differentiate between three clusters of potential docking poses: 1) a diagnostic SERT(Y95F) mutation, which greatly reduced the affinity for [(3)H]imipramine but did not affect substrate binding; 2) competition binding experiments in the presence and absence of carbamazepine (i.e., a tricyclic imipramine analog with a short side chain that competes with [(3)H]imipramine binding to SERT). Binding of releasers (para-chloroamphetamine, methylene-dioxy-methamphetamine/ecstasy) and of carbamazepine were mutually exclusive, but Dixon plots generated in the presence of carbamazepine yielded intersecting lines for serotonin, MPP(+), paroxetine, and ibogaine. These observations are consistent with a model, in which 1) the tricyclic ring is docked into the outer vestibule and the dimethyl-aminopropyl side chain points to the substrate binding site; 2) binding of amphetamines creates a structural change in the inner and outer vestibule that precludes docking of the tricyclic ring; 3) simultaneous binding of ibogaine (which binds to the inward-facing conformation) and of carbamazepine is indicative of a second binding site in the inner vestibule, consistent with the pseudosymmetric fold of monoamine transporters. This may be the second low-affinity binding site for antidepressants. PMID:20829432

  16. Effect of N-(m-bromoanilinomethyl)-p-isopropoxyphenylsuccinimide on the anticonvulsant action of four classical antiepileptic drugs in the mouse maximal electroshock-induced seizure model

    OpenAIRE

    Luszczki Jarogniew J.; Marzeda Ewa; Kondrat-Wrobel Maria W.; Pyrka Daniel; Kocharov Sergey L.; Florek-Luszczki Magdalena

    2014-01-01

    The purpose of this study was to determine the effects of N-(m-bromoanilinomethyl)- p-isopropoxyphenylsuccinimide (BAM-IPPS - a new succinimide derivative) on the protective action of four classical antiepileptic drugs (AEDs: carbamazepine [CBZ], phenobarbital [PB], phenytoin [PHT] and valproate [VPA]) in the mouse maximal electroshock (MES)-induced tonic seizure model. Tonic hind limb extension (seizure activity) was evoked in adult male albino Swiss mice by a current (sine-wave, 25 mA, 500 ...

  17. Recurrent pain of a pseudotabetic variety after laminectomy for lumbar disc lesion.

    OpenAIRE

    Martin, G.

    1980-01-01

    A variety of pain resembling the lightning pains of tabes dorsalis is described in patients suffering from persistent sciatica, following laminectomy for lumbar disc disease. It occurs in about 13% of those complaining of post-laminectomy pain and in 5% of all those having a laminectomy for disc disease. It is associated with damage to the nerve root and may be precipitated by nerve root resection. About half the patients may get some relief from carbamazepine or clonazepam and the syndrome s...

  18. Study of potential drug-drug interactions between benzodiazepines and four commonly used antiepileptic drugs in mice

    OpenAIRE

    Kartik N. Shah; Rana, Devang A.; Patel, Varsha J.

    2014-01-01

    Background: Benzodiazepines (BZD) is one of the commonly used drug groups for certain neurological diseases. As sometimes, the anti-epileptic drugs (AEDs) may be used concomitantly with BZD there is a potential for drug-drug interactions. Study aimed to study potential drug-drug interactions between four commonly used AEDs (phenytoin, carbamazepine (CBZ), phenobarbitone, sodium valproate) and BZD (diazepam, clonazepam) in mice using maximal electroshock seizure (MES) method and pentylenetetra...

  19. A Multi-System Approach Assessing the Interaction of Anticonvulsants with P-gp

    OpenAIRE

    Dickens, David; Yusof, Siti R.; Abbott, N. Joan; Weksler, Babette; Romero, Ignacio A; Couraud, Pierre-Olivier; Alfirevic, Ana; Pirmohamed, Munir; Owen, Andrew

    2013-01-01

    30% of epilepsy patients receiving antiepileptic drugs (AEDs) are not fully controlled by therapy. The drug transporter hypothesis for refractory epilepsy proposes that P-gp is over expressed at the epileptic focus with a role of P-gp in extruding AEDs from the brain. However, there is controversy regarding whether all AEDs are substrates for this transporter. Our aim was to investigate transport of phenytoin, lamotrigine and carbamazepine by using seven in-vitro transport models. Uptake assa...

  20. Generation of synthetic influent data to perform (micro)pollutant wastewater treatment modelling studies

    DEFF Research Database (Denmark)

    Snip, Laura; Flores Alsina, Xavier; Aymerich, I;

    2016-01-01

    of its metabolites with samples taken every 2-4h: the anti-inflammatory drug ibuprofen (IBU), the antibiotic sulfamethoxazole (SMX) and the psychoactive carbamazepine (CMZ). Information about type of excretion and total consumption rates forms the basis for creating the data-defined profiles used to......, and the future opportunities of the presented approach balancing model structure/calibration procedure complexity versus predictive capabilities....

  1. Occurrence and removal of pharmaceutically active compounds in sewage treatment plants with different technologies

    Science.gov (United States)

    Ying, Guang-Guo; Kookana, Rai S.; Kolpin, Dana W.

    2009-01-01

    Occurrence of eight selected pharmaceutically active compounds (PhACs; caffeine, carbamazepine, triclosan, gemfibrozil, diclofenac, ibuprofen, ketoprofen and naproxen) were investigated in effluents from fifteen sewage treatment plants (STPs) across South Australia. In addition, a detailed investigation into the removal of these compounds was also carried out in four STPs with different technologies (Plant A: conventional activated sludge; plant B: two oxidation ditches; plant C: three bioreactors; and plant D: ten lagoons in series). The concentrations of these compounds in the effluents from the fifteen STPs showed substantial variations among the STPs, with their median concentrations ranging from 26 ng/L for caffeine to 710 ng/L for carbamazepine. Risk assessment based on the "worst case scenario" of the monitoring data from the present study suggested potential toxic risks to aquatic organisms posed by carbamazepine, triclosan and diclofenac associated with such effluent discharge. With the exception of carbamazepine and gemfibrozil, significant concentration decreases between influent and effluent were observed in the four STPs studied in more detail. Biodegradation was found to be the main mechanism for removing concentrations from the liquid waste stream for the PhACs within the four STPs, while adsorption onto sludge appeared to be a minor process for all target PhACs except for triclosan. Some compounds (e.g. gemfibrozil) exhibited variable removal efficiencies within the four STPs. Plant D (10 lagoons in series) was least efficient in the removal of the target PhACs; significant biodegradation of these compounds only occurred from the sixth or seventh lagoon.

  2. The concentration of three anti-seizure medications in hair: the effects of hair color, controlling for dose and age

    OpenAIRE

    2001-01-01

    Background This paper assess the relationship between the quantity of three anti-seizure medications in hair and the color of the analyzed hair, while controlling for the effects of dose, dose duration, and patient age for 140 clinical patients undergoing anti-seizure therapy. Three drugs are assessed: carbamazepine (40 patients), valproic acid (40 patients), and phenytoin (60 patients). The relationship between hair assay results, hair color, dose, dose duration, and age is modeled using an ...

  3. A Review of Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Epilepsy

    OpenAIRE

    Singh, Rajinder P.; Asconapé, Jorge J.

    2011-01-01

    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. Howev...

  4. Evaluation of neurotoxic and neuroprotective pathways affected by antiepileptic drugs in cultured hippocampal neurons

    OpenAIRE

    Morte, Maria I.; Carreira, Bruno P.; Falcão, Maria J.; Ambrosio, António M.; Soares-da-Silva, Patrício; Araújo, Inês M.; Carvalho, Caetana M.

    2013-01-01

    In this study we evaluated the neurotoxicity of eslicarbazepine acetate (ESL), and of its in vivo metabolites eslicarbazepine (S-Lic) and R-licarbazepine (R-Lic), as compared to the structurally-related compounds carbamazepine (CBZ) and oxcarbazepine (OXC), in an in vitro model of cultured rat hippocampal neurons. The non-related antiepileptic drugs (AEDs) lamotrigine (LTG) and sodium valproate (VPA) were also studied. We assessed whether AEDs modulate pro-survival/pro-apoptotic p...

  5. Update on the role of eslicarbazepine acetate in the treatment of partial-onset epilepsy

    OpenAIRE

    Tambucci R; Basti C; Maresca M.; Coppola G.; Verrotti A

    2016-01-01

    Renato Tambucci,1 Claudia Basti,1 Maria Maresca,1 Giangennaro Coppola,2 Alberto Verrotti11Department of Pediatrics, University of L’Aquila, L’Aquila, Italy; 2Child and Adolescent Neuropsychiatry Unit, University of Salerno, Salerno, ItalyAbstract: Eslicarbazepine acetate (ESL) is a once daily new third generation antiepileptic drug that shares the basic chemical structure of carbamazepine and oxcarbazepine – a dibenzazepine nucleus with the 5-ca...

  6. Investigating Generic and Brand Name Pharmaceutical’s Market Shares and Prices in Tunisia

    OpenAIRE

    Chebbi, Houssem Eddine; Boujelbene, Younes; Ayadi, Inès

    2008-01-01

    The purpose of this paper is to investigate how the brand name’s market shares in Tunisia are affected by generic competition during the pre-reform period of the Tunisian health insurance system following the methodological approach developed by Aronsson et al. (2001). In this study we use data for three molecules Captopril (antihypertensive) Glibenclamide (antidiabetic) and Carbamazepine (antiepileptic) from IMS Health database. The data span from the third quarter 2002 to second quarter 200...

  7. Antiepileptic Drugs in the Treatment of Anxiety Disorders

    OpenAIRE

    Levent Mete; Sinem Akyalcin; Pinar Cetinay Aydin

    2009-01-01

    In addition to epilepsy, antiepileptic drugs are used in neurologic conditions such as chronic pain and in the treatment of bipolar disorder in psychiatry. There are studies reporting its use in the treatment of anxiety disorders. The efficacy of antiepileptic drugs as carbamazepine, valproic asid, lamotrigine, topiramate, gabapentin, pregabalin in anxiety disorders has been shown in some clinical studies. The strongest evidence has been presented for pregabalin in generalized anxiety disorde...

  8. Treating bipolar disorder. Evidence-based guidelines for family medicine.

    OpenAIRE

    McIntyre, Roger S; Mancini, Deborah A.; Lin, Peter; Jordan, John

    2004-01-01

    OBJECTIVE: To provide an evidence-based summary of medications commonly used for bipolar disorders and a practical approach to managing bipolar disorders in the office. QUALITY OF EVIDENCE: Articles from 1990 to 2003 were selected from MEDLINE using the key words "bipolar disorder," "antiepileptics," "antipsychotics," "antidepressants," and "mood stabilizers." Good-quality evidence for many of these treatments comes from randomized trials. Lithium, divalproex, carbamazepine, lamotrigine, oxca...

  9. Extending the KCNQ2 encephalopathy spectrum: clinical and neuroimaging findings in 17 patients

    DEFF Research Database (Denmark)

    Weckhuysen, S.; Ivanovic, V.; Hendrickx, R.;

    2013-01-01

    . Recurrent mutations lead to relatively homogenous phenotypes. One patient responded favorably to retigabine; 5 patients had a good response to carbamazepine. In 6 patients, seizures with bradycardia were recorded. One patient died of probable sudden unexpected death in epilepsy. CONCLUSION: KCNQ2 mutations...... cause approximately 13% of unexplained NEE. Patients present with a wide spectrum of severity and, although rare, infantile epilepsy onset is possible....

  10. Oxcarbazepine Induced Maculopapular Rash - A Case Report

    OpenAIRE

    Biswas, Arunava; Mitra, Ritabrata; Sen, Sukanta; Pal, Agnik; Tripathi, Santanu Kumar

    2015-01-01

    Unlike carbamazepine, newer anti epileptic drug like oxcarbazepine, reports fewer side effects. In this report we describe a case of oxcarbazepine induced maculopapular rash probably happened because of a drug interaction with isoniazid, and a brief review of the existing literature is presented herewith. A 40-year-old male patient received oxcarbazepine 300mg twice daily along with other anti-tubercular drugs including isoniazid (300mg) once daily since two days. Extensive cutaneous rash wit...

  11. The impact on receiving waters of pharmaceutical residues and antibiotic resistant faecal bacteria found in urban waste water effluents

    OpenAIRE

    Tuckwell, Rebecca

    2015-01-01

    Pharmaceuticals intended for human use are frequently detected in the aquatic environment. This is predominantly from their excretion following ingestion and subsequent discharge in domestic sewage. Wastewater treatment provides an opportunity to control their release to surface waters however, their removal is often incomplete. This thesis addresses this pharmaceutical pathway and the potential impact on the aquatic environment. The progress of bezafibrate, carbamazepine, ciprofloxacin a...

  12. Effect of the Dysbindin Gene on Antimanic Agents in Patients with Bipolar I Disorder

    OpenAIRE

    Yun, Dong-Hwan; Pae, Chi-Un; Drago, Antonio; Mandelli, Laura; De Ronchi, Diana; Patkar, Ashwin A.; Paik, In Ho; Serretti, Alessandro; Kim, Jung-Jin

    2008-01-01

    Objective We previously reported an association between dysbindin gene (DTNBP1) variants and bipolar I disorder (BID). This paper expands upon previous findings suggesting that DTNBP1 variants may play a role in the response to acute mood stabilizer treatment. Methods A total of 45 BID patients were treated with antimanic agents (lithium, valproate, or carbamazepine) for an average of 36.52 (±19.87) days. After treatment, the patients were evaluated using the Clinical Global Impression (CGI) ...

  13. EFFECT OF SEIZURE CONTROL ON IMPROVEMENT OF COGNITIVE FUNCTIONS IN EPILEPTIC PATIENTS

    OpenAIRE

    Nainian, M.R.; Behere, P.B.; Mohanti, S.

    1993-01-01

    SUMMARY A group of fifty epileptic patients were tested with neuropsychological tools for cognitive functions like memory, intelligence, visuomotor coordination, spatial perception and body schema perception. Patients were on carbamazepine and were tested after three months. Seizure improvement was shown to have different effects on different cognitive functions. Memory and intellectual deficits improved, while no difference was observed in visuomotor coordination, spatial and personal percep...

  14. Rare case of phenytoin induced acute generalized exanthematous pustulosis with cerebellar syndrome

    Science.gov (United States)

    Shingade, Pravin U; Wankhede, Vaishali; Kataria, Pritam S; Sonone, Nitin

    2014-01-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare drug induced cutaneous hypersensitivity reaction characterized by sudden onset of fever with sterile pustules overlying an erythematous skin occurring all over the body. The offending drugs are usually B-lactams and macrolides. Among anticonvulsants carbamazepine and Phenobarbital are commonly associated with AGEP. Only one case of phenytoin induced AGEP has been reported in literature. We present a rare case of AGEP with cerebellar syndrome occurring after receiving loading dose of phenytoin. PMID:24700960

  15. New genetic findings lead the way to a better understanding of fundamental mechanisms of drug hypersensitivity

    OpenAIRE

    Pirmohamed, Munir; Ostrov, David A.; Park, B. Kevin

    2015-01-01

    Drug hypersensitivity reactions are an important clinical problem for both health care and industry. Recent advances in genetics have identified a number of HLA alleles associated with a range of these adverse reactions predominantly affecting the skin but also other organs, such as the liver. The associations between abacavir hypersensitivity and HLA-B*57:01 and carbamazepine-induced Stevens-Johnson syndrome and HLA-B*15:02 have been implemented in clinical practice. There are many different...

  16. Effects of chronic clozapine administration on markers of arachidonic acid cascade and synaptic integrity in rat brain

    OpenAIRE

    Kim, Hyung-Wook; Cheon, Yewon; Modi, Hiren R.; Rapoport, Stanley I; Rao, Jagadeesh S.

    2012-01-01

    The mode of action of clozapine, an atypical antipsychotic approved for treating schizophrenia and bipolar disorder (BD) mania, remains unclear. We tested for overlap with the actions of the mood stabilizers, lithium, carbamazepine and valproate, which downregulate arachidonic acid (AA) cascade markers in rat brain and upregulate BDNF. AA cascade markers are upregulated in the postmortem BD brain in association with neuroinflammation and synaptic loss, while BDNF is decreased. Rats were injec...

  17. Acute and long-term treatment of mania

    OpenAIRE

    Vieta, Eduard; Sanchez-Moreno, Jose

    2008-01-01

    The treatment of mania starts with a correct diagnosis and elementary measures to prevent risks for the patient, relatives, and others. Sometimes, compulsory admission and treatment may be required for a few days. Patients with psychotic or mixed mania may be more difficult to treat. At the present time, there is solid evidence supporting the use of lithium, the anticonvulsants valproate and carbamazepine, and the antipsychotics chlorpromazine, haloperidol, risperidone, olanzapine, quetiapine...

  18. Current and Emerging Therapies for the Management of Bipolar Disorders

    OpenAIRE

    El-Mallakh, Rif S; Elmaadawi, Ahmed Z.; Yonglin Gao; Kavita Lohano; R. Jeannie Roberts

    2011-01-01

    Bipolar disorder is a complex condition to treat because agents that may be effective for a specific phase may not be effective for other phases, or may even worsen the overall course of the illness. Over the last decade there has been an increase in research activity in the treatment of bipolar illness. There are now several agents that are well established for the treatment of acute mania (lithium, divalproex, carbamazepine, nearly all antipsychotics), acute bipolar depression (lamotrigine,...

  19. Effects of chronic treatment with commonly used antiepileptic drugs on passive avoidance learning in prepubertal rats

    OpenAIRE

    Yildirim, Mehmet; ABİDİN, Ismail; CANSU, Ali

    2013-01-01

    Antiepileptic drugs (AEDs), which are widely used to control and prevent epileptic seizures in children with epilepsy, have potential cognitive side effects. There have been several reports respecting different effects of the first and second generation ADEs on learning and memory. Therefore, we investigated the effects of valproate, carbamazepine, levetiracetam, oxcarbazepine, lamotrigine and topiramate, administered chronically by gavage for 21 days, on learning and memory retention of male...

  20. Elimination of Micropollutants using Engineered Constructed Wetlands – A Laboratory Scale Study

    OpenAIRE

    Rossi, Luca; Brovelli, Alessandro; Queloz, Pierre; Ho, Dien; Barry, David Andrew

    2011-01-01

    In Switzerland, a new standard for wastewater treatment plants (WWTP) – 80% reduction of micropollutants from raw sewage – is under consideration. Five substances have been proposed as target compounds: Diclofenac, Carbamazepine, Mecoprop, Sulfamethoxazole and Benzotriazole. Although very efficient and reliable, advanced treatment technologies for traditional WWTPs – such as ozonation – are expensive and difficult to implement on relatively small WWTPs, of which there are many in Switzerland....

  1. Etude de l'impact de micropolluants pharmaceutiques sur le colmatage des BAM utilisés en traitement des eaux usées urbaines : cas de la carbamazépine

    OpenAIRE

    Li, Chengcheng

    2014-01-01

    Membrane fouling still remains the main limitation for the development of membrane bioreactor (MBR). In this thesis, the main objective focuses on the effects of pharmaceutical micropollutants which are frequently found in domestic wastewater on MBR fouling. Carbamazepine (CBZ), an anti-epileptic drug, was chosen in this study due to its occurrence in domestic wastewater and persistency in MBR process. The effects of CBZ on MBR fouling were investigated in two different ways of contact, i.e. ...

  2. Suspected-target screening strategy to investigate degradation by ozonation or photolysis of urban micropollutants in waste waters

    OpenAIRE

    Bados, P.; Mathon, B.; Brzokewicz, T.; Choubert, J.M.; Chovelon, J.M.; Coquery, M.; Miege, C.

    2015-01-01

    Conventional wastewater treatment plants (WWTPs) partially eliminate micropollutants present in domestic and industrial discharges (Martin-Ruel et al., 2010; Choubert et al., 2011). However, some molecules still occur in effluents of WWTPs at concentrations close to 0.1 μg/L for some pesticides (e.g. diuron) and pharmaceuticals (e.g., carbamazepine, sotalol, diclofenac). The potential hazard of these compounds requires the development of new processes (tertiary) to anticipate possible re...

  3. Research on mood stabilizers in India

    OpenAIRE

    Avasthi, Ajit; Grover, Sandeep; Aggarwal, Munish

    2010-01-01

    Mood stabilizers have revolutionized the treatment of bipolar affective disorders. We review data originating from India in the form of efficacy, effectiveness, usefulness, safety and tolerability of mood stabilizers. Data is mainly available for the usefulness and side-effects of lithium. A few studies in recent times have evaluated the usefulness of carbamazepine, valproate, atypical antipsychotics and verapamil. Occasional studies have compared two mood stabilizers. Data for long term effi...

  4. The impact of interacting drugs on dispensed doses of warfarin in the Swedish population: A novel use of population based drug registers.

    Science.gov (United States)

    Andersson, M L; Lindh, J D; Mannheimer, B

    2013-12-01

    To investigate the impact of interacting drugs on the dispensed doses of warfarin in the Swedish population. This was a retrospective, cross-sectional population based register study of patients being dispensed warfarin. Warfarin doses were estimated in different age groups, in men and women, and in patients using interacting drugs. The influence of interacting drugs on the dispensed warfarin dose was analyzed using multiple regression. All 143,729 patients dispensed warfarin were analyzed. The dispensed dose of warfarin was highest in patients 30-39 years old and decreased with age. Co-medication with carbamazepine, simvastatin, paracetamol, amiodarone, fluconazole, lactulose, or bezafibrate was associated with significant changes in dispensed warfarin doses, by +40%, -3.4%, -7.3%, -8.2%, -8.8%, -9.0%, and -9.7%, respectively. After adjustment for age and gender, sulfamethoxazole was also found to significantly alter the dispensed warfarin dose (-6.1%). We provide new support for the previous scarce evidence of interactions between warfarin and carbamazepine, bezafibrate, and lactulose. Initiation or discontinuation of bezafibrate or lactulose in a patient on warfarin should warrant close clinical monitoring. The marked increased warfarin requirement associated with carbamazepine use supports moving from a more conservative reactive towards a proactive strategy including preventive warfarin dose adjustments to avoid potential adverse effects. PMID:24038065

  5. Determination of pharmaceuticals in groundwater collected in five cemeteries' areas (Portugal).

    Science.gov (United States)

    Paíga, P; Delerue-Matos, C

    2016-11-01

    There are growing public attention and concern about the possibility of ecosystem and human health effects from pharmaceuticals in environment. Several types of environmental samples were target of studies by the scientific community, namely drinking water, groundwater, surface water (river, ocean), treated water (influent and effluent), soils, and sediments near to Wastewater Treatment Plants or near to others potential sources of contaminations. Normally, studies in the cemeteries areas are for historical and architectural research and questions of the potential risk for adverse impact of cemeteries in environment have never received enough attention. However, this risk may exist when cemeteries are placed in areas that are vulnerable to contamination. The objective of the present work was the determination of pharmaceuticals (nonsteroidal anti-inflammatory/analgesics, antibiotics and psychiatric drugs) in groundwater samples collected inside of the cemeteries areas. Acetaminophen, salicylic acid, ibuprofen, ketoprofen, nimesulide, carbamazepine, fluoxetine, and sertraline were the pharmaceuticals achieved in the analysed samples. None of the studied antibiotics were detected. The highest concentration was obtained for salicylic acid (in the range of 33.7 to 71.0ng/L) and carbamazepine (between 20.0 and 22.3ng/L), respectively. By the cluster analysis similarity between carbamazepine and fluoxetine was achieved. PMID:27328395

  6. Modulation of trichloroethylene in vitro metabolism by different drugs in human.

    Science.gov (United States)

    Cheikh Rouhou, Mouna; Haddad, Sami

    2014-08-01

    Toxicological interactions with drugs have the potential to modulate the toxicity of trichloroethylene (TCE). Our objective is to identify metabolic interactions between TCE and 14 widely used drugs in human suspended hepatocytes and characterize the strongest using microsomal assays. Changes in concentrations of TCE and its metabolites were measured by headspace GC-MS. Results with hepatocytes show that amoxicillin, cimetidine, ibuprofen, mefenamic acid and ranitidine caused no significant interactions. Naproxen and salicylic acid showed to increase both TCE metabolites levels, whereas acetaminophen, carbamazepine and erythromycin rather decreased them. Finally, diclofenac, gliclazide, sulphasalazine and valproic acid had an impact on the levels of only one metabolite. Among the 14 tested drugs, 5 presented the most potent interactions and were selected for confirmation with microsomes, namely naproxen, salicylic acid, acetaminophen, carbamazepine and valproic acid. Characterization in human microsomes confirmed interaction with naproxen by competitively inhibiting trichloroethanol (TCOH) glucuronidation (Ki=2.329 mM). Inhibition of TCOH formation was also confirmed for carbamazepine (partial non-competitive with Ki=70 μM). Interactions with human microsomes were not observed with salicylic acid and acetaminophen, similar to prior results in rat material. For valproic acid, interactions with microsomes were observed in rat but not in human. Inhibition patterns were shown to be similar in human and rat hepatocytes, but some differences in mechanisms were noted in microsomal material between species. Next research efforts will focus on determining the adequacy between in vitro observations and the in vivo situation. PMID:24632077

  7. Analysis of selected pharmaceuticals in fish and the fresh water bodies directly affected by reclaimed water using liquid chromatography-tandem mass spectrometry.

    Science.gov (United States)

    Wang, Jian; Gardinali, Piero R

    2012-11-01

    A comprehensive method for the analysis of 11 target pharmaceuticals representing multiple commonly used therapeutic classes was developed for biological tissues (fish), reclaimed water, and the surface water directly affected by irrigation with reclaimed water. One gram of fish tissue homogenate was extracted by accelerated solvent extraction with methylene chloride followed by mixed-mode cation exchange solid phase extraction (SPE) cleanup and analyzed by liquid chromatography-tandem mass spectrometry. Compared to previously reported methods, the protocol produces cleaner extracts resulting in lower method detection limits. Similarly, an SPE method based on Oasis HLB cartridges was used to concentrate and cleanup reclaimed and surface water samples. Among the 11 target compounds analyzed, trimethoprim, caffeine, sulfamethoxazole, diphenhydramine, diltiazem, carbamazepine, erythromycin, and fluoxetine were consistently detected in reclaimed water. Caffeine, diphenhydramine, and carbamazepine were consistently detected in fish and surface water samples. Bioaccumulation factors for caffeine, diphenhydramine, and carbamazepine in mosquito fish (Gambusia holbrooki) were calculated at 29 ± 26, 821 ± 422, and 108 ± 144, respectively. This is the first report of potential accumulation of caffeine in fish from a water body directly influenced by reclaimed water. Figure The pharmaceuticals detected in reclaimed water and the fresh water directly affected by reclaimed water. PMID:22678759

  8. Induction of nuclear receptors and drug resistance in the brain microvascular endothelial cells treated with antiepileptic drugs.

    Science.gov (United States)

    Lombardo, Laura; Pellitteri, Rosalia; Balazy, Michael; Cardile, Venera

    2008-05-01

    Our work contributes to the understanding of the mechanisms of drug resistance in epilepsis. This study aimed to investigate i) the levels of expression of P-glycoprotein (P-gp), and multidrug resistance-associated proteins (MRP)1 and 2, ii) the activation of the pregnane X receptor (PXR) and the constitutive androstane receptor (CAR), and iii) the relationship between increased P-gp and MRPs expression and PXR and CAR activation, in immortalized rat brain microvascular endothelial cell lines, GPNT and RBE4, following treatment with the antiepileptic drugs (AEDs), topiramate, phenobarbital, carbamazepine, tiagabine, levetiracetam, and phenytoin, using Western blotting and immunocytochemistry methods. Carbamazepine, phenobarbital and phenytoin induced the highest levels of P-gp and MPRs expression that was associated with increased activation of PXR and CAR receptors as compared to levetiracetam, tiagabine and topiramate. We conclude that P-gp and MRPs are differently overexpressed in GPNT and RBE4 by various AEDs and both PXR and CAR are involved in the drug-resistant epilepsy induced by carbamazepine, phenobarbital and phenytoin. PMID:18473823

  9. Investigating landfill leachate as a source of trace organic pollutants.

    Science.gov (United States)

    Clarke, Bradley O; Anumol, Tarun; Barlaz, Morton; Snyder, Shane A

    2015-05-01

    Landfill leachate samples (n=11) were collected from five USA municipal solid waste (MSW) landfills and analyzed for ten trace organic pollutants that are commonly detected in surface and municipal wastewater effluents (viz., carbamazepine, DEET, fluoxetine, gemfibrozil, PFOA, PFOS, primidone, sucralose, sulfamethoxazole and trimethoprim). Carbamazepine, DEET, PFOA and primidone were detected in all leachate samples analyzed and gemfibrozil was detected in samples from four of the five-landfill sites. The contaminants found in the highest concentrations were DEET (6900-143000 ng L(-1)) and sucralose (<10-621000 ng L(-1)). Several compounds were not detected (fluoxetine) or detected infrequently (sulfamethoxazole, trimethoprim and PFOS). Using the average mass of DEET in leachate amongst the five landfills and scaling the mass release from the five test landfills to the USA population of landfills, an order of magnitude estimate is that over 10000 kg DEET yr(-1) may be released in leachate. Some pharmaceuticals have similar annual mean discharges to one another, with the estimated annual discharge of carbamazepine, gemfibrozil, primidone equating to 53, 151 and 128 kg year(-1). To the authors knowledge, this is the first time that primidone has been included in a landfill leachate study. While the estimates developed in this study are order of magnitude, the values do suggest the need for further research to better quantify the amount of chemicals sent to wastewater treatment facilities with landfill leachate, potential impacts on treatment processes and the significance of landfill leachate as a source of surface water contamination. PMID:25753851

  10. Ornamental plants for micropollutant removal in wetland systems.

    Science.gov (United States)

    Macci, Cristina; Peruzzi, Eleonora; Doni, Serena; Iannelli, Renato; Masciandaro, Grazia

    2015-02-01

    The objective of this paper was to evaluate the efficiency of micropollutant removal, such as Cu, Zn, carbamazepine, and linear alkylbenzene sulfonates (LAS), through the use of a subsurface vertical flow constructed wetland system with ornamental plants. Zantedeschia aethiopica, Canna indica, Carex hirta, Miscanthus sinensis, and Phragmites australis were selected and planted in lysimeters filled up with gravel. The lysimeters were completely saturated with synthetic wastewater (N 280 mg L(-1), P 30 mg L(-1), Cu 3.6 mg L(-1), Zn 9 mg L(-1), carbamazepine 5 μg L(-1), linear alkylbenzene sulfonates 14 mg L(-1)), and the leaching water was collected for analysis after 15, 30, and 60 days in winter-spring and spring-summer periods. Nutrients (N and P) and heavy metals decreased greatly due to both plant activity and adsorption. C. indica and P. australis showed the highest metal content in their tissues and also the greatest carbamazepine and LAS removal. In these plants, the adsorption/degradation processes led to particularly high oxidative stress, as evidenced by the significantly high levels of ascorbate peroxidase activity detected. Conversely, Z. aethiopica was the less efficient plant in metal and organic compound removal and was also less stressed in terms of ascorbate peroxidase activity. PMID:24798922

  11. Metabolism of pharmaceutical and personal care products by carrot cell cultures.

    Science.gov (United States)

    Wu, Xiaoqin; Fu, Qiuguo; Gan, Jay

    2016-04-01

    With the increasing use of treated wastewater and biosolids in agriculture, residues of pharmaceutical and personal care products (PPCPs) in these reused resources may contaminate food produce via plant uptake, constituting a route for human exposure. Although various PPCPs have been reported to be taken up by plants in laboratories or under field conditions, at present little information is available on their metabolism in plants. In this study, we applied carrot cell cultures to investigate the plant metabolism of PPCPs. Five phase I metabolites of carbamazepine were identified and the potential metabolism pathways of carbamazepine were proposed. We also used the carrot cell cultures as a rapid screening tool to initially assess the metabolism potentials of 18 PPCPs. Eleven PPCPs, including acetaminophen, caffeine, meprobamate, primidone, atenolol, trimethoprim, DEET, carbamazepine, dilantin, diazepam, and triclocarban, were found to be recalcitrant to metabolism. The other 7 PPCPs, including triclosan, naproxen, diclofenac, ibuprofen, gemfibrozil, sulfamethoxazole, and atorvastatin, displayed rapid metabolism, with 0.4-47.3% remaining in the culture at the end of the experiment. Further investigation using glycosidase hydrolysis showed that 1.3-20.6% of initially spiked naproxen, diclofenac, ibuprofen, and gemfibrozil were transformed into glycoside conjugates. Results from this study showed that plant cell cultures may be a useful tool for initially exploring the potential metabolites of PPCPs in plants as well as for rapidly screening the metabolism potentials of a variety of PPCPs or other emerging contaminants, and therefore may be used for prioritizing compounds for further comprehensive evaluations. PMID:26745399

  12. Fate of hormones and pharmaceuticals during combined anaerobic treatment and nitrogen removal by partial nitritation-anammox in vacuum collected black water.

    Science.gov (United States)

    de Graaff, M S; Vieno, N M; Kujawa-Roeleveld, K; Zeeman, G; Temmink, H; Buisman, C J N

    2011-01-01

    Vacuum collected black (toilet) water contains hormones and pharmaceuticals in relatively high concentrations (μg/L to mg/L range) and separate specific treatment has the potential of minimizing their discharge to surface waters. In this study, the fate of estrogens (natural and synthetical hormones) and pharmaceuticals (paracetamol, metoprolol, propranolol, cetirizine, doxycycline, tetracycline, ciprofloxacin, trimethoprim, carbamazepine, ibuprofen and diclofenac) in the anaerobic treatment of vacuum collected black water followed by nitrogen removal by partial nitritation-anammox was investigated. A new analytical method was developed to detect the presence of several compounds in the complex matrix of concentrated black water. Detected concentrations in black water ranged from 1.1 μg/L for carbamazepine to >1000 μg/L for paracetamol. Anaerobic treatment was only suitable to remove the majority of paracetamol (>90%). Metoprolol was partly removed (67%) during aerobic treatment. Deconjugation could have affected the removal efficiency of ibuprofen as concentrations even increased during anaerobic treatment and only after the anammox treatment 77% of ibuprofen was removed. The presence of persistent micro-pollutants (diclofenac, carbamazepine and cetirizine), which are not susceptible for biodegradation, makes the application of advanced physical and chemical treatment unavoidable. PMID:20832097

  13. Investigating the removal of some pharmaceutical compounds in hospital wastewater treatment plants operating in Saudi Arabia.

    Science.gov (United States)

    Al Qarni, Hamed; Collier, Philip; O'Keeffe, Juliette; Akunna, Joseph

    2016-07-01

    The concentrations of 12 pharmaceutical compounds (atenolol, erythromycin, cyclophosphamide, paracetamol, bezafibrate, carbamazepine, ciprofloxacin, caffeine, clarithromycin, lidocaine, sulfamethoxazole and N-acetylsulfamethoxazol (NACS)) were investigated in the influents and effluents of two hospital wastewater treatment plants (HWWTPs) in Saudi Arabia. The majority of the target analytes were detected in the influent samples apart from bezafibrate, cyclophosphamide, and erythromycin. Caffeine and paracetamol were detected in the influent at particularly high concentrations up to 75 and 12 ug/L, respectively. High removal efficiencies of the pharmaceutical compounds were observed in both HWWTPs, with greater than 90 % removal on average. Paracetamol, sulfamethoxazole, NACS, ciprofloxacin, and caffeine were eliminated by between >95 and >99 % on average. Atenolol, carbamazepine, and clarithromycin were eliminated by >86 % on average. Of particular interest were the high removal efficiencies of carbamazepine and antibiotics that were achieved by the HWWTPs; these compounds have been reported to be relatively recalcitrant to biological treatment and are generally only partially removed. Elevated temperatures and high levels of sunlight were considered to be the main factors that enhanced the removal of these compounds. PMID:26996911

  14. Pharmaceutically active compounds and endocrine disrupting chemicals in water, sediments and mollusks in mangrove ecosystems from Singapore.

    Science.gov (United States)

    Bayen, Stéphane; Estrada, Elvagris Segovia; Juhel, Guillaume; Kit, Lee Wei; Kelly, Barry C

    2016-08-30

    This study investigated the occurrence of bisphenol A (BPA), atrazine and selected pharmaceutically active compounds (PhACs) in mangrove habitats in Singapore in 2012-2013, using multiple tools (sediment sampling, POCIS and filter feeder molluscs). Using POCIS, the same suite of contaminants (atrazine, BPA and eleven PhACs) was detected in mangrove waters in 28-days deployments in both 2012 and 2013. POCIS concentrations ranged from pg/L to μg/L. Caffeine, BPA, carbamazepine, E1, triclosan, sulfamerazine, sulfamethazine, and lincomycin were also detected in mangrove sediments from the low pg/g dw (e.g. carbamazepine) to ng/g dw (e.g. BPA). The detection of caffeine, carbamazepine, BPA, sulfamethoxazole or lincomycin in bivalve tissues also showed that these chemicals are bioavailable in the mangrove habitat. Since there are some indications that some pharmaceutically active substances may be biologically active in the low ppb range in marine species, further assessment should be completed based on ecotoxicological data specific to mangrove species. PMID:27393211

  15. Role of wetland organic matters as photosensitizer for degradation of micropollutants and metabolites.

    Science.gov (United States)

    Lee, Eunkyung; Shon, Ho Kyong; Cho, Jaeweon

    2014-07-15

    Overall photodegradation of pharmaceuticals, personal care products (PPCPs) and pharmaceutical metabolites were investigated in order to evaluate their photochemical fate in aquatic environments in various natural organic matter (NOM) enriched solutions. Tested PPCPs exhibited different rates of loss during direct and indirect photolysis. Here, only ultraviolet (UV) light source was used for direct photolysis and UV together with (3)DOM(*)for indirect photolysis. Diclofenac and sulfamethoxazole were susceptible to photodegradation, whereas carbamazepine, caffeine, paraxanthine and tri(2-chloroethyl) phosphate (TCEP) showed low levels of photodegradation rate, reflecting their conservative photoreactivity. During indirect photodegradation, in contrast to the hydrophilic autochthonous NOM, allochthonous NOM with relatively high molecular weight (MW), specific ultraviolet absorbance (SUVA) and hydrophobicity (e.g., Suwannee River humic acid (SRHA)) revealed to significantly inhibit the photolysis of target micropollutants. The presence of Typha wetland NOM enhanced the indirect photolysis of well-known conservative micopollutants (carbamazepine and paraxanthine). And atenolol, carbamazepine, glimepiride, and N-acetyl-sulfamethoxazole were found to be sensitive to the triplet excited state of dissolved organic matter ((3)DOM(*)) with Typha wetland NOM under deoxygenated condition. This suggests that photolysis in constructed wetlands connected to the wastewater treatment plant can enhance the degradation of some anthropogenic micropollutants by the interaction with (3)DOM(*) in wetlands. PMID:24862465

  16. Pharmaceutical load in sewage sludge and biochar produced by hydrothermal carbonization.

    Science.gov (United States)

    vom Eyser, C; Palmu, K; Schmidt, T C; Tuerk, J

    2015-12-15

    We investigated the removal of twelve pharmaceuticals in sewage sludge by hydrothermal carbonization (HTC), which has emerged as a technology for improving the quality of organic waste materials producing a valuable biochar material. In this study, the HTC converted sewage sludge samples to a biochar product within 4h at a temperature of 210 °C and a resulting pressure of about 15 bar. Initial pharmaceutical load of the sewage sludge was investigated as well as the residual concentrations in biochar produced from spiked and eight native sewage sludge samples from three waste water treatment plants. Additionally, the solid contents of source material and product were compared, which showed a considerable increase of the solid content after filtration by HTC. All pharmaceuticals except sulfamethoxazole, which remained below the limit of quantification, frequently occurred in the investigated sewage sludges in the μg/kg dry matter (DM) range. Diclofenac, carbamazepine, metoprolol and propranolol were detected in all sludge samples with a maximum concentration of 800 μg/kgDM for metoprolol. HTC was investigated regarding its contaminant removal efficiency using spiked sewage sludge. Pharmaceutical concentrations were reduced for seven compounds by 39% (metoprolol) to≥97% (carbamazepine). In native biochar samples the four compounds phenazone, carbamazepine, metoprolol and propranolol were detected, which confirmed that the HTC process can reduce the load of micropollutants. In contrast to the other investigated compounds phenazone concentration increased, which was further addressed in thermal behaviour studies including three structurally similar potential precursors. PMID:26282751

  17. Impact of soil properties on selected pharmaceuticals adsorption in soils

    Science.gov (United States)

    Kodesova, Radka; Kocarek, Martin; Klement, Ales; Fer, Miroslav; Golovko, Oksana; Grabic, Roman; Jaksik, Ondrej

    2014-05-01

    The presence of human and veterinary pharmaceuticals in the environment has been recognized as a potential threat. Pharmaceuticals may contaminate soils and consequently surface and groundwater. Study was therefore focused on the evaluation of selected pharmaceuticals adsorption in soils, as one of the parameters, which are necessary to know when assessing contaminant transport in soils. The goals of this study were: (1) to select representative soils of the Czech Republic and to measure soil physical and chemical properties; (2) to measure adsorption isotherms of selected pharmaceuticals; (3) to evaluate impact of soil properties on pharmaceutical adsorptions and to propose pedotransfer rules for estimating adsorption coefficients from the measured soil properties. Batch sorption tests were performed for 6 selected pharmaceuticals (beta blockers Atenolol and Metoprolol, anticonvulsant Carbamazepin, and antibiotics Clarithromycin, Trimetoprim and Sulfamethoxazol) and 13 representative soils (soil samples from surface horizons of 11 different soil types and 2 substrates). The Freundlich equations were used to describe adsorption isotherms. The simple correlations between measured physical and chemical soil properties (soil particle density, soil texture, oxidable organic carbon content, CaCO3 content, pH_H2O, pH_KCl, exchangeable acidity, cation exchange capacity, hydrolytic acidity, basic cation saturation, sorption complex saturation, salinity), and the Freundlich adsorption coefficients were assessed using Pearson correlation coefficient. Then multiple-linear regressions were applied to predict the Freundlich adsorption coefficients from measured soil properties. The largest adsorption was measured for Clarithromycin (average value of 227.1) and decreased as follows: Trimetoprim (22.5), Metoprolol (9.0), Atenolol (6.6), Carbamazepin (2.7), Sulfamethoxazol (1.9). Absorption coefficients for Atenolol and Metoprolol closely correlated (R=0.85), and both were also

  18. Sorption and degradation of selected pharmaceuticals in representative soils of the Czech Republic

    Science.gov (United States)

    Kodesova, Radka; Kocarek, Martin; Klement, Ales; Golovko, Oksana; Grabic, Roman; Fer, Miroslav; Nikodem, Antonin; Jaksik, Ondrej

    2015-04-01

    Knowledge of contaminant behavior (e.g. its sorption onto soil particle, degradation etc.) is essential when assessing contaminant migration in soil and groundwater environment. This study was focused on evaluating sorption isotherms and half-lives for 7 pharmaceuticals (clarithromycin, trimethoprim, metoprolol, atenolol, clindamycin, carbamazepine, sulfamethoxazole) on 13 soils of different soil properties. Sorption of ionizable compounds was highly affected by soil pH. The sorption coefficient of sulfamethoxazole was negatively correlated to soil pH and thus positively related to hydrolytic acidity and exchangeable acidity. Sorption coefficients for clindamycin and clarithromycin were positively related to soil pH and thus negatively related to hydrolytic acidity and exchangeable acidity and positively related to base cation saturation. Sorption coefficients for the remaining pharmaceuticals (trimethoprim, metoprolol, atenolol, and carbamazepine) were also positively correlated with the base cation saturation and cation exchange capacity. Degradation rates in some degree reflected sorption of studied pharmaceuticals on soil particles and increased with decreasing sorption. The highest mobility in studied soils was observed for sulfamethoxazole, but this pharmaceutical was relatively quickly degraded. The second highest mobility was found for carbamazepine, which mostly did not noticeably degrade during our experiments. Thus this pharmaceutical has the highest potential to migrate in water environment. The lowest mobility was observed for clarithromycin. However, this pharmaceutical due to its stability may be retained in an environment for a long time. Acknowledgement: The authors acknowledge the financial support of the Czech Science Foundation (Project No. 13-12477S, Transport of pharmaceuticals in soils). References: Kodesova, R., Grabic, R., Kocarek, M., Klement, A., Golovko, O., Fer, M., Nikodem, A., Jaksik, O., Pharmaceuticals' sorptions relative to

  19. Role of wetland organic matters as photosensitizer for degradation of micropollutants and metabolites

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eunkyung [Department of Civil and Environmental Engineering, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 120-749 (Korea, Republic of); Shon, Ho Kyong [School of Civil and Environmental Engineering, University of Technology, Sydney (UTS), PO Box 123, Broadway, Sydney 2007, NSW (Australia); Cho, Jaeweon, E-mail: chojw@yonsei.ac.kr [Department of Civil and Environmental Engineering, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul 120-749 (Korea, Republic of)

    2014-07-15

    Highlights: • Photodegradation of PPCPs was investigated in various NOM enriched solutions. • Direct and indirect photolysis experiments were conducted upon UV irradiation. • PPCPs showed different levels of photodegradation rates depending on their photoreactivity. • Allochthonous NOM inhibited the photolysis of target PPCPs. • Wetland NOM enhanced photodegradation of some conservative PPCPs. - Abstract: Overall photodegradation of pharmaceuticals, personal care products (PPCPs) and pharmaceutical metabolites were investigated in order to evaluate their photochemical fate in aquatic environments in various natural organic matter (NOM) enriched solutions. Tested PPCPs exhibited different rates of loss during direct and indirect photolysis. Here, only ultraviolet (UV) light source was used for direct photolysis and UV together with {sup 3}DOM{sup *}for indirect photolysis. Diclofenac and sulfamethoxazole were susceptible to photodegradation, whereas carbamazepine, caffeine, paraxanthine and tri(2-chloroethyl) phosphate (TCEP) showed low levels of photodegradation rate, reflecting their conservative photoreactivity. During indirect photodegradation, in contrast to the hydrophilic autochthonous NOM, allochthonous NOM with relatively high molecular weight (MW), specific ultraviolet absorbance (SUVA) and hydrophobicity (e.g., Suwannee River humic acid (SRHA)) revealed to significantly inhibit the photolysis of target micropollutants. The presence of Typha wetland NOM enhanced the indirect photolysis of well-known conservative micopollutants (carbamazepine and paraxanthine). And atenolol, carbamazepine, glimepiride, and N-acetyl-sulfamethoxazole were found to be sensitive to the triplet excited state of dissolved organic matter ({sup 3}DOM{sup *}) with Typha wetland NOM under deoxygenated condition. This suggests that photolysis in constructed wetlands connected to the wastewater treatment plant can enhance the degradation of some anthropogenic micropollutants

  20. Low removal of acidic and hydrophilic pharmaceutical products by various types of municipal wastewater treatment plants

    Directory of Open Access Journals (Sweden)

    Christian Gagnon

    2012-03-01

    Full Text Available Pharmaceutical substances represent a risk for aquatic environments and their potential impacts on the receiving environment are poorly understood. Municipal effluents are important sources of contaminants including common pharmaceuticals like anti-inflammatory and anti-convulsive substances. The removal of pharmaceuticals, particularly those highly soluble can represent a great challenge to conventional wastewater treatment processes. Hydrophilic drugs (e.g. acidic drugs have properties that can highly influence removal efficiencies of treatment plants. The performance of different wastewater treatment processes for the removal of specific pharmaceutical products that are expected to be poorly removed was investigated. The obtained results were compared to inherent properties of the studied substances. Clofibric acid, carbamazepine, diclofenac, ibuprofen and naproxen were largely found in physicochemical primary-treated effluents at concentrations ranging from 77 to 2384 ng/L. This treatment type showed removal yields lower than 30%. On the other hand, biological treatments with activated sludge under aerobic conditions resulted in much better removal rates (>50% for 5 of the 8 studied substances. Interestingly, this latter type of process showed evidence of selectivity with respect to the size (R2=0.7388, solubility (R2=0.6812, and partitioning (R2=0.9999 of the removed substances; the smallest and least sorbed substances seemed to be removed at better rates, while the persistent carbamazepine (392 ng/L and diclofenac (66 ng/L were poorly removed (<10% after biological treatment. In the case of treatment by aerated lagoons, the most abundant substances were the highly soluble hydroxy-ibuprofen (350-3321 ng/L, followed by naproxen (42-413 n/L and carbamazepine (254-386 ng/L. In order to assess the impacts of all these contaminants of various properties on the environment and human health, we need to better understand the chemical and physical

  1. Pharmacokinetic interactions of the macrolide antibiotics.

    Science.gov (United States)

    Ludden, T M

    1985-01-01

    The macrolide antibiotics erythromycin and triacetyloleandomycin (troleandomycin) are prescribed for many types of infections. As such they are often added to other preexisting drug therapy. Thus, there are frequent opportunities for the interaction of these antibiotics with other drugs. Both erythromycin and triacetyloleandomycin appear to have the potential to inhibit drug metabolism in the liver and also drug metabolism by micro-organisms in the gut, either through their antibiotic effect or through complex formation and inactivation of microsomal drug oxidising enzymes. Of the two agents, triacetyloleandomycin appears to be the more potent inhibitor of microsomal drug metabolism. Published studies indicate that triacetyloleandomycin can significantly decrease the metabolism of methylprednisolone, theophylline and carbamazepine. Its ability to cause ergotism in patients receiving ergot alkaloids and cholestatic jaundice in patients on oral contraceptives may also be related to its inhibitory effect on drug metabolism. Erythromycin appears to be a much weaker inhibitor of drug metabolism. There are numerous reports describing apparent interactions of erythromycin with theophylline and a lesser number of reports dealing with carbamazepine, warfarin methylprednisolone and digoxin. There are sufficient data to suggest that erythromycin can, in some individuals, inhibit the elimination of methylprednisolone, theophylline, carbamazepine and warfarin. The mean change in drug clearance is about 20 to 25% in most cases, with some patients having a much larger change than others. Like tetracycline, erythromycin also appears to have the potential for increasing the bioavailability of digoxin in patients who excrete high amounts of reduced digoxin metabolites, apparently through destruction of the gut flora that form these compounds. Concurrent administration of triacetyloleandomycin with drugs whose metabolism is known to be affected or that could potentially be affected

  2. In-stream attenuation of neuro-active pharmaceuticals and their metabolites

    Science.gov (United States)

    Writer, Jeffrey; Antweiler, Ronald C.; Ferrar, Imma; Ryan, Joseph N.; Thurman, Michael

    2013-01-01

    In-stream attenuation was determined for 14 neuro-active pharmaceuticals and associated metabolites. Lagrangian sampling, which follows a parcel of water as it moves downstream, was used to link hydrological and chemical transformation processes. Wastewater loading of neuro-active compounds varied considerably over a span of several hours, and thus a sampling regime was used to verify that the Lagrangian parcel was being sampled and a mechanism was developed to correct measured concentrations if it was not. In-stream attenuation over the 5.4-km evaluated reach could be modeled as pseudo-first-order decay for 11 of the 14 evaluated neuro-active pharmaceutical compounds, illustrating the capacity of streams to reduce conveyance of neuro-active compounds downstream. Fluoxetine and N-desmethyl citalopram were the most rapidly attenuated compounds (t1/2 = 3.6 ± 0.3 h, 4.0 ± 0.2 h, respectively). Lamotrigine, 10,11,-dihydro-10,11,-dihydroxy-carbamazepine, and carbamazepine were the most persistent (t1/2 = 12 ± 2.0 h, 12 ± 2.6 h, 21 ± 4.5 h, respectively). Parent compounds (e.g., buproprion, carbamazepine, lamotrigine) generally were more persistent relative to their metabolites. Several compounds (citalopram, venlafaxine, O-desmethyl-venlafaxine) were not attenuated. It was postulated that the primary mechanism of removal for these compounds was interaction with bed sediments and stream biofilms, based on measured concentrations in stream biofilms and a column experiment using stream sediments.

  3. Evaluation of memory enhancing clinically available standardized extract of Bacopa monniera on P-glycoprotein and cytochrome P450 3A in Sprague-Dawley rats.

    Directory of Open Access Journals (Sweden)

    Rajbir Singh

    Full Text Available Bacopa monniera is a traditional Ayurvedic herbal medicine used to treat various mental ailments from ancient times. Recently, chemically standardized alcoholic extract of Bacopa monniera (BM has been developed and currently available as over the counter herbal remedy for memory enhancement in children and adults. However, the consumption of herbal drugs has been reported to alter the expression of drug metabolizing enzymes and membrane transporters. Present study in male Sprague-Dawley rat was performed to evaluate the effect of memory enhancing standardized extract of BM on hepatic and intestinal cytochrome P450 3A and P-glycoprotein expression and activity. The BM (31 mg/kg/day was orally administered for one week in BM pre-treated group while the control group received the same amount of vehicle for the same time period. The BM treatment decreased the cytochrome P450 3A (CYP3A mediated testosterone 6β-hydroxylation activity of the liver and intestine by 2 and 1.5 fold, respectively compared to vehicle treated control. Similarly pretreatment with BM extract decreased the expression of intestinal P-glycoprotein (Pgp as confirmed by Western blot analysis but did not alter the expression of hepatic Pgp. To investigate whether this BM pretreatment mediated decrease in activity of CYP3A and Pgp would account for the alteration of respective substrate or not, pharmacokinetic study with carbamazepine and digoxin was performed in BM pre-treated rats and vehicle treated rats. Carbamazepine and digoxin were used as CYP3A and Pgp probe drugs, respectively. Significant increase in AUC and Cmax of carbamazepine (4 and 1.8 fold and digoxin (1.3 and 1.2 fold, respectively following the BM pre-treatment confirmed the down regulation of CYP3A and Pgp.

  4. Temporal evolution in PPCP removal from urban wastewater by constructed wetlands of different configuration: a medium-term study.

    Science.gov (United States)

    Reyes-Contreras, Carolina; Hijosa-Valsero, María; Sidrach-Cardona, Ricardo; Bayona, Josep M; Bécares, Eloy

    2012-06-01

    Pharmaceuticals and personal care products (PPCPs) are widely distributed in urban wastewaters and can be removed to some extent by constructed wetlands (CWs). The medium-term (3-5 years) behaviour of these systems regarding PPCP removal is still unknown. Seven mesocosm-scale (1 m(2)) CWs of different configurations were operated outdoors for 39 months under the same conditions to assess their PPCP removal ability and temporal evolution. CWs differed in some design parameters, namely plant presence, species chosen (Typha angustifolia vs Phragmites australis), flow configuration and presence/absence of gravel bed (floating macrophytes surface flow, FM-SF; free-water surface flow, FW-SF; free-water subsurface flow, FW-SSF; or conventional horizontal subsurface flow, SSF). PPCP efficiencies decreased throughout time and performance differences among CWs disappeared with the systems aging. This could be due to a homogenization process in the systems caused by detrimental factors like saturation, clogging and shading. Winter efficiencies were lower than summer ones for salicylic acid, caffeine, methyl dihydrojasmonate, galaxolide and tonalide, and seasonal biological activities seem key factors to explain this fact. Maximal removal efficiencies were achieved in an unplanted-FW-SSF for ketoprofen (47-81%), naproxen (58-81%) and salicylic acid (76-98%); in an unplanted-SSF for caffeine (65-99%); in a Phragmites-FM-SF for ibuprofen (49-96%) and diclofenac (16-68%); in a Typha-FM-SF for carbamazepine (35-71%); and in a Typha-FW-SSF for methyl dihydrojasmonate (71-96%), galaxolide (67-82%) and tonalide (55-74%). Photodegradation could be involved in ketoprofen, naproxen, ibuprofen and diclofenac removal. Carbamazepine and diclofenac were moderately removed by the most efficient CWs studied. Carbamazepine might be eliminated by vegetal uptake. PMID:22436587

  5. Role of wetland organic matters as photosensitizer for degradation of micropollutants and metabolites

    International Nuclear Information System (INIS)

    Highlights: • Photodegradation of PPCPs was investigated in various NOM enriched solutions. • Direct and indirect photolysis experiments were conducted upon UV irradiation. • PPCPs showed different levels of photodegradation rates depending on their photoreactivity. • Allochthonous NOM inhibited the photolysis of target PPCPs. • Wetland NOM enhanced photodegradation of some conservative PPCPs. - Abstract: Overall photodegradation of pharmaceuticals, personal care products (PPCPs) and pharmaceutical metabolites were investigated in order to evaluate their photochemical fate in aquatic environments in various natural organic matter (NOM) enriched solutions. Tested PPCPs exhibited different rates of loss during direct and indirect photolysis. Here, only ultraviolet (UV) light source was used for direct photolysis and UV together with 3DOM*for indirect photolysis. Diclofenac and sulfamethoxazole were susceptible to photodegradation, whereas carbamazepine, caffeine, paraxanthine and tri(2-chloroethyl) phosphate (TCEP) showed low levels of photodegradation rate, reflecting their conservative photoreactivity. During indirect photodegradation, in contrast to the hydrophilic autochthonous NOM, allochthonous NOM with relatively high molecular weight (MW), specific ultraviolet absorbance (SUVA) and hydrophobicity (e.g., Suwannee River humic acid (SRHA)) revealed to significantly inhibit the photolysis of target micropollutants. The presence of Typha wetland NOM enhanced the indirect photolysis of well-known conservative micopollutants (carbamazepine and paraxanthine). And atenolol, carbamazepine, glimepiride, and N-acetyl-sulfamethoxazole were found to be sensitive to the triplet excited state of dissolved organic matter (3DOM*) with Typha wetland NOM under deoxygenated condition. This suggests that photolysis in constructed wetlands connected to the wastewater treatment plant can enhance the degradation of some anthropogenic micropollutants by the interaction with

  6. A nonlinear mixed effects modelling analysis of topiramate pharmacokinetics in patients with epilepsy.

    Science.gov (United States)

    Vovk, Tomaz; Jakovljević, Mihajlo B; Kos, Mojca Kerec; Janković, Slobodan M; Mrhar, Ales; Grabnar, Iztok

    2010-01-01

    Topiramate pharmacokinetics is influenced by individual factors such as patient age, renal function and co-treatment. The aim of this study was to develop a population pharmacokinetic model of topiramate to assist dosage adjustments in individual patients. Steady-state topiramate plasma concentrations in patients with epilepsy were determined by HPLC using fluorescent labelling. Demographic, biochemical data and dosing history including concomitant drug therapy were collected from patients' charts. Nonlinear mixed effects modelling was used to fit a one-compartment pharmacokinetic model. The influence of patient weight and gender, body surface area, age, creatinine clearance, serum transaminases, topiramate daily dose and co-treatment with carbamazepine, valproic acid, benzodiazepines, and risperidone on topiramate pharmacokinetics was evaluated. Additionally, the relationship between topiramate plasma concentration and clinical response was investigated. Volume of distribution of topiramate was 0.518 l/kg. For a typical patient oral clearance was estimated at 1.47 l/h, with interindividual variability of 39.2%. Clearance was 70% higher in patients co-treated with carbamazepine and was found to increase with patient age. Somnolence was the most frequently observed adverse event. Incidence of headache was associated with topiramate plasma concentration. Somnolence, ataxia, tremor, speech disorders and fatigue were associated with adjunctive therapy with carbamazepine, valproic acid, benzodiazepines, risperidone, and clozapine. No association of topiramate plasma concentration with frequency of seizures or patient quality of life was observed. The developed model can be used for Bayesian estimation of pharmacokinetic parameters based on sparse plasma samples and for selection of optimum dosing in routine patient care. PMID:20606310

  7. Photo-regenerable multi-walled carbon nanotube membranes for the removal of pharmaceutical micropollutants from water.

    Science.gov (United States)

    Zaib, Qammer; Mansoor, Bilal; Ahmad, Farrukh

    2013-08-01

    Pharmaceutical micropollutants fall in the category of "emerging contaminants" in water because of their prevalence and persistence in the aqueous environment, and because of a poor understanding of their low-dose exposure effects on human and animal populations. In this study, photo-regenerable multiwalled carbon nanotube membranes with variable water permeabilities were produced by embedding hierarchical TiO2 structures (having porous, spherical morphology) onto a pre-deposited bed of multi-walled carbon nanotubes (MWNTs) using a modified sol-gel technique. These MWNT-TiO2 composites and their constituent materials were characterized by analytical electron microscopy, surface charge measurement, thermogravimetric analysis, and hydrophobicity determination. The adsorption removal potential of MWNT-TiO2 membranes was demonstrated for three representative pharmaceuticals: acetaminophen, carbamazepine and ibuprofen. The peak initial removal percentages of the pharmaceuticals by the MWNT-TiO2 membranes were 80%, 45%, and 24% for carbamazepine, ibuprofen, and acetaminophen, respectively. The ability of the membranes to be regenerated, once they were saturated with the pharmaceutical compounds, was verified by repeating the adsorption removal experiment on the same membranes after exposure to UV light at 254 nm. Peak removal efficiencies after regeneration were 55%, 32%, and 19% for carbamazepine, ibuprofen, and acetaminophen, respectively, indicating some loss in sorptive capacity upon regeneration. Furthermore, the effect of pH on adsorption of ibuprofen, the pharmaceutical that attained the highest mass loading on the sorbent at equilibrium saturation, was studied and its mechanism of adsorption was proposed at pH below pKa. PMID:23811952

  8. Behaviour of pharmaceuticals and psychotic drugs in conventional and advanced wastewater treatments

    International Nuclear Information System (INIS)

    The occurrence of various pharmaceuticals and psychotic drugs in wastewater and their removal rates in a conventional wastewater treatment plant has been investigated. The psychoactive drugs are poorly removed in the biological step. However, most pharmaceuticals except of carbamazepine, are significantly biodegraded depending the removal degree on the type of compound and on the sludge retention time of the biological treatment. Also, the removal efficiency of conventional tertiary treatments and ultrafiltration and nano filtration membranes using two pilot plants was examined. the effects of retaining pharmaceuticals with ultrafiltration and nano filtration membranes do not greatly differ despite the difference in their pore size. (Author) 25 refs.

  9. Widespread occurrence of neuro-active pharmaceuticals and metabolites in 24 Minnesota rivers and wastewaters

    Science.gov (United States)

    Writer, Jeffrey; Ferrer, Imma; Barber, Larry B.; Thurman, E. Michael

    2013-01-01

    Concentrations of 17 neuro-active pharmaceuticals and their major metabolites (bupropion, hydroxy-bupropion, erythro-hydrobupropion, threo-hydrobupropion, carbamazepine, 10,11,-dihydro-10,11,-dihydroxycarbamazepine, 10-hydroxy-carbamazepine, citalopram, N-desmethyl-citalopram, fluoxetine, norfluoxetine, gabapentin, lamotrigine, 2-N-glucuronide-lamotrigine, oxcarbazepine, venlafaxine and O-desmethyl-venlafaxine), were measured in treated wastewater and receiving surface waters from 24 locations across Minnesota, USA. The analysis of upstream and downstream sampling sites indicated that the wastewater treatment plants were the major source of the neuro-active pharmaceuticals and associated metabolites in surface waters of Minnesota. Concentrations of parent compound and the associated metabolite varied substantially between treatment plants (concentrations ± standard deviation of the parent compound relative to its major metabolite) as illustrated by the following examples; bupropion and hydrobupropion 700 ± 1000 ng L−1, 2100 ± 1700 ng L−1, carbamazepine and 10-hydroxy-carbamazepine 480 ± 380 ng L−1, 360 ± 400 ng L−1, venlafaxine and O-desmethyl-venlafaxine 1400 ± 1300 ng L−1, 1800 ± 2300 ng L−1. Metabolites of the neuro-active compounds were commonly found at higher or comparable concentrations to the parent compounds in wastewater effluent and the receiving surface water. Neuro-active pharmaceuticals and associated metabolites were detected only sporadically in samples upstream from the effluent outfall. Metabolite to parent ratios were used to evaluate transformation, and we determined that ratios in wastewater were much lower than those reported in urine, indicating that the metabolites are relatively more labile than the parent compounds in the treatment plants and in receiving waters. The widespread occurrence of neuro-active pharmaceuticals and metabolites in Minnesota effluents and surface waters indicate that

  10. Behaviour of pharmaceuticals and psychotic drugs in conventional and advanced wastewater treatments; Comportamiento de medicamentos y psicofarmacos en tratamaientos de depuracion convencionales y terciarios

    Energy Technology Data Exchange (ETDEWEB)

    Cortacans Torre, J. A.; Castillo Gonzalez, I. del; Hernandez Lehmann, A.; Hernandez Munoz, A.; Rodriguez Barrera, X.

    2009-07-01

    The occurrence of various pharmaceuticals and psychotic drugs in wastewater and their removal rates in a conventional wastewater treatment plant has been investigated. The psychoactive drugs are poorly removed in the biological step. However, most pharmaceuticals except of carbamazepine, are significantly biodegraded depending the removal degree on the type of compound and on the sludge retention time of the biological treatment. Also, the removal efficiency of conventional tertiary treatments and ultrafiltration and nano filtration membranes using two pilot plants was examined. the effects of retaining pharmaceuticals with ultrafiltration and nano filtration membranes do not greatly differ despite the difference in their pore size. (Author) 25 refs.

  11. Determination of human pharmaceuticals in pre- and post-sewage treatment

    Science.gov (United States)

    Tahrim, Nurfaizah Abu; Abdullah, Md. Pauzi; Aziz, Yang Farina Abdul

    2013-11-01

    In this present work, an analytical method based on solid phase extraction (SPE) followed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF-MS) in positive electrospray ionisation mode was successfully applied to real samples for the determination of human pharmaceuticals in pre- and post-sewage treatment samples. The ten target compounds selected in this study include acetaminophen, theophylline, caffeine, metoprolol, sulfamethoxazole, carbamazepine, prednisolone, ketoprofen, norgestrel and simvastatin. Acetaminophen, theophylline and caffeine were present at all five raw sewage samples. In addition, this work provides the first report on the investigation and detection of theophylline in sewage treatment plant (STP) samples in Malaysia.

  12. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  13. Drug-Induced Bullous Sweet Syndrome with Multiple Autoimmune Features

    Directory of Open Access Journals (Sweden)

    Jared J. Lund

    2010-01-01

    Full Text Available Sweet syndrome (SS (Acute Febrile Neutrophilic Dermatosis has been reported in association with autoimmune phenomena including relapsing polychondritis, drug-induced lupus, and the development of antineutrophil cytoplasmic antibodies (ANCAs. However, a combination of these autoimmune features has not been reported. Herein, we report a case of drug-induced bullous SS with ocular and mucosal involvement, glomerulonephritis, and multiple autoimmune features including clinical polychondritis with antitype II collagen antibodies, ANCAs, antinuclear (HEp-2, and antihistone antibodies in a patient on hydralazine and carbamazepine.

  14. Can the clinical course of cancer be influenced by non-antineoplastic drugs?

    OpenAIRE

    Brandes, L. J.; Friesen, L A

    1995-01-01

    Laboratory and anecdotal clinical evidence suggests that some common non-antineoplastic drugs may affect the course of cancer. The authors present two cases that appear to be consistent with such a possibility: that of a 63-year-old woman in whom a high-grade angiosarcoma of the forehead improved after discontinuation of lithium therapy and then progressed rapidly when treatment with carbamazepine was started, and that of a 74-year-old woman with metastatic adenocarcinoma of the colon that re...

  15. Continuous-flow photocatalytic treatment of pharmaceutical micropollutants: Activity, inhibition, and deactivation of TiO2 photocatalysts in wastewater effluent

    KAUST Repository

    Carbonaro, Sean

    2013-01-01

    Titanium dioxide (TiO2) photocatalysts have been shown to be effective at degrading a wide range of organic micropollutants during short-term batch experiments conducted under ideal laboratory solution conditions (e.g., deionized water). However, little research has been performed regarding longer-term photocatalyst performance in more complex matrices representative of contaminated water sources (e.g., wastewater effluent, groundwater). Here, a benchtop continuous-flow reactor was developed for the purpose of studying the activity, inhibition, and deactivation of immobilized TiO2 photocatalysts during water treatment applications. As a demonstration, degradation of four pharmaceutical micropollutants (iopromide, acetaminophen, sulfamethoxazole, and carbamazepine) was monitored in both a pH-buffered electrolyte solution and a biologically treated wastewater effluent (WWE) to study the effects of non-target constituents enriched in the latter matrix. Reactor performance was shown to be stable over 7d when treating micropollutants in buffered electrolyte, with 7-d averaged kobs values (acetaminophen=0.97±0.10h-1; carbamazepine=0.50±0.04h-1; iopromide=0.49±0.03h-1; sulfamethoxazole=0.79±0.06h-1) agreeing closely with measurements from short-term circulating batch reactions. When reactor influent was switched to WWE, treatment efficiencies decreased to varying degrees (acetaminophen=40% decrease; carbamazepine=60%; iopromide=78%; sulfamethoxazole=54%). A large fraction of the catalyst activity was recovered upon switching back to the buffered electrolyte influent after 4d, suggesting that much of the observed decrease resulted from reversible inhibition by non-target constituents (e.g., scavenging of photocatalyst-generated OH). However, there was also a portion of the decrease in activity that was not recovered, indicating WWE constituents also contributed to photocatalyst deactivation (acetaminophen=6% deactivation; carbamazepine=24%; iopromide=16

  16. [Update on the management of trigeminal neuralgia].

    Science.gov (United States)

    Alcántara Montero, A; Sánchez Carnerero, C I

    2016-01-01

    Trigeminal neuralgia is one of the most severe facial pain syndromes. The annual incidence varies between 4-13% and has a significant effect on patient quality of life. The initial treatment of trigeminal neuralgia is pharmacological, and although other drugs have demonstrated efficacy, albeit in more limited form, carbamazepine is the only drug with sufficient level of evidence. When medical treatment fails, surgery should be considered and can opt for open surgery or minimally invasive percutaneous techniques. This paper reviews the medical and surgical therapeutic options for the treatment of trigeminal neuralgia, based on current available evidence. PMID:26643391

  17. SCHIZOAFFECTIVE DISORDER WITH MANIC TYPE : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.A. Gede Ocha Rama Kharisma Putra

    2014-02-01

    Full Text Available Schizoaffective disorder is a disease with persistent psychotic symptoms, such ashallucinations or delusions, occurs together with mood disorder such as depression,manic, or mixed episodes. Schizoaffective disorder is estimated to occur morefrequently than bipolar disorder. A psychotic disorder with symptoms of schizophreniaand manic air equally prominent in one episode of the same disease. This reportdescribes the case of b schizoaffective disorder with manic type in women aged 42years. These patients get therapy is pharmacotherapy Carbamazepine 2x200 mg orallyand Stelazine 2x5 mg orally.

  18. Fate of pharmaceuticals and pesticides in fly larvae composting.

    Science.gov (United States)

    Lalander, C; Senecal, J; Gros Calvo, M; Ahrens, L; Josefsson, S; Wiberg, K; Vinnerås, B

    2016-09-15

    A novel and efficient organic waste management strategy currently gaining great attention is fly larvae composting. High resource recovery efficiency can be achieved in this closed-looped system, but pharmaceuticals and pesticides in waste could potentially accumulate in every loop of the treatment system and spread to the environment. This study evaluated the fate of three pharmaceuticals (carbamazepine, roxithromycin, trimethoprim) and two pesticides (azoxystrobin, propiconazole) in a fly larvae composting system and in a control treatment with no larvae. It was found that the half-life of all five substances was shorter in the fly larvae compost (pesticides into the environment. PMID:27177134

  19. [Drugs from the classes of tricyclic antidepressives and antiepileptics, nitrosatable under simulated human gastric conditions].

    Science.gov (United States)

    Ziebarth, D; Schramm, T; Töppel, A

    1989-01-01

    The nitrosatability of Pryleugan (imipramine), Herphonal (trimipramine), and Finlepsin (carbamazepine) was investigated under simulated human gastric conditions using a colorimetric measuring method. All of them proved to be nitrosatable even at very low nitrite concentrations. In the presence of ascorbic acid, the formation of N-nitroso compounds under model conditions was inhibited markedly. N-nitroso-dihydrodibenzazepine and N-nitroso-dibenzazepine could be identified by thin layer chromatography as main products. The biological effects of these N-nitroso compounds are not known up to now. PMID:2802933

  20. [Quantitative EEG analysis of a single dose of psychotropic drugs in healthy probands].

    Science.gov (United States)

    Fischer, W; Streubel, F R; Heydenreich, F; Rabending, G

    1986-08-01

    In a series of 74 experiments in a double blind study, 25 healthy test persons were medicated with a single dose of Clomipramin, Desipramin, Imipramin, Diazepam, Carbamazepin, Haloperidol, and a placebo. At the end of one hour, and again at the end of three hours, an EEG was made whose frequency analysis revealed significant changes in about half the test persons. The antidepressives induced an increase in the theta waves, the slow alpha waves, and the slow beta waves, and a decrease in the fast alpha waves. The factors influencing the EEG are discussed. PMID:3786575

  1. Thirty-Two Cases of Trigeminal Neuralgia Treated with Acupuncture plus Chinese Traditional Drugs

    Institute of Scientific and Technical Information of China (English)

    Zheng Xiangmei; Suo Yunxi; Chen Zhengqiu

    2006-01-01

    @@ Trigeminal neuralgia refers to the kind of pain occurring in the distribution areas of the trigeminal nerves. The pain attacking periodically is so intense like either knife-cutting or electric stroke. However,no abnormality is found in the patients when the attack ceases. By means of acupuncture plus Chinese traditional drugs, the authors had treated 32cases of the disease from March of 1999 to March of 2003, and its effect is compared with that of carbamazepine in 29 cases. A report follows.

  2. Evaluation of regional cerebral blood flow in a patient with musical hallucinations.

    Science.gov (United States)

    Shoyama, Masaru; Ukai, Satoshi; Kitabata, Yuji; Yamamoto, Masahiro; Okumura, Masatoshi; Kose, Asami; Tsuji, Tomikimi; Shinosaki, Kazuhiro

    2010-02-01

    A 52-year-old woman with musical hallucinations was examined using brain single photon emission computed tomography (SPECT) with 99mTc-ECD. Changes in regional cerebral blood flow (rCBF) after carbamazepine treatment were assessed using a three-dimensional stereotaxic ROI template. Following treatment, rCBF was decreased in the subcortical structures and increased in the global cortical regions. From our findings, we propose that rCBF values in subcortical structures represent abnormalities similar to those reported in previous reports or other psychiatric disorders, while those in cortical regions suggest background brain dysfunctions that result in generation of musical hallucinations. PMID:20391182

  3. Phenobarbitone induced drug reaction with eosinophilia and systemic symptoms (DRESS: a case report

    Directory of Open Access Journals (Sweden)

    Navreet K. Natt

    2013-06-01

    Full Text Available Drug reaction with eosinophilia and systemic symptoms (DRESS is a life threatening cutaneous drug reaction with visceral involvement and hematological abnormalities. Being a rare side effect, it is often under-reported and misdiagnosed. The fatal adverse drug reaction is associated most commonly with aromatic anti-epileptics phenytoin, carbamazepine and less frequently with phenobarbitone. Here, we report a case of phenobarbitone induced DRESS in a 1 year old male child. He succumbed to fulminant hepatic failure inspite of being put on steroids, hepatoprotectives, antibiotics and ventilatory support. [Int J Basic Clin Pharmacol 2013; 2(3.000: 333-335

  4. Adverse Effects in the Pharmacologic Management of Bipolar Disorder During Pregnancy.

    Science.gov (United States)

    Hogan, Charlotte S; Freeman, Marlene P

    2016-09-01

    Management of bipolar disorder during pregnancy often involves medications with potential adverse effects, including risks to the mother and fetus. Although some specifics are known, many medications continue to have incompletely characterized reproductive safety profiles. Women with bipolar disorder who are planning pregnancy face challenging decisions about their treatment; careful risk-benefit discussions are necessary. With the goal of further informing these discussions, this article reviews the data currently available regarding medication safety in the management of bipolar disorder during pregnancy, with specific attention to lithium, valproic acid, lamotrigine, carbamazepine, and antipsychotic medications. PMID:27514299

  5. pH-Triggered Molecular Alignment for Reproducible SERS Detection via an AuNP/Nanocellulose Platform

    OpenAIRE

    Haoran Wei; Vikesland, Peter J.

    2015-01-01

    The low affinity of neutral and hydrophobic molecules towards noble metal surfaces hinders their detection by surface-enhanced Raman spectroscopy (SERS). Herein, we present a method to enhance gold nanoparticle (AuNP) surface affinity by lowering the suspension pH below the analyte pKa. We developed an AuNP/bacterial cellulose (BC) nanocomposite platform and applied it to two common pollutants, carbamazepine (CBZ) and atrazine (ATZ) with pKa values of 2.3 and 1.7, respectively. Simple mixing ...

  6. Pharmacokinetic interactions between contraceptives and antiepileptic drugs

    DEFF Research Database (Denmark)

    Sabers, A.

    2008-01-01

    The occurrence of bi-directional drug interactions between antiepileptic drugs (AEDs) and combined oral contraceptives (M) pose potential risks of unintended pregnancy and as well as seizure deterioration. It is well established that several of the older AEDs (carbamazepine, phenytoin and...... phenobarbital), are strong inducers of the hepatic cytochrome P450 (CYP) 3A4 enzyme system, and are associated with increased the risk of contraceptive failure. In addition, it is demonstrated that also some of the newer AEDs, oxcarbazepine and topiramate influence on the pharmacokinetics of OCs, which is...

  7. [Music as an uninvited guest: the auditive variant of the Charles Bonnet syndrome].

    Science.gov (United States)

    Tuerlings, J H A M; Wijnen, H; Boerman, R; Verwey, B

    2009-01-01

    Visually handicapped patients can be tormented by complex visual hallucinations (Charles Bonnet syndrome). Likewise, deaf patients and patients with impaired hearing can be plagued by auditory hallucinations, mostly involving music. Our article focuses on three female patients who suffered from musical hallucinations. In one of these patients the hallucinations ceased when her hearing was restored. In the second patient the hallucinations ceased when carbamazepine was prescribed. Quetiapine reduced the musical hallucinations in the third patient. The differential diagnoses and therapeutic options are discussed. PMID:19904711

  8. Medico-legal investigation of narcotics & other drug involved deaths

    Directory of Open Access Journals (Sweden)

    Tofighi H

    1994-04-01

    Full Text Available Today narcotics and other drugs have become the major cause of poisoning in big cities of Iran. Typical study of 50 drug-related deaths caused by use of narcotics, phenobarbital, tricyclic antiderpressants, meprobamate, aspirin, diazepam, chloropromazine, phenytoin, carbamazepine and propranolole, alone or with other drugs and toxic substances is described. This study covered the following topics: age, sex, pathological examination, autopsy cause of death, medical care prior to death. In toxicological examinations, samples from stomach content, liver, kidney, findings, urine and blood samples were analysed by TLC, GC, Emit d.a.u. assay and colour test methods

  9. Rare case of phenytoin induced acute generalized exanthematous pustulosis with cerebellar syndrome

    Directory of Open Access Journals (Sweden)

    Pravin U Shingade

    2014-01-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare drug induced cutaneous hypersensitivity reaction characterized by sudden onset of fever with sterile pustules overlying an erythematous skin occurring all over the body. The offending drugs are usually B-lactams and macrolides.Among anticonvulsants carbamazepine and Phenobarbital are commonly associated with AGEP. Only one case of phenytoin induced AGEP has been reported in literature. We present a rare case of AGEP with cerebellar syndrome occurring after receiving loading dose of phenytoin.

  10. Fatal Stevens-Johnson syndrome induced by phenytoin: a case report

    Directory of Open Access Journals (Sweden)

    Ritu J. Budania

    2013-12-01

    Full Text Available Toxic epidermal necrolysis (TEN and Stevens-Johnson syndrome (SJS are rare (one to two per 10,00,00 population per year but life threatening adverse drug reactions. Drugs commonly implicated are anti-epileptics, anti-microbials and non-steroidal anti-inflammatory drugs (NSAIDS. Amongst anti-epileptics, carbamazepine and phenytoin are the major culprits. We report here a fatal case of SJS due to phenytoin. [Int J Basic Clin Pharmacol 2013; 2(6.000: 843-845

  11. [Haematological adverse effects caused by psychiatric drugs].

    Science.gov (United States)

    Mazaira, Silvina

    2008-01-01

    Almost all clases of psychiatric drugs (typical and atypical antipsychotics, antidepressants, mood stabilizers, benzodiazepines) have been reported as possible causes of haematological toxicity. This is a review of the literature in which different clinical situations involving red blood cells, white blood cells, platelets and impaired coagulation are detailed and the drugs more frequently involved are listed. The haematological adverse reactions detailed here include: aplastic anemia, haemolitic anemia, leukopenia, agranulocytosis, leukocytosis, eosinophilia, thrombocytosis, thrombocytopenia, disordered platelet function and impaired coagulation. The haematologic toxicity profile of the drugs more frequently involved: lithium, clozapine, carbamazepine, valproic acid and SSRI antidepressants is mentioned. PMID:19424521

  12. Combined symptomatology of psychosis, pica syndrome, and hippocampal sclerosis: a case report.

    Science.gov (United States)

    Rohde, Judith; Claussen, Malte Christian; Kuechenhoff, Bernhard; Seifritz, Erich; Schuepbach, Daniel

    2013-01-01

    Pica is the developmentally and culturally inappropriate eating of nonnutritive substances for at least 1 month. Herein, we present the case of a male patient that suddenly showed behavioral changes including aggressiveness, withdrawal, and perceptional disturbances at the age of 12. About 7 years later, pica symptoms emerged additionally. Neither pharmacotherapy nor electroconvulsive therapy led to success. Magnetic resonance imaging showed bilateral sclerosis of the hippocampus. The therapy with carbamazepine, clozapine, diazepam, and zinc finally improved the symptoms including the pica symptoms. PMID:23034722

  13. Comparison Between Ionizing and Non-Ionizing Radiation Technologies for Wastewater Remediation

    International Nuclear Information System (INIS)

    A study on the decomposition of a surfactant (SDBS) and of four emerging pollutants (ofloxacin, carbamazepine, benzophenone-3, benzophenenone-4) in a multicomponent system is presented. These pollutants are decomposed in water by a few types of Advanced Oxidation Processes. The remediation methods included UV and γ-rays, all running in atmospheric conditions. It is shown that UV degradation methods can be improved by adding a photocatalyst (TiO2), or a radical mediator (H2O2). The processes were monitored step by step, by determining the concentration of pollutants by UV, HPLC and a specific surfactant selective kit, and measuring the total organic carbon content. (author)

  14. Pharmacokinetic interactions with calcium channel antagonists (Part II).

    Science.gov (United States)

    Schlanz, K D; Myre, S A; Bottorff, M B

    1991-12-01

    Since calcium channel antagonists are a diverse class of drugs frequently administered in combination with other agents, the potential for clinically significant pharmacokinetic drug interactions exists. These interactions occur most frequently via altered hepatic blood flow and impaired hepatic enzyme activity. Part I of the article, which appeared in the previous issue of the Journal, dealt with interactions between calcium antagonists and marker compounds, theophylline, midazolam, lithium, doxorubicin, oral hypoglycaemics and cardiac drugs. Part II examines interactions with cyclosporin, anaesthetics, carbamazepine and cardiovascular agents. PMID:1782739

  15. Removal and fate of micropollutants in a sponge-based moving bed bioreactor.

    Science.gov (United States)

    Luo, Yunlong; Guo, Wenshan; Ngo, Huu Hao; Nghiem, Long Duc; Hai, Faisal Ibney; Kang, Jinguo; Xia, Siqing; Zhang, Zhiqiang; Price, William Evan

    2014-05-01

    This study investigated the removal of micropollutants using polyurethane sponge as attached-growth carrier. Batch experiments demonstrated that micropollutants could adsorb to non-acclimatized sponge cubes to varying extents. Acclimatized sponge showed significantly enhanced removal of some less hydrophobic compounds (log Dmicropollutants. Particularly, carbamazepine, ketoprofen and pentachlorophenol were found at high concentrations (7.87, 6.05 and 5.55 μg/g, respectively) on suspended biosolids. As a whole, the effectiveness of MBBR for micropollutant removal was comparable with those of activated sludge processes and MBRs. PMID:24658104

  16. Evidence of reduced oral bioavailability of paracetamol in rats following multiple ingestion of grapefruit juice.

    Science.gov (United States)

    Qinna, Nidal A; Ismail, Obbei A; Alhussainy, Tawfiq M; Idkaidek, Nasir M; Arafat, Tawfiq A

    2016-04-01

    The aim of the current investigation was to assess the ability GFJ to modulate the pharmacokinetic profile of paracetamol following single or repeated administrations of GFJ in Sprague-Dawley rats. Diclofenac and carbamazepine were both used as positive controls. Rats received single GFJ or single distilled water doses or pretreated with three doses of GFJ prior to test drug administration. Blood samples were collected, processed and analyzed using validated HPLC methods, and pharmacokinetic data were constructed for each group. Increase in the bioavailability of both diclofenac and carbamazepine following multiple GFJ ingestion was revealed. Conversely, the bioavailability of paracetamol was significantly reduced following multiple GFJ administration. The percentage of reduction in the C max and AUC of paracetamol were calculated as 31 and 51 %, respectively, compared to none-GFJ-treated control (P < 0.05). The T max was not essentially changed. In conclusion, frequent administration of GFJ was confirmed to modulate the pharmacokinetics of paracetamol in rats by reducing its bioavailability. Meanwhile, it may be advisable not to ingest large amounts of GFJ along with paracetamol to avoid a possible potential loss of the efficacy. PMID:25547640

  17. Chloride Channel Myotonia: Study of Five Cases

    Directory of Open Access Journals (Sweden)

    M Ghofrani

    2002-09-01

    Full Text Available Chloride channel Myotonia is a form of channelopathy, and Myotonia is its manifestation. Myotonia may be defined as delayed relaxation of skeletal muscle after its contraction. Decreased chloride conductance across the transverse tubular system, renders the muscle membrane hyper-excitable and leads to repetitive firing, creating Myotonia. Myotonia congenital is another name for chloride channel Myotonia. Myotonia congenital appears in autosomal dominant type called Thomson disease, autosomal recessive type called Becker disease, and a type with sporadic occurrence. Symptoms appear in the first or second decade of life. Repeated muscle contraction, the so called warm up, result in resolution of the Myotonia stiffness. Muscle stiffness and hypertrophy is another finding at physical examination. In this study we report on 5 patients, which had clinical and electrical signs of Myotonia. Muscle hypertrophy and warm up phenomena were present in all cases. CPK measurement of all cases were normal. 2 patients underwent muscle biopsy that showed only atrophy and increased central nuclei. In three cases autosomal recessive inheritance (Becker, in one case autosomal dominant inheritance (Thomsen and in one case sporadic occurrence was suggested. With respect to successful results of carbamazepine therapy in 4 patients, and being excellent in one of them, we suggest carbamazepine for the first choice of Myotonia treatment.

  18. Use of pharmaceuticals and pesticides to constrain nutrient sources in coastal groundwater of northwestern Long Island, New York, USA

    Science.gov (United States)

    Zhao, S.; Zhang, P.; Crusius, J.; Kroeger, K.D.; Bratton, J.F.

    2011-01-01

    In developed, non-agricultural, unsewered areas, septic systems and fertilizer application to lawns and gardens represent two major sources of nitrogen to coastal groundwater, in addition to atmospheric input. This study was designed to distinguish between these two possible nitrogen sources by analyzing groundwater samples for pharmaceutical residuals, because fertilizers do not contain any of these pharmaceuticals, but domestic wastewater commonly does. In addition, several herbicides and insecticides used in lawn treatment were analyzed as indicators of nitrogen delivery to groundwater from fertilizers. Groundwater samples were taken through piezometres at shoreline sites in unsewered areas surrounding Northport Harbor and in sewered areas adjacent to Manhasset Bay (hereafter referred to as "Northport" and "Manhasset", respectively), both in northwestern Long Island, USA. Excessive nitrogen loading has led to reduced dissolved oxygen concentrations in Long Island Sound, and the groundwater contribution to the nitrogen budget is poorly constrained. The frequent detection of the anticonvulsant compound carbamazepine in groundwater samples of the Northport Harbor area (unsewered), together with the fact that few pesticides associated with lawn applications were detected, suggests that wastewater input and atmospheric input are the likely sources of nitrogen in the Northport groundwater. High concentrations of nitrogen were also detected in the Manhasset (sewered) groundwater. The low detection frequency and concentration of carbamazepine, however, suggest that the sewer system effectively intercepts nitrogen from wastewater there. The likely sources of nitrogen in the Manhasset groundwater are atmospheric deposition and lawn fertilizers, as this area is densely populated.

  19. Pharmaceuticals, alkylphenols and pesticides in Mediterranean coastal waters: Results from a pilot survey using passive samplers

    Science.gov (United States)

    Munaron, Dominique; Tapie, Nathalie; Budzinski, Hélène; Andral, Bruno; Gonzalez, Jean-Louis

    2012-12-01

    21 pharmaceuticals, 6 alkylphenols and 27 hydrophilic pesticides and biocides were investigated using polar organic contaminant integrative samplers (POCIS) during a large-scale study of contamination of French Mediterranean coastal waters. Marine and transitional water-bodies, defined under the EU Water Framework Directive were monitored. Our results show that the French Mediterranean coastal waters were contaminated with a large range of emerging contaminants, detected at low concentrations during the summer season. Caffeine, carbamazepine, theophilline and terbutaline were detected with a detection frequency higher than 83% in the coastal waters sampled, 4-nonylphenol (4-NP), 4-tert-octylphenol (4-OP) and 4-nonylphenol diethoxylate (NP2EO) were detected in all coastal waters sampled, and diuron, terbuthylazine, atrazine, irgarol and simazine were detected in more than 77% of samples. For pharmaceuticals, highest time-weighted average (TWA) concentrations were measured for caffeine and carbamazepine (32 and 12 ng L-1, respectively). For alkylphenols, highest TWA concentrations were measured for 4-nonylphenol mono-ethoxylate and 4-nonylphenol (41 and 33 ng L-1, respectively), and for herbicides and biocides, they were measured for diuron and irgarol (33 and 2.5 ng L-1, respectively). Except for Diana lagoon, lagoons and semi-enclosed bays were the most contaminated areas for herbicides and pharmaceuticals, whilst, for alkylphenols, levels of contamination were similar in lagoons and coastal waters. This study demonstrates the relevance and utility of POCIS as quantitative tool for measuring low concentrations of emerging contaminants in marine waters.

  20. Adsorptive removal of selected pharmaceuticals by mesoporous silica SBA-15

    Energy Technology Data Exchange (ETDEWEB)

    Bui, Tung Xuan, E-mail: bxtung@gist.ac.kr [Department of Environmental Science and Engineering, Gwangju Institute of Science and Technology (GIST), 261 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712 (Korea, Republic of); Choi, Heechul, E-mail: hcchoi@gist.ac.kr [Department of Environmental Science and Engineering, Gwangju Institute of Science and Technology (GIST), 261 Cheomdan-gwagiro, Buk-gu, Gwangju 500-712 (Korea, Republic of)

    2009-09-15

    The removal of five selected pharmaceuticals, viz., carbamazepine, clofibric acid, diclofenac, ibuprofen, and ketoprofen was examined by batch sorption experiments onto a synthesized mesoporous silica SBA-15. SBA-15 was synthesized and characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), N{sub 2} adsorption-desorption measurement, and point of zero charge (PZC) measurement. Pharmaceutical adsorption kinetics was rapid and occurred on a scale of minutes, following a pseudo-second-order rate expression. Adsorption isotherms were best fitted by the Freundlich isotherm model. High removal rates of individual pharmaceuticals were achieved in acidic media (pH 3-5) and reached 85.2% for carbamazepine, 88.3% for diclofenac, 93.0% for ibuprofen, 94.3% for ketoprofen, and 49.0% for clofibric acid at pH 3 but decreased with increase in pH. SBA-15 also showed high efficiency for removal of a mixture of 5 pharmaceuticals. Except for clofibric acid (35.6%), the removal of pharmaceuticals in the mixture ranged from 75.2 to 89.3%. Based on adsorption and desorption results, the mechanism of the selected pharmaceuticals was found to be a hydrophilic interaction, providing valuable information for further studies to design materials for the purpose. The results of this study suggest that mesoporous-silica-based materials are promising adsorbents for removing pharmaceuticals from not only surface water but also wastewater of pharmaceutical industrial manufactures.

  1. Tandem Solid Phase Extraction for the Determination of Pharmaceuticals in Wastewater

    International Nuclear Information System (INIS)

    In this study, a simple and rapid tandem solid phase extraction (SPE) was developed for the analysis of seven pharmaceuticals (acetaminophen, caffeine, carbamazepine, diclofenac, naproxen, ibuprofen and metaprolol) in wastewater sample. The novel aspect of coupling SPE cartridge in tandem is the ability to simplify the SPE procedure (sample introduction step) as no single sorbent was able to retain and concentrate all selected compounds since these compounds are of different physicochemical properties. A tandem SPE cartridges using Oasis HLB and octadecyl bonded silica (C18) was found to be efficient with the advantages of minimizing sample volume and reducing analysis time. Using this approach, carbamazepine, diclofenac, naproxen and metaprolol were trapped in the Oasis HLB while acetaminophen, caffeine and ibuprofen were trapped in the second cartridge (C18). The instrumental limits of detection (LOD) ranged from 0.01 to 0.04 μg/ L and satisfactory recoveries were obtained between 76 % to 104 %. The calibration curves were linear from 0.1 to 5.0 μg/ mL, with correlation coefficients (R2) in the range of 0.995 to 0.999. The developed method was applied to the analysis of pharmaceuticals in wastewater samples. The amount of pharmaceuticals detected in wastewater samples varied from 0.4 to 24.5 mg/ L. (author)

  2. NQR investigation and characterization of cocrystals and crystal polymorphs

    Energy Technology Data Exchange (ETDEWEB)

    Seliger, Janez, E-mail: janez.seliger@fmf.uni-lj.si; Zagar, Veselko [Jozef Stefan Institute (Slovenia); Asaji, Tetsuo [Nihon University, Department of Chemistry, College of Humanities and Sciences (Japan)

    2013-05-15

    The application of {sup 14}N NQR to the study of cocrystals and crystal polymorphs is reviewed. In ferroelectric and antiferroelectric organic cocrystals {sup 14}N NQR is used to determine proton position in an N-H...O hydrogen bond and proton displacement below T{sub C}. In cocrystal isonicitinamide - oxalic acid (2:1) {sup 14}N NQR is used to distinguish between two polymorphs and to determine the type of the hydrogen bond (N{sup -}...H-O). The difference in the {sup 14}N NQR spectra of cocrystal formers and cocrystal is investigated in case of carbamazepine, saccharin and carbamazepine - saccharin (1:1). The experimental resolution allows an unambiguous distinction between the {sup 14}N NQR spectrum of the cocrystal and the {sup 14}N NQR spectra of the cocrystal formers. The possibility of application of NQR and double resonance for the determination of the inhomogeneity of the sample and for the study of the life time of an unstable polymorph is discussed.

  3. Site of anticonvulsant action on sodium channels: autoradiographic and electrophysiological studies in rat brain

    International Nuclear Information System (INIS)

    The anticonvulsants phenytoin and carbamazepine interact allosterically with the batrachotoxin binding site of sodium channels. In the present study, we demonstrate an autoradiographic technique to localize the batrachotoxin binding site on sodium channels in rat brain using [3H]batrachotoxinin-A 20-alpha-benzoate (BTX-B). Binding of [3H]BTX-B to brain sections is dependent on potentiating allosteric interactions with scorpion venom and is displaced by BTX-B (Kd approximately 200 nM), aconitine, veratridine, and phenytoin with the same rank order of potencies as described in brain synaptosomes. The maximum number of [3H]BTX-B binding sites in forebrain sections also agrees with biochemical determinations. Autoradiographic localizations indicate that [3H]BTX-B binding sites are not restricted to cell bodies and axons but are present in synaptic zones throughout the brain. For example, a particularly dense concentration of these sites in the substantia nigra is associated with afferent terminals of the striatonigral projection. By contrast, myelinated structures possess much lower densities of binding sites. In addition, we present electrophysiological evidence that synaptic transmission, as opposed to axonal conduction, is preferentially sensitive to the action of aconitine and veratridine. Finally, the synaptic block produced by these sodium channel activators is inhibited by phenytoin and carbamazepine at therapeutic anticonvulsant concentrations

  4. Complex partial seizures and aphasia as initial manifestations of non-ketotic hyperglycemia: case report Crises parciais complexas e afasia como manifestações iniciais de hiperglicemia não cetótica: relato de caso

    Directory of Open Access Journals (Sweden)

    MARCUS SABRY AZAR BATISTA

    1998-06-01

    Full Text Available We describe a case of non-ketotic hyperglycemia (NKH, heralded by complex partial seizures and aphasia of epileptic origin, besides versive and partial motor seizures. This clinical picture was accompanied by left fronto-temporal spikes in the EEG. The seizures were controlled by carbamazepine only after the control of the diabetes. A month later, carbamazepine was discontinued. The patient remained without seizures, with normal language, using only glybenclamide. Complex partial seizures, opposed to simple partial seizures, are rarely described in association to NKH. Epileptic activity localized over language regions can manifest as aphasia.Descrevemos um caso de hiperglicemia não-cetótica (HNC cujas manifestações iniciais foram crises parciais complexas e afasia de origem epiléptica, além de crises versivas e parcias motoras. Este quadro clínico foi acompanhado por atividade epileptiforme na região fronto-temporal esquerda ao eletrencefalograma. As crises epilépticas foram controladas com carbamazepina (CBZ apenas após o controle do diabetes mellitus. Após um mês, a CBZ foi suspensa, permanecendo a paciente com linguagem normal, sem novas crises epilépticas, em uso apenas de glibenclamida. Crises parciais complexas, ao contrário de crises parciais simples, são raramente descritas como manifestação de HNC. Atividade epileptiforme nas regiões relacionadas a linguagem podem manifestar-se como afasia.

  5. Removal of pharmaceutically active compounds (PhACs) and toxicological response of Cyperus alternifolius exposed to PhACs in microcosm constructed wetlands.

    Science.gov (United States)

    Yan, Qing; Feng, Guozhong; Gao, Xu; Sun, Chengxiao; Guo, Jin-song; Zhu, Zhiwei

    2016-01-15

    This study investigated the effects of selected four pharmaceutically active compounds (PhACs) (carbamazepine, sulfamethoxazole, ofloxacin, and roxithromycin) on the photosynthesis and antioxidant enzymes of Cyperus alternifolius in constructed wetlands (CWs). Moreover, the removal and kinetics of PhACs in CWs were evaluated to explore the related removal mechanisms. Results showed that C. alternifolius can uptake and withstand certain PhACs. The PhAC tolerance of C. alternifolius might be attributed to their capacity to maintain relatively normal photosynthetic activity and elevated antioxidative defense. CWs offered comparable or even higher removal efficiencies for the selected PhACs compared with conventional WWTPs. The removal of the target PhACs was enhanced in the planted CWs versus the unplanted CWs mostly because of plant uptake and rhizosphere effects. In particular, carbamazepine, which is considered the most recalcitrant of the PhACs, was significantly reduced (p<0.05). The removal of target PhACs fitted into two distinct periods. The initial fast step (within the first 2 h) was essentially attributed to the adsorption onto the CW medium surface. The subsequent slow process (2-12 h) closely followed first-order kinetics probably because of the interaction between microorganisms and plants. The obtained results indicate that C. alternifolius can phytoremediate PhAC-contaminated waters in CWs. PMID:26465971

  6. Mechanistic Analysis of Cocrystal Dissolution as a Function of pH and Micellar Solubilization.

    Science.gov (United States)

    Cao, Fengjuan; Amidon, Gordon L; Rodriguez-Hornedo, Nair; Amidon, Gregory E

    2016-03-01

    The purpose of this work is to provide a mechanistic understanding of the dissolution behavior of cocrystals under the influence of ionization and micellar solubilization. Mass transport models were developed by applying Fick's law of diffusion to dissolution with simultaneous chemical reactions in the hydrodynamic boundary layer adjacent to the dissolving cocrystal surface to predict the pH at the dissolving solid-liquid interface (i.e., interfacial pH) and the flux of cocrystals. To evaluate the predictive power of these models, dissolution studies of carbamazepine-saccharin (CBZ-SAC) and carbamazepine-salicylic acid (CBZ-SLC) cocrystals were performed at varied pH and surfactant concentrations above the critical stabilization concentration (CSC), where the cocrystals were thermodynamically stable. The findings in this work demonstrate that the pH dependent dissolution behavior of cocrystals with ionizable components is dependent on interfacial pH. This mass transport analysis demonstrates the importance of pH, cocrystal solubility, diffusivity, and micellar solubilization on the dissolution rates of cocrystals. PMID:26877267

  7. Irrigation of root vegetables with treated wastewater: evaluating uptake of pharmaceuticals and the associated human health risks.

    Science.gov (United States)

    Malchi, Tomer; Maor, Yehoshua; Tadmor, Galit; Shenker, Moshe; Chefetz, Benny

    2014-08-19

    To meet mounting water demands, treated wastewater has become an important source of irrigation. Thus, contamination of treated wastewater by pharmaceutical compounds (PCs) and the fate of these compounds in the agricultural environment are of increasing concern. This field study aimed to quantify PC uptake by treated wastewater-irrigated root crops (carrots and sweet potatoes) grown in lysimeters and to evaluate potential risks. In both crops, the nonionic PCs (carbamazepine, caffeine, and lamotrigine) were detected at significantly higher concentrations than ionic PCs (metoprolol, bezafibrate, clofibric acid, diclofenac, gemfibrozil, ibuprofen, ketoprofen, naproxen, sulfamethoxazole, and sildenafil). PCs in leaves were found at higher concentrations than in the roots. Carbamazepine metabolites were found mainly in the leaves, where the concentration of the metabolite 10,11-epoxycarbamazepine was significantly higher than the parent compound. The health risk associated with consumption of wastewater-irrigated root vegetables was estimated using the threshold of toxicological concern (TTC) approach. Our data show that the TTC value of lamotrigine can be reached for a child at a daily consumption of half a carrot (∼60 g). This study highlights that certain PCs accumulated in edible organs at concentrations above the TTC value should be categorized as contaminants of emerging concern. PMID:25026038

  8. [Successful treatment with anti-epileptic-drug of an 83-year-old man with musical hallucinosis].

    Science.gov (United States)

    Futamura, Akinori; Katoh, Hirotaka; Kawamura, Mitsuru

    2014-05-01

    An 83-year-old man with 3 years symptomatic hearing loss suddenly experienced musical hallucinosis. He heard children's songs, folk songs, military songs, and the Japanese national anthem for seven months every day. He sometime had paroxysmal nausea, dull headaches and depressive mood. On examination he had no psychosis or neurological symptoms except sensorineural hearing loss in both ears. MRI brain imaging and electroencephalography showed no significant abnormalities, however 123I-IMP brain SPECT showed decreased activity in the right temporal lobe and increased activity in the left temporal and parietal lobes. Late phase 123I-iomazenil brain SPECT showed decreased accumulation in the right temporal lobe compared to the early phase. This indicates right temporal lobe epilepsy. He was diagnosed with epilepsy because of paroxysmal nausea and headache and the laterality of 123I-IMP brain SPECT and 123I-iomazenil brain SPECT. The musical hallucinosis was much reduced by carbamazepine 200mg per day. Nine months after beginning carbamazepine we detected decreased activity in the right temporal lobe and increased activity in left temporal and parietal lobes was improved. We do not believe he had epileptogenic musical hallucinosis because his musical hallusinosis was neither paroxysmal nor lateral. We diagnosed auditory Charles Bonnet syndrome with onset 3 years after sensorineural hearing loss due to reversible epileptic like discharge in temporal and parietal lobes. There is no established treatment for musical hallucinosis, but anti-epileptic drugs may be of some help. PMID:24807375

  9. Structural characterization and aging of glassy pharmaceuticals made using acoustic levitation.

    Science.gov (United States)

    Benmore, Chris J; Weber, J K R; Tailor, Amit N; Cherry, Brian R; Yarger, Jeffery L; Mou, Qiushi; Weber, Warner; Neuefeind, Joerg; Byrn, Stephen R

    2013-04-01

    Here, we report the structural characterization of several amorphous drugs made using the method of quenching molten droplets suspended in an acoustic levitator. (13) C NMR, X-ray, and neutron diffraction results are discussed for glassy cinnarizine, carbamazepine, miconazole nitrate, probucol, and clotrimazole. The (13) C NMR results did not find any change in chemical bonding induced by the amorphization process. High-energy X-ray diffraction results were used to characterize the ratio of crystalline to amorphous material present in the glasses over a period of 8 months. All the glasses were stable for at least 6 months except carbamazepine, which has a strong tendency to crystallize within a few months. Neutron and X-ray pair distribution function analyses were applied to the glassy materials, and the results were compared with their crystalline counterparts. The two diffraction techniques yielded similar results in most cases and identified distinct intramolecular and intermolecular correlations. The intramolecular scattering was calculated based on the crystal structure and fit to the measured X-ray structure factor. The resulting intermolecular pair distribution functions revealed broad-nearest and next-nearest neighbor molecule-molecule correlations. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:1290-1300, 2013. PMID:23381910

  10. Atherosclerotic effects of long-term old and new antiepileptic drugs monotherapy: a cross-sectional comparative study.

    Science.gov (United States)

    El-Farahaty, Reham M; El-Mitwalli, Ashraf; Azzam, Hanan; Wasel, Yasser; Elrakhawy, Mohamed M; Hasaneen, Bothina Mohammed

    2015-03-01

    This work aimed to evaluate the metabolic and atherogenic effects of long-term antiepileptic drugs in a group of Egyptian epileptic patients. Sixty-nine epileptic patients on antiepileptic drug monotherapy for at least 2 years and 34 control subjects were recruited in this study. Patients were divided into 5 subgroups according to antiepileptic drugs used (valproate, carbamazepine, lamotrigine, topiramate, and levetiracetam). Fasting lipid profile (total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), lipoprotein(a), homocysteine, free thyroxine, thyroid-stimulating hormone, and common carotid artery intima-media thickness were measured for all subjects. Significant higher mean values of low-density lipoprotein cholesterol, low-density lipoprotein / high-density lipoprotein ratio, lipoprotein(a), homocysteine, significantly lower mean value of high-density lipoprotein cholesterol, and significantly larger diameter of common carotid artery intima-media thickness were observed in each drug-treated group versus control group. Our study supports that long-term monotherapy treatment with valproate, carbamazepine, lamotrigine, and topiramate had altered markers of vascular risk that might enhance atherosclerosis, whereas levetiracetam exerted minimal effect. PMID:25342306

  11. Corrigendum to “Sorption/desorption of non-hydrophobic and ionisable pharmaceutical and personal care products from reclaimed water onto/from a natural sediment” Sci Total Environ 472 (2014) 273–281

    International Nuclear Information System (INIS)

    In the present work, the sorption of pharmaceutical and personal care products (PPCPs) (acetaminophen, atenolol, carbamazepine, caffeine, naproxen and sulphamethoxazole) onto the natural organic matter (NOM) and the inorganic surfaces of a natural sandy loam sediment was quantified separately. The quantification was based on the PPCP charge, their degree of ionisation, their octanol-water partitioning coefficient (KOW) and the sediment organic carbon fraction (ƒOC). PPCP desorption from the sediment was examined under conditions of infiltrating water containing a high concentration of inorganic ions (mimicking infiltrating reclaimed water), and a low concentration (and smaller diversity) of inorganic ions (mimicking rainwater infiltration). Batch tests were performed using a sediment/water ratio of 1:4 and a PPCP initial concentration ranging from 1 to 100 μg L−1. The results showed the type and degree of PPCP ionisation to strongly influence the sorption of these compounds onto the sediment. The sorption of cationic species onto the sediment was higher than that of anionic species and mostly reversible; the sorption of neutral species was negligible with the exception of caffeine. The anionic species sorbed less onto the sediment, but also desorbed less easily. Most of the compounds showed a sorption that was highly influenced by interaction with mineral surfaces. The presence of inorganic ions had no impact on the desorption of the PPCPs from the sediment. According to the calculated percentages of removal, the mobility followed the order: carbamazepine > acetaminophen > naproxen > atenolol > sulphamethoxazole > caffeine

  12. Changes of serum and brain tissue contents of IL-1β, IL-6 and TNF-α in rat models of epilepsy

    International Nuclear Information System (INIS)

    Objective: To investigate the neuro-immuno-modulation effect of the cytokines IL-1β, IL-6 and TNF-α as well as the influence of carbamazepine (CBZ) in experimental rat models with epilepsy. Methods: Sixty rat models of epilepsy (KA group) were prepared with intraperitoneal injection of kainic acid (10 mg/kg). Another 60 models (CBZ group) were prepared with the same injection but pretreated with CBZ gavage (45 mg/kg) daily for 7 days. Sixty rats with sham injection and sham gavage were used as controls. In the two model groups, ten animals were sacrificed at each of the time points: 1, 4, 12, 24, 48, 72h after the development of epilepsy and the serum and brain homogenate contents of the cytokines were repeatedly determined with RIA. The same was applied to the control group at the corresponding time point. Results: In the two epileptic models, serum and brain homogenate contents of these cytokines increased gradually and attained peak levels at 24h (TNF-α) or 48h (IL-1β, IL-6). The levels in the KA group at any time point were significantly higher than those in the CBZ group and control group ( P<0.01). Levels in the CBZ group were also significantly higher than those in controls (P<0.05, P<0.01). Conclusion: The immune system was greatly activated in the rat epileptic models, carbamazepine might provide some protective action through immunosuppression. (authors)

  13. Ozone oxidation of antidepressants in wastewater –Treatment evaluation and characterization of new by-products by LC-QToFMS

    Directory of Open Access Journals (Sweden)

    Lajeunesse André

    2013-01-01

    Full Text Available Abstract Background The fate of 14 antidepressants along with their respective N-desmethyl metabolites and the anticonvulsive drug carbamazepine was examined in a primary sewage treatment plant (STP and following advanced treatments with ozone (O3. The concentrations of each pharmaceutical compound were determined in raw sewage, effluent and sewage sludge samples by LC-MS/MS analysis. The occurrence of antidepressant by-products formed in treated effluent after ozonation was also investigated. Results Current primary treatments using physical and chemical processes removed little of the compounds (mean removal efficiency: 19%. Experimental sorption coefficients (Kd of each studied compounds were also calculated. Sorption of venlafaxine, desmethylvenlafaxine, and carbamazepine on sludge was assumed to be negligible (log Kd ≤ 2, but higher sorption behavior can be expected for sertraline (log Kd ≥ 4. Ozonation treatment with O3 (5 mg/L led to a satisfactory mean removal efficiency of 88% of the compounds. Screening of the final ozone-treated effluent samples by high resolution-mass spectrometry (LC-QqToFMS did confirm the presence of related N-oxide by-products. Conclusion Effluent ozonation led to higher mean removal efficiencies than current primary treatment, and therefore represented a promising strategy for the elimination of antidepressants in urban wastewaters. However, the use of O3 produced by-products with unknown toxicity.

  14. OBSERVATION OF THERAPEUTIC EFFECT ON TREATMENT OF THE GREATER OCCIPITAL NEURALGIA WITH ACUPUNCTURE

    Institute of Scientific and Technical Information of China (English)

    LIU Xue-qi; LIU Wei

    2006-01-01

    Objective: To compare the differences in therapeutic effects on treatments of the greater occipital neuralgia between acupuncture and western medicine. Method: Sixty cases of the greater occipital neuralgia were randomized into acupuncture group (30 cases) and western medicine group (30 cases). In acupuncture group, acupuncture was applied on Fengchi (风池 GB 20), Chengling (承灵 GB 18), Xuanzhong (悬钟 GB 39) and Ashi (阿是穴), once everyday. In western medicine group, carbamazepine was administrated orally, 100 mg, Bid × 10 days. Results: In acupuncture group, 25 cases (83.3%) were cured, 4 cases (13.3%) remarkably effective, 1 case (3.4%) effective and 0 case ineffective. In western medicine group, 16 cases (53.3%) were cured, 7 cases (23.3%) remarkably effective, 2 cases (6.7%) effective and 5 cases ( 16.7 % ) ineffective. The cured-markedly effective rates of two groups were 96.6 % and 76.6 % respectively, indicating significant difference between two groups ( P < 0.05). Conclusion: The therapeutic effect with acupuncture on the greater occipital neuralgia was significant compared with that with carbamazepine.

  15. Corrigendum to “Sorption/desorption of non-hydrophobic and ionisable pharmaceutical and personal care products from reclaimed water onto/from a natural sediment” Sci Total Environ 472 (2014) 273–281

    Energy Technology Data Exchange (ETDEWEB)

    Martínez-Hernández, Virtudes, E-mail: virtudes.martinez@imdea.org [IMDEA Agua, Madrid Institute for Advanced Studies in Water, Parque Científico Tecnológico de la Universidad de Alcalá, 28805 Alcalá de Henares, Madrid (Spain); Meffe, Raffaella; Herrera, Sonia [IMDEA Agua, Madrid Institute for Advanced Studies in Water, Parque Científico Tecnológico de la Universidad de Alcalá, 28805 Alcalá de Henares, Madrid (Spain); Arranz, Elena [University of Alcalá, Geography and Geology Department, 28871 Alcalá de Henares, Madrid (Spain); Bustamante, Irene de [IMDEA Agua, Madrid Institute for Advanced Studies in Water, Parque Científico Tecnológico de la Universidad de Alcalá, 28805 Alcalá de Henares, Madrid (Spain); University of Alcalá, Geography and Geology Department, 28871 Alcalá de Henares, Madrid (Spain)

    2015-02-01

    In the present work, the sorption of pharmaceutical and personal care products (PPCPs) (acetaminophen, atenolol, carbamazepine, caffeine, naproxen and sulphamethoxazole) onto the natural organic matter (NOM) and the inorganic surfaces of a natural sandy loam sediment was quantified separately. The quantification was based on the PPCP charge, their degree of ionisation, their octanol-water partitioning coefficient (K{sub OW}) and the sediment organic carbon fraction (ƒ{sub OC}). PPCP desorption from the sediment was examined under conditions of infiltrating water containing a high concentration of inorganic ions (mimicking infiltrating reclaimed water), and a low concentration (and smaller diversity) of inorganic ions (mimicking rainwater infiltration). Batch tests were performed using a sediment/water ratio of 1:4 and a PPCP initial concentration ranging from 1 to 100 μg L{sup −1}. The results showed the type and degree of PPCP ionisation to strongly influence the sorption of these compounds onto the sediment. The sorption of cationic species onto the sediment was higher than that of anionic species and mostly reversible; the sorption of neutral species was negligible with the exception of caffeine. The anionic species sorbed less onto the sediment, but also desorbed less easily. Most of the compounds showed a sorption that was highly influenced by interaction with mineral surfaces. The presence of inorganic ions had no impact on the desorption of the PPCPs from the sediment. According to the calculated percentages of removal, the mobility followed the order: carbamazepine > acetaminophen > naproxen > atenolol > sulphamethoxazole > caffeine.

  16. Characterization of pharmaceutically active compounds in Dongting Lake, China: Occurrence, chiral profiling and environmental risk.

    Science.gov (United States)

    Ma, Ruixue; Wang, Bin; Lu, Shaoyong; Zhang, Yizhe; Yin, Lina; Huang, Jun; Deng, Shubo; Wang, Yujue; Yu, Gang

    2016-07-01

    Twenty commonly used pharmaceuticals including eight chiral drugs were investigated in Dongting Lake, China. The contamination level was relatively low on a global scale. Twelve pharmaceuticals were identified. The most abundant compound was caffeine followed by diclofenac, DEET, mefenamic acid, fluoxetine, ibuprofen and carbamazepine with mean concentrations from 2.0 to 80.8ngL(-1). Concentrations between East and West Dongting Lake showed spatial difference, with the West Dongting Lake less polluted. The relatively high ratio of caffeine versus carbamazepine (over 50) may indicate there was possible direct discharge of domestic wastewater into the lake. This is the first study presenting a survey allowing for comprehensive analysis of multiclass achiral and chiral pharmaceuticals including beta-blockers, antidepressants and anti-inflammatory drugs in freshwater lake. The enantiomeric compositions presented racemic to weakly enantioselective, with the highest enantiomeric fraction (EF) of 0.63 for fluoxetine. Meanwhile, venlafaxine was identified and evaluated the environment risk in surface water in China for the first time. The results of risk assessment suggested that fluoxetine, venlafaxine and diclofenac acid might pose a significant risk to aquatic organisms in Dongting Lake. The resulting data will be useful to enrich the research of emerging pollutants in freshwater lake and stereochemistry for environment investigations. PMID:27016674

  17. Oxidation of pharmaceutically active compounds by a ligninolytic fungal peroxidase.

    Science.gov (United States)

    Eibes, Gemma; Debernardi, Gianfranco; Feijoo, Gumersindo; Moreira, M Teresa; Lema, Juan M

    2011-06-01

    Pharmaceuticals are an important group of emerging pollutants with increasing interest due to their rising consumption and the evidence for ecotoxicological effects associated to trace amounts in aquatic environments. In this paper, we assessed the potential degradation of a series of pharmaceuticals: antibiotics (sulfamethoxazole), antidepressives (citalopram hydrobromide and fluoxetine hydrochloride), antiepileptics (carbamazepine), anti-inflammatory drugs (diclofenac and naproxen) and estrogen hormones (estrone, 17β-estradiol, 17α-ethinylestradiol) by means of a versatile peroxidase (VP) from the ligninolytic fungus Bjerkandera adusta. The effects of the reaction conditions: VP activity, organic acid concentration and H(2)O(2) addition rate, on the kinetics of the VP based oxidation system were evaluated. Diclofenac and estrogens were completely degraded after only 5-25 min even with a very low VP activity (10 U l(-1)). High degradation percentages (80%) were achieved for sulfamethoxazole and naproxen. Low or undetectable removal yields were observed for citalopram (up to 18%), fluoxetine (lower than 10%) and carbamazepine (not degraded). PMID:20972884

  18. Prediction of concentration levels of metformin and other high consumption pharmaceuticals in wastewater and regional surface water based on sales data.

    Science.gov (United States)

    Oosterhuis, Mathijs; Sacher, Frank; Ter Laak, Thomas L

    2013-01-01

    Local consumption data of pharmaceuticals were used to study the emission to wastewater and surface waters in two small Dutch water catchments. For nine high consumption pharmaceuticals: metformin, metoprolol, sotalol, losartan, valsartan, irbesartan, hydrochlorothiazide, diclofenac and carbamazepine, predicted emissions were compared to wastewater concentrations, removal in sewage treatment plants and recovery in regional surface water. The study shows that local consumption data can be very useful to select pharmaceuticals for monitoring and to predict wastewater concentrations. Measured influent concentrations were on average 78% with a range of 31-138% of predicted influent concentrations. Metformin is the pharmaceutical with the highest concentration in wastewater (64-98 μg/L) but it is removed with >98% in sewage treatment plants (STP). Guanylurea, a biodegradation product of metformin, was detected in STP effluents and surface waters at concentrations of 39-56 μg/L and 1.8-3.9 μg/L, respectively. The STP removal of the different pharmaceuticals varied strongly. For carbamazepine, hydrochlorothiazide and sotalol a significant better removal was found at higher temperatures and longer hydraulic retention times while for metoprolol significantly better removal was only observed at higher temperatures. Predicting environmental concentrations from regional consumption data might be an alternative to monitoring of pharmaceuticals in wastewater and surface waters. PMID:23183121

  19. Adsorptive removal of selected pharmaceuticals by mesoporous silica SBA-15

    International Nuclear Information System (INIS)

    The removal of five selected pharmaceuticals, viz., carbamazepine, clofibric acid, diclofenac, ibuprofen, and ketoprofen was examined by batch sorption experiments onto a synthesized mesoporous silica SBA-15. SBA-15 was synthesized and characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), N2 adsorption-desorption measurement, and point of zero charge (PZC) measurement. Pharmaceutical adsorption kinetics was rapid and occurred on a scale of minutes, following a pseudo-second-order rate expression. Adsorption isotherms were best fitted by the Freundlich isotherm model. High removal rates of individual pharmaceuticals were achieved in acidic media (pH 3-5) and reached 85.2% for carbamazepine, 88.3% for diclofenac, 93.0% for ibuprofen, 94.3% for ketoprofen, and 49.0% for clofibric acid at pH 3 but decreased with increase in pH. SBA-15 also showed high efficiency for removal of a mixture of 5 pharmaceuticals. Except for clofibric acid (35.6%), the removal of pharmaceuticals in the mixture ranged from 75.2 to 89.3%. Based on adsorption and desorption results, the mechanism of the selected pharmaceuticals was found to be a hydrophilic interaction, providing valuable information for further studies to design materials for the purpose. The results of this study suggest that mesoporous-silica-based materials are promising adsorbents for removing pharmaceuticals from not only surface water but also wastewater of pharmaceutical industrial manufactures.

  20. Pharmacokinetics and drug interactions of eslicarbazepine acetate.

    Science.gov (United States)

    Bialer, Meir; Soares-da-Silva, Patricio

    2012-06-01

    Eslicarbazepine acetate (ESL) is a novel once-daily antiepileptic drug (AED) approved in Europe since 2009 that was found to be efficacious and well tolerated in a phase III clinical program in adult patients with partial onset seizures previously not controlled with treatment with one to three AEDs, including carbamazepine (CBZ). ESL shares with CBZ and oxcarbazepine (OXC) the dibenzazepine nucleus bearing the 5-carboxamide substitute, but is structurally different at the 10,11 position. This molecular variation results in differences in metabolism, preventing the formation of toxic epoxide metabolites such as carbamazepine-10,11-epoxide. Unlike OXC, which is metabolized to both eslicarbazepine and (R)-licarbazepine, ESL is extensively converted to eslicarbazepine. The systemic exposure to eslicarbazepine after ESL oral administration is approximately 94% of the parent dose, with minimal exposure to (R)-licarbazepine and OXC. After ESL oral administration, the effective half-life (t(1/2,eff) ) of eslicarbazepine was 20-24 h, which is approximately two times longer than its terminal half-life (t(1/2)). At clinically relevant doses (400-1,600 mg/day) ESL has linear pharmacokinetics (PK) with no effects of gender or moderate liver impairment. However, because eslicarbazepine is eliminated primarily (66%) by renal excretion, dose adjustment is recommended for patients with renal impairment. Eslicarbazepine clearance is induced by phenobarbital, phenytoin, and CBZ and it dose-dependently decreases plasma exposure of oral contraceptive and simvastatin. PMID:22612290

  1. Rejection of pharmaceuticals by forward osmosis membranes.

    Science.gov (United States)

    Jin, Xue; Shan, Junhong; Wang, Can; Wei, Jing; Tang, Chuyang Y

    2012-08-15

    Rejection of four pharmaceutical compounds, carbamazepine, diclofenac, ibuprofen and naproxen, by forward osmosis (FO) membranes was investigated in this study. For the first time, the rejection efficiency of the pharmaceutical compounds was compared between commercial cellulose triacetate (CTA) based membranes and thin film composite (TFC) polyamide based membranes. The rejection behavior was related to membrane interfacial properties, physicochemical characteristics of the pharmaceutical molecules and feed solution pH. TFC polyamide membranes exhibited excellent overall performance, with high water flux, excellent pH stability and great rejection of all pharmaceuticals investigated (>94%). For commercial CTA based FO membranes, hydrophobic interaction between the compounds and membranes exhibited strong influence on their rejection under acidic conditions. The pharmaceuticals rejection was well correlated to their hydrophobicity (log D). Under alkaline conditions, both electrostatic repulsion and size exclusion contributed to the removal of deprotonated molecules. The pharmaceuticals rejection by CTA-HW membrane at pH 8 followed the order: diclofenac (99%)>carbamazepine (95%)>ibuprofen (93%) ≈ naproxen (93%). These results can be important for FO membrane synthesis, modification and their application in water purification. PMID:22640821

  2. Micropollutant removal in an algal treatment system fed with source separated wastewater streams.

    Science.gov (United States)

    de Wilt, Arnoud; Butkovskyi, Andrii; Tuantet, Kanjana; Leal, Lucia Hernandez; Fernandes, Tânia V; Langenhoff, Alette; Zeeman, Grietje

    2016-03-01

    Micropollutant removal in an algal treatment system fed with source separated wastewater streams was studied. Batch experiments with the microalgae Chlorella sorokiniana grown on urine, anaerobically treated black water and synthetic urine were performed to assess the removal of six spiked pharmaceuticals (diclofenac, ibuprofen, paracetamol, metoprolol, carbamazepine and trimethoprim). Additionally, incorporation of these pharmaceuticals and three estrogens (estrone, 17β-estradiol and ethinylestradiol) into algal biomass was studied. Biodegradation and photolysis led to 60-100% removal of diclofenac, ibuprofen, paracetamol and metoprolol. Removal of carbamazepine and trimethoprim was incomplete and did not exceed 30% and 60%, respectively. Sorption to algal biomass accounted for less than 20% of the micropollutant removal. Furthermore, the presence of micropollutants did not inhibit C. sorokiniana growth at applied concentrations. Algal treatment systems allow simultaneous removal of micropollutants and recovery of nutrients from source separated wastewater. Nutrient rich algal biomass can be harvested and applied as fertilizer in agriculture, as lower input of micropollutants to soil is achieved when algal biomass is applied as fertilizer instead of urine. PMID:26546707

  3. Mitigation of micropollutants for black water application in agriculture via composting of anaerobic sludge.

    Science.gov (United States)

    Butkovskyi, A; Ni, G; Hernandez Leal, L; Rijnaarts, H H M; Zeeman, G

    2016-02-13

    The excess sludge from Up-flow anaerobic sludge bed (UASB) reactor operated on source separated toilet wastewater is a potential source of nutrients and organic matter. It can be further stabilized and dried by composting and applied as a soil amendment. Presence of pathogens, heavy metals and micropollutants in the compost derived from anaerobic sludge is thus undesirable. This paper focuses on removal of micropollutants, typically present in domestic wastewater, via composting of UASB sludge with waste wood. Estrone, diclofenac, ibuprofen, metoprolol, carbamazepine, galaxolide and triclosan were spiked to a mixture of UASB sludge and waste wood. Their concentrations were monitored during 92 days of composting at controlled temperature conditions. All studied micropollutants were removed at various rates with overall removal ranging from 99.9% for ibuprofen, diclofenac and estrone to 87.8% for carbamazepine. Accumulation of methyltriclosan as by-product of triclosan degradation was observed. The prospects and limitations of the integration of a composting process into Source Separated Sanitation concepts are discussed. PMID:26513562

  4. Levels of pharmaceuticals in Slovene municipal and hospital wastewaters: a preliminary study.

    Science.gov (United States)

    Klančar, Anita; Trontelj, Jurij; Kristl, Albin; Justin, Maja Zupančič; Roškar, Robert

    2016-06-01

    Pharmaceuticals in wastewater have clearly raised concern and a broad range of analytical methods has been used to assess the risk as accurately as possible. The aim of our study was to measure and compare the concentrations of atorvastatin, bisoprolol, carbamazepine, ciprofloxacin, clofibric acid, diclofenac, fluoxetine, metoprolol, and sertraline in wastewater samples taken from one municipal and one hospital wastewater treatment plant in Slovenia and to predict the potential environmental burden using the risk quotient. In both effluents only clofibric acid and fluoxetine were not detected. The measured concentrations of the remaining seven pharmaceuticals varied between the ng L-1 and the μg L-1 range. Hospital effluent showed higher concentrations, except for diclofenac and carbamazepine. However, high risk quotient was found only for ciprofloxacin and diclofenac in both municipal and hospital effluent. In conclusion, our method can provide a useful tool for systematic monitoring of pharmaceuticals commonly found in wastewater, which will enable a reliable assessment of the risks for the aquatic biota and humans. Knowing the risks will help to plan wastewater treatment and preserve our environment. PMID:27331298

  5. Assessment of the mechanisms involved in the removal of emerging contaminants by microalgae from wastewater: a laboratory scale study.

    Science.gov (United States)

    Matamoros, Víctor; Uggetti, Enrica; García, Joan; Bayona, Josep M

    2016-01-15

    Aerated batch reactors (2.5L) fed either with urban or synthetic wastewater were inoculated with microalgae (dominated by Chlorella sp. and Scenedesmus sp.) to remove caffeine, ibuprofen, galaxolide, tributyl phosphate, 4-octylphenol, tris(2-chloroethyl) phosphate and carbamazepine for 10 incubation days. Non-aerated and darkness reactors were used as controls. Microalgae grew at a rate of 0.25 d(-1) with the complete removal of N-NH4 during the course of the experiment. After 10 incubation days, up to 99% of the microcontaminants with a Henry's law constant higher than 3 10(-1) Pa m(3) mol(-1) (i.e., 4-octylphenol, galaxolide, and tributyl phosphate) were removed by volatilization due to the effect of air stripping. Whereas biodegradation was effective for removing ibuprofen and caffeine, carbamazepine and tris(2-chloroethyl) phosphate behaved as recalcitrant compounds. The use of microalgae was proved to be relevant for increasing the biodegradation removal efficiency of ibuprofen by 40% and reducing the lag phase of caffeine by 3 days. Moreover, the enantioselective biodegradation of S-ibuprofen suggested a biotic prevalent removal process, which was supported by the identification of carboxy-ibuprofen and hydroxy-ibuprofen. The results from microalgae reactors fed with synthetic wastewater showed no clear evidences of microalgae uptake of any of the studied microcontaminants. PMID:26364268

  6. Mood stabilisers and pregnancy outcomes: a review

    Directory of Open Access Journals (Sweden)

    Costoloni, Giulia

    2014-10-01

    Full Text Available The purpose of this review is to give useful information to guide clinicians when treating pregnant women affected by bipolar disorder. This review focuses on mood stabilizers including lithium, sodium valproate, carbamazepine, oxcarbazepine, gabapentin, lamotrigine and topiramate. Data have been extracted from a MEDLINE search. Data from prospective, retrospective and case-control studies as well as systematic reviews, meta-analysis and data from Pregnancy Registry were included. Major congenital malformations as well as specific malformations were reported for each drug. Preliminary findings seem to identify lamotrigine as one of the safest antiepileptic drugs to be used in pregnancy. Teratogenity risk of topiramate is still largely unknown and there are not enough studies to draw even preliminary conclusions. Preliminary studies failed to report an increased risk for major congenital malformations among gabapentin or oxcarbazepine exposed pregnancies. Even if raising less concern when compared to valproate, carbamazepine should be avoided for its documented teratogenity risk. Valproate seems to be the worst considering major congenital malformations, specific malformations as well as its detrimental effects on neurodevelopment. On the other hand, lithium might be considered a good option when treating pregnant women affected by bipolar disorder. Given the limited research on mood stabilizers in pregnancy, clinicians need to be very careful when treating child bearing age women. Clinicians have to balance the potential teratogenity risk against that of untreated mental illness considering individual circumstances such as severity of illness and risk of relapse.

  7. [Mood stabilisers and pregnancy outcomes - a review].

    Science.gov (United States)

    Costoloni, Giulia; Pierantozzi, Elisa; Goracci, Arianna; Bolognesi, Simone; Fagiolini, Andrea

    2014-01-01

    The purpose of this review is to give useful information to guide clinicians when treating pregnant women affected by bipolar disorder. This review focuses on mood stabilizers including lithium, sodium valproate, carbamazepine, oxcarbazepine, gabapentin, lamotrigine and topiramate. Data have been extracted from a MEDLINE search. Data from prospective, retrospective and case-control studies as well as systematic reviews, meta-analysis and data from Pregnancy Registry were included. Major congenital malformations as well as specific malformations were reported for each drug. Preliminary findings seem to identify lamotrigine as one ofthe safest antiepileptic drugs to be used in pregnancy. Teratogenity risk oftopiramate is still largely unknown and there are not enough studies to draw even preliminary conclusions. Preliminary studies failed to report an increased risk for major congenital malformations among gabapentin or.oxcarbazepine exposed pregnancies. Even if raising less concern when compared to valproate, carbamazepine should be avoided for its documented teratogenity risk. Valproate seems to be the worst considering major congenital malformations, specific malformations as,well as its detrimental effects on neurodevelopment. On the other hand, lithium might be considered a good option when treating pregnant women affected by bipolar disorder. Given the limited research on mood stabilizers in pregnancy, clinicians need to be very careful when treating child bearing age women. Clinicians have to balance the potential teratogenityrisk against that of untreated mental illness considering individual circumstances such as severity of illness and risk of relapse. PMID:25639010

  8. The effects of pharmaceuticals on the regeneration of the cnidarian, Hydra attenuata.

    Science.gov (United States)

    Quinn, Brian; Gagné, François; Blaise, Christian

    2008-08-25

    The Hydra attenuata regeneration assay was used to identify the teratogenic potential of 10 pharmaceuticals identified in effluent from a large city wastewater treatment plant (WWTP). Three types of solvents were used to solubilise the pharmaceuticals (DMSO, acetone and ethanol), at concentrations determined to have no significant effect on measured endpoints. On the one hand, regeneration was significantly inhibited at (nominal) concentrations of 1, 5 and 1 mg/L for gemfibrozil, ibuprofen and naproxen respectively and at the higher concentration of 50 mg/L for bezafibrate and trimethoprim. On the other hand, carbamazepine and the antibiotics sulfapyridine, oxytetracycline and novobiocin significantly increased regeneration at 25, 5, 50 and 50 mg/L respectively. Relatively high IC50 values of 0.9, 3.84, 4.9 and 22.5 mg/L were calculated for gemfibrozil, ibuprofen, naproxen and bezafibrate, respectively. However when subjected to tier two toxicity assessment under EU regulatory guidance using environmentally relevant concentrations a MEC/PNEC value>1 was calculated for gemfibrozil, ibuprofen and naproxen indicating teratogenic potential and the necessity for further tier three assessment. A toxicity index (TI) was also calculated using three different techniques, with TI values>3 (indicating teratogenic potential) found for gemfibrozil, ibuprofen, naproxen and bezafibrate and >1 (indicating a weak teratogenic potential) found for carbamazepine. These results are discussed in the context of their environmental relevance and toxic potential. PMID:18538376

  9. Leaching of pharmaceuticals and personal care products in turfgrass soils during recycled water irrigation.

    Science.gov (United States)

    Bondarenko, S; Gan, J; Ernst, F; Green, R; Baird, J; McCullough, M

    2012-01-01

    An important beneficial reuse of treated wastewater (recycled water) in arid and semiarid regions is landscape irrigation. However, the environmental fate, especially groundwater contamination potential, of trace contaminants such as pharmaceuticals and personal care products (PPCPs) is a significant concern that can hinder the acceptance and adoption of such reuses. In this study, we irrigated mature turfgrass plots with nonspiked tertiary treated wastewater for over 6 mo at 100 or 130% of the reference evapotranspiration rate (ETo) and collected leachate water at the 90-cm depth on a weekly basis. In the recycled water, all 14 target PPCPs were consistently found, and the mean levels of atenolol, gemfibrozil, meprobamate, carbamazepine, and sulfamethoxazole were above 100 ng L. However, only five compounds were detected in the leachate at trace levels. Trimethoprim and primidone were frequently found, whereas the detection of sulfamethoxazole, meprobamate and carbamazepine was less frequent (meprobamate. The majority of the target PPCPs were completely removed. Given that the irrigation rates were higher than normal, this study clearly demonstrated the efficacy of turfgrass systems in attenuating PPCPs during recycled water irrigation. However, it is also apparent that some PPCPs are more susceptible to leaching than others, and these PPCPs thus merit further research attention. PMID:22751071

  10. Qualitative and quantitative study of polymorphic forms in drug formulations by near infrared FT-Raman spectroscopy

    Science.gov (United States)

    Auer, Martin E.; Griesser, Ulrich J.; Sawatzki, Juergen

    2003-12-01

    Near infrared FT-Raman spectroscopy was applied for the determination of polymorphic forms in a number of commercial drug products containing the polymorphic drug compounds sorbitol, mannitol, famotidine, acemetacin, carbamazepine, meprobamate and phenylbutazone. The crystal forms present in the drug products were identified based on the position, intensity and shape of characteristic bands. Quantitative analysis of a mixture of two crystal forms of mannitol in a drug product was carried out using a partial least-squares method. In drug products containing meprobamate, sorbitol, and carbamazepine, the thermodynamically stable form was found exclusively, whereas metastable polymorphs were found in solid dosage forms of acemetacin, phenylbutazone, famotidine and mannitol. A mixture of two polymorphic forms of mannitol in Lipobay tablets was determined to consist of 30.8±3.8% of the metastable modification I. The simple sample preparation, the occurrence of sharp bands in the spectra as well as the high reproducibility and accuracy qualifies FT-Raman spectroscopy for the identification and quantification of crystal forms in drug products. The method is perfectly suited to meet the regulatory requirements of monitoring crystal forms during processing and storage and often succeeds in detecting the present crystal form in drug products even when the used excipients are not known.

  11. Removal of pharmaceuticals and personal care products in a membrane bioreactor wastewater treatment plant.

    Science.gov (United States)

    Kim, M; Guerra, P; Shah, A; Parsa, M; Alaee, M; Smyth, S A

    2014-01-01

    Ninety-nine pharmaceuticals and personal care products (PPCPs) were analyzed in influent, final effluent, and biosolids samples from a wastewater treatment plant employing a membrane bioreactor (MBR). High concentrations in influent were found for acetaminophen, caffeine, metformin, 2-hydroxy-ibuprofen, paraxanthine, ibuprofen, and naproxen (10(4)-10(5) ng/L). Final effluents contained clarithromycin, metformin, atenolol, carbamazepine, and trimethoprim (>500 ng/L) at the highest concentrations, while triclosan, ciprofloxacin, norfloxacin, triclocarban, metformin, caffeine, ofloxacin, and paraxanthine were found at high concentrations in biosolids (>10(3) ng/g dry weight). PPCP removals varied from -34% to >99% and 23 PPCPs had ≥90% removal. Of the studied PPCPs, 26 compounds have been rarely or never studied in previous membrane bioreactor (MBR) investigations. The removal pathway showed that acetaminophen, 2-hydroxy-ibuprofen, naproxen, ibuprofen, codeine, metformin, enalapril, atorvastatin, caffeine, paraxanthine, and cotinine exhibited high degradation/transformation. PPCPs showing strong sorption to solids included triclocarban, triclosan, miconazole, tetracycline, 4-epitetracycline, norfloxacin, ciprofloxacin, doxycycline, paroxetine, and ofloxacin. Trimethoprim, oxycodone, clarithromycin, thiabendazole, hydrochlorothiazide, erythromycin-H2O, carbamazepine, meprobamate, and propranolol were not removed during treatment, and clarithromycin was even formed during treatment. This investigation extended our understanding of the occurrence and fate of PPCPs in an MBR process through the analysis of the largest number of compounds in an MBR study to date. PMID:24901615

  12. Volume-selective proton MR spectroscopy for in-vitro quantification of anticonvulsants

    International Nuclear Information System (INIS)

    Administration of anticonvulsant drugs is clinically monitored by checking seizure frequency and by determining the serum concentration of the drug. In a few reports, drug concentrations in brain parenchyma have been determined using ex vivo techniques. Little is known about the in vivo concentration in the brain parenchyma. Our goals were to characterise the NMR spectra of the anticonvulsants at therapeutic concentrations, to determine the minimum detectable concentrations, and to quantify the drugs noninvasively. Volume-selective 1H-MR spectroscopy (MRS) was performed under standard clinical conditions using a single-voxel STEAM (stimulated-echo acquisition mode) sequence at 1.5 T. Spectra of the anticonvulsants carbamazepine, phenobarbital, phenytoin and valproate were acquired in vitro in hydrous solutions at increasing dilution. Phenytoin, phenobarbital and valproate were detectable below maximum therapeutic serum concentrations. Within therapeutic ranges, there was good agreement between concentrations determined by 1H-MRS and those by standard fluorescence polarisation immunoassay. Due to the absence of signals of brain metabolites, the aromatic protons of phenobarbital, phenytoin and carbamazepine, with resonance lines around 7.4 ppm, allow the drugs to be detected. Valproate, with two resonances around 1.2 ppm, should be differentiable from potential brain metabolites using nonlinear analysis of the brain spectrum. Volume-selective 1H-MRS is therefore expected to be able to monitor anticonvulsant therapy in vivo. (orig.)

  13. Recurrence and Relapse in Bipolar Mood Disorder

    Directory of Open Access Journals (Sweden)

    S Gh Mousavi

    2004-06-01

    Full Text Available Background: Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. Methods: In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. Results: The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%, compared to those using carbamazepine (80%. Recurrence was higher in patients treated with only pharmacotherapy (44.5% compared to those treated with both pharmacotherapy and psychotherapy (22.2%. Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. Conclusion: The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress. Keywords: Bipolar Mood Disorder, Recurrence, Relapse.

  14. Resistance to atracurium-induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants.

    Science.gov (United States)

    Tempelhoff, R; Modica, P A; Jellish, W S; Spitznagel, E L

    1990-12-01

    Previous studies have demonstrated that, with the exception of atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients receiving no anticonvulsant therapy (MED = 0); 14 epileptic patients treated with carbamazepine for years (MED = 1); and 18 epileptic patients treated with carbamazepine plus either phenytoin or valproic acid for years (MED = 2). The evoked compound electromyogram of the adductor pollicis brevis was recorded, and results were analyzed using analysis of covariance, with weight and age as covariables. The onset time was not significantly different among the three groups. Times for recovery of baseline and train-of-four responses to stimuli were significantly shorter in the MED = 1 and MED = 2 groups than in control patients (MED = 0). The recovery index (time between 25% and 75% recovery of baseline electromyogram values) was progressively shorter in the three groups (MED = 0: 8.02 min; MED = 1: 5.93 min; MED = 2: 1.96 min; P less than 0.001). This study demonstrates that atracurium, when used on epileptic patients requiring long-term (that is, years of) anticonvulsant therapy, has a shorter duration of action than when used in nonepileptic patients. PMID:2240640

  15. Batch versus continuous feeding strategies for pharmaceutical removal by subsurface flow constructed wetland

    International Nuclear Information System (INIS)

    This study evaluated the effect of continuous and batch feeding on the removal of 8 pharmaceuticals (carbamazepine, naproxen, diclofenac, ibuprofen, caffeine, salicylic acid, ketoprofen and clofibric acid) from synthetic wastewater in mesocosm-scale constructed wetlands (CWs). Both loading modes were operated at hydraulic application rates of 5.6 cm day−1 and 2.8 cm day−1. Except for carbamazepine, clofibric acid and naproxen, removal in CWs was significantly (p ow) and removal efficiencies of pharmaceutical compounds in the CWs, showed that pharmaceutical removal efficiency was significantly (p ow value, but not with log Kow value. - Highlights: ► Batch feeding in mesocosm-scale constructed wetlands enhances pharmaceutical removal. ► K values for the 8 pharmaceuticals were in the range of 0.01–0.1 m day−1. ► The pharmaceutical removal efficiency was inversely correlated with log Dow value. - Batch (drain and fill) feeding in mesocosm-scale constructed wetlands enhances pharmaceutical removal.

  16. Wastewater treatment--adsorption of organic micropollutants on activated HTC-carbon derived from sewage sludge.

    Science.gov (United States)

    Kirschhöfer, Frank; Sahin, Olga; Becker, Gero C; Meffert, Florian; Nusser, Michael; Anderer, Gilbert; Kusche, Stepan; Klaeusli, Thomas; Kruse, Andrea; Brenner-Weiss, Gerald

    2016-01-01

    Organic micropollutants (MPs), in particular xenobiotics and their transformation products, have been detected in the aquatic environment and the main sources of these MPs are wastewater treatment plants. Therefore, an additional cleaning step is necessary. The use of activated carbon (AC) is one approach to providing this additional cleaning. Industrial AC derived from different carbonaceous materials is predominantly produced in low-income countries by polluting processes. In contrast, AC derived from sewage sludge by hydrothermal carbonization (HTC) is a regional and sustainable alternative, based on waste material. Our experiments demonstrate that the HTC-AC from sewage sludge was able to remove most of the applied MPs. In fact more than 50% of sulfamethoxazole, diclofenac and bezafibrate were removed from artificial water samples. With the same approach carbamazepine was eliminated to nearly 70% and atrazine more than 80%. In addition a pre-treated (phosphorus-reduced) HTC-AC was able to eliminate 80% of carbamazepine and diclofenac. Atrazine, sulfamethoxazole and bezafibrate were removed to more than 90%. Experiments using real wastewater samples with high organic content (11.1 g m(-3)) succeeded in proving the adsorption capability of phosphorus-reduced HTC-AC. PMID:26877044

  17. Pharmaceuticals as indictors of sewage-influenced groundwater

    Science.gov (United States)

    Müller, Beate; Scheytt, Traugott; Asbrand, Martin; de Casas, Andrea Mross

    2012-09-01

    A set of human pharmaceuticals enables identification of groundwater that is influenced by sewage and provides information on the time of recharge. As the consumption rates of the investigated pharmaceuticals have changed over time, so too has the composition of the sewage. At the study area, south of Berlin (Germany), irrigation was performed as a method of wastewater clean-up at sewage irrigation farms until the early 1990s. Today, treated wastewater is discharged into the surface-water-stream Nuthegraben. Groundwater and surface-water samples were analyzed for the pharmaceutical substances clofibric acid, bezafibrate, diclofenac, carbamazepine and primidone, the main ions and organic carbon. The pharmaceutical substances were detected at concentrations up to microgram-per-liter level in groundwater and surface-water samples from the Nuthegraben Lowland area and from the former irrigation farms. Concentrations detected in groundwater are generally much lower than in surface water and there is significant variation in the distribution of pharmaceutical concentrations in groundwater. Groundwater influenced by the irrigation of sewage water shows higher primidone and clofibric-acid concentrations. Groundwater influenced by recent discharge of treated sewage water into the surface water shows high carbamazepine concentrations while concentrations of primidone and clofibric acid are low.

  18. Determination of selected pharmaceuticals in tap water and drinking water treatment plant by high-performance liquid chromatography-triple quadrupole mass spectrometer in Beijing, China.

    Science.gov (United States)

    Cai, Mei-Quan; Wang, Rong; Feng, Li; Zhang, Li-Qiu

    2015-02-01

    A simultaneous determination method of 14 multi-class pharmaceuticals using solid-phase extraction (SPE) followed by high-performance liquid chromatography-tandem mass spectrometer (HPLC-MS/MS) was established to measure the occurrence and distribution of these pharmaceuticals in tap water and a drinking water treatment plant (DWTP) in Beijing, China. Target compounds included seven anti-inflammatory drugs, two antibacterial drugs, two lipid regulation drugs, one antiepileptic drug, and one hormone. Limits of detection (LODs) and limits of quantitation (LOQs) ranged from 0.01 to 1.80 ng/L and 0.05 to 3.00 ng/L, respectively. Intraday and inter-day precisions, recoveries of different matrices, and matrix effects were also investigated. Of the 14 pharmaceutical compounds selected, nine were identified in tap water of Beijing downtown with the concentration up to 38.24 ng/L (carbamazepine), and the concentration levels of detected pharmaceuticals in tap water (bezafibrate. Ibuprofen was found to be the highest concentration pharmaceutical during DWTP, up to 53.30 ng/L. DWTP shows a positive effect on the removal of most pharmaceuticals with 81.2-99.5 % removal efficiencies, followed by carbamazepine with 55.4 % removal efficiency, but it has no effect for removing ibuprofen and bezafibrate. PMID:25196960

  19. Schwartz-jampel syndrome: report of five cases

    Directory of Open Access Journals (Sweden)

    Reed Umbertina Conti

    2002-01-01

    Full Text Available We describe five patients with Schwartz-Jampel syndrome (SJS examined at the outpatient service for neuromuscular disorders at our Institution from 1996 to 1999 with the objective of emphasizing the characteristic dysmorphic phenotype of SJS and its different clinical forms. Two cases presented SJS-type 1A, two had SJS-type 1B and one manifested SJS-type 2. Two boys with 3 and 13 years of age had generalized stiffness and the characteristic facial as well as osteoarticular changes from birth. Other two boys with 11 and 7 years had less marked dysmorphic changes at birth and manifested myotonia, as a limiting factor, during the second year of age. A girl with two months of age had severe myotonia from birth leading to feeding diffuculties. In all cases the diagnosis was based on dysmorphic features, and on electromyographic changes showing continuous electrical activity of muscle fibers. All were treated with carbamazepine, 20-30 mg/Kg since diagnosis. The four boys (all with normal intelligence improved of myotonia in daily activities, markedly in three, and moderately in one. The girl did not improve and showed global development delay: by the last follow-up (at 20 months of age she did not sit unsupported, and had mental retardation. Carbamazepine in SJS-type 1 improves general daily performance and psychological status of the patients.

  20. [Anticonvulsants and antipsychotics in the treatment of bipolar disorder].

    Science.gov (United States)

    Moreno, Ricardo Alberto; Moreno, Doris Hupfeld; Soares, Márcia Britto de Macedo; Ratzke, Roberto

    2004-10-01

    Bipolar disorder is a complex medical condition, and up to the date there is no single treatment with proven efficacy in the control of all aspects of the illness. The available literature on the use of anticonvulsants (valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin, topiramate, clonazepam) and atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole) for acute and prophylactic treatment of bipolar disorder was reviewed. There is a large amount of evidence that lithium is efficacious in the prophylaxis of episodes and better for acute mania than for depressive episodes. Other data show that carbamazepine and valproate are effective in acute manic episodes. Lamotrigine has been shown to reduce cycling and effective in depressive episodes. Based on the available data, olanzapine was found to be the most appropriate atypical antipsychotic agent for the treatment of manic bipolar patients, although there are also studies suggesting the efficacy of risperidone, aripiprazole and clozapine. The preliminary data evaluating the efficacy of quetiapine and ziprasidone in bipolar disorder are still very limited. There is no consistent information supporting the prophylactic use of newer antipsychotics. PMID:15597138

  1. An integrated approach to improved toxicity prediction for the safety assessment during preclinical drug development using Hep G2 cells.

    Science.gov (United States)

    Noor, Fozia; Niklas, Jens; Müller-Vieira, Ursula; Heinzle, Elmar

    2009-06-01

    Efficient and accurate safety assessment of compounds is extremely important in the preclinical development of drugs especially when hepatotoxicity is in question. Multiparameter and time resolved assays are expected to greatly improve the prediction of toxicity by assessing complex mechanisms of toxicity. An integrated approach is presented in which Hep G2 cells and primary rat hepatocytes are compared in frequently used cytotoxicity assays for parent compound toxicity. The interassay variability was determined. The cytotoxicity assays were also compared with a reliable alternative time resolved respirometric assay. The set of training compounds consisted of well known hepatotoxins; amiodarone, carbamazepine, clozapine, diclofenac, tacrine, troglitazone and verapamil. The sensitivity of both cell systems in each tested assay was determined. Results show that careful selection of assay parameters and inclusion of a kinetic time resolved assay improves prediction for non-metabolism mediated toxicity using Hep G2 cells as indicated by a sensitivity ratio of 1. The drugs with EC(50) values 100 microM or lower were considered toxic. The difference in the sensitivity of the two cell systems to carbamazepine which causes toxicity via reactive metabolites emphasizes the importance of human cell based in-vitro assays. Using the described system, primary rat hepatocytes do not offer advantage over the Hep G2 cells in parent compound toxicity evaluation. Moreover, respiration method is non invasive, highly sensitive and allows following the time course of toxicity. Respiration assay could serve as early indicator of changes that subsequently lead to toxicity. PMID:19332084

  2. Drug-induced weight gain.

    Science.gov (United States)

    Ness-Abramof, Rosane; Apovian, Caroline M

    2005-01-01

    Drug-induced weight gain is a serious side effect of many commonly used drugs leading to noncompliance with therapy and to exacerbation of comorbid conditions related to obesity. Improved glycemic control achieved by insulin, insulin secretagogues or thiazolidinedione therapy is generally accompanied by weight gain. It is a problematic side effect of therapy due to the known deleterious effect of weight gain on glucose control, increased blood pressure and worsening lipid profile. Weight gain may be lessened or prevented by adherence to diet and exercise or combination therapy with metformin. Weight gain is also common in psychotropic therapy. The atypical antipsychotic drugs (clozapine, olanzepine, risperidone and quetiapine) are known to cause marked weight gain. Antidepressants such as amitriptyline, mirtazapine and some serotonin reuptake inhibitors (SSRIs) also may promote appreciable weight gain that cannot be explained solely by improvement in depressive symptoms. The same phenomenon is observed with mood stabilizers such as lithium, valproic acid and carbamazepine. Antiepileptic drugs (AEDs) that promote weight gain include valproate, carbamazepine and gabapentin. Lamotrigine is an AED that is weight-neutral, while topiramate and zonisamide may induce weight loss. PMID:16341287

  3. Effects of anticonvulsants on soman-induced epileptiform activity in the guinea-pig in vitro hippocampus.

    Science.gov (United States)

    Harrison, Patrick K; Sheridan, Robert D; Green, A Chris; Tattersall, John E H

    2005-08-22

    Seizures arising from acetylcholinesterase inhibition are a feature of organophosphate anticholinesterase intoxication. Although benzodiazepines are effective against these seizures, alternative anticonvulsant drugs may possess greater efficacy and fewer side-effects. We have investigated in the guinea-pig hippocampal slice preparation the ability of a series of anticonvulsants to suppress epileptiform bursting induced by the irreversible organophosphate anticholinesterase, soman (100 nM). Carbamazepine (300 microM), phenytoin (100 microM), topiramate (100-300 microM) and retigabine (1-30 microM) reduced the frequency of bursting but only carbamazepine and phenytoin induced a concurrent reduction in burst duration. Felbamate (100-500 microM) and clomethiazole (100-300 microM) had no effect on burst frequency but decreased burst duration. Clozapine (3-30 microM) reduced the frequency but did not influence burst duration. Levetiracetam (100-300 microM) and gabapentin (100-300 microM) were without effect. These data suggest that several compounds, in particular clomethiazole, clozapine, felbamate, topiramate and retigabine, merit further evaluation as possible treatments for organophosphate poisoning. PMID:16054127

  4. The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-spectrum psychotropics.

    Science.gov (United States)

    Ernst, Carrie L; Goldberg, Joseph F

    2002-01-01

    There has been growing concern about the potential iatrogenic effects of several newer psychotropic drugs on reproductive health safety in women. Areas of particular concern in this regard include (1) controversies about a potential association between the use of valproate and development of polycystic ovary syndrome (PCOS), (2) the safety of use of newer psychotropic medications during pregnancy, and (3) safety issues with these medications in women while breastfeeding. This review summarizes current information about each of these areas. In particular, existing data suggest that (1) PCOS very likely represents a complex neuroendocrine disorder with multiple determinants; (2) menstrual irregularities may be a frequently seen phenomenon in women with bipolar illness, at least partially independent of psychotropic drug therapy; (3) potential central nervous system teratogenicity remains substantial during first-trimester exposure to valproate or carbamazepine; (4) with newer agents used for bipolar disorder and schizophrenia, safety data during pregnancy, while not definitive, are most abundant with olanzapine and with lamotrigine; relatively less is known about systematic pregnancy outcomes with other atypical antipsychotics or newer anticonvulsants; and (5) risks for neonatal safety during lactation continue to appear substantial with lithium, are of potential concern with lamotrigine and clozapine, are quite likely minimal with valproate or carbamazepine, and are indeterminate with most other new anticonvulsants or atypical antipsychotics. Recommendations are presented for clinical management in each of these instances. PMID:11913676

  5. Drug-induced hypersensitivity syndrome with human herpesvirus-6 reactivation

    Directory of Open Access Journals (Sweden)

    Najeeba Riyaz

    2012-01-01

    Full Text Available A 45-year-old man, on carbamazepine for the past 3 months, was referred as a case of atypical measles. On examination, he had high-grade fever, generalized itchy rash, cough, vomiting and jaundice. A provisional diagnosis of drug hypersensitivity syndrome to carbamazepine was made with a differential diagnosis of viral exanthema with systemic complications. Laboratory investigations revealed leukocytosis with eosnophilia and elevated liver enzymes. Real-time multiplex polymerase chain reaction (PCR on throat swab and blood was suggestive of human herpesvirus-6 (HHV-6. Measles was ruled out by PCR and serology. The diagnosis of drug-induced hypersensitivity syndrome (DIHS was confirmed, which could explain all the features manifested by the patient. HHV-6 infects almost all humans by age 2 years. It infects and replicates in CD4 T lymphocytes and establishes latency in human peripheral blood monocytes or macrophages and early bone marrow progenitors. In DIHS, allergic reaction to the causative drug stimulates T cells, which leads to reactivation of the herpesvirus genome. DIHS is treated by withdrawal of the culprit drug and administration of systemic steroids. Our patient responded well to steroids and HHV-6 was negative on repeat real-time multiplex PCR at the end of treatment.

  6. An integrated approach to improved toxicity prediction for the safety assessment during preclinical drug development using Hep G2 cells

    International Nuclear Information System (INIS)

    Efficient and accurate safety assessment of compounds is extremely important in the preclinical development of drugs especially when hepatotoxicty is in question. Multiparameter and time resolved assays are expected to greatly improve the prediction of toxicity by assessing complex mechanisms of toxicity. An integrated approach is presented in which Hep G2 cells and primary rat hepatocytes are compared in frequently used cytotoxicity assays for parent compound toxicity. The interassay variability was determined. The cytotoxicity assays were also compared with a reliable alternative time resolved respirometric assay. The set of training compounds consisted of well known hepatotoxins; amiodarone, carbamazepine, clozapine, diclofenac, tacrine, troglitazone and verapamil. The sensitivity of both cell systems in each tested assay was determined. Results show that careful selection of assay parameters and inclusion of a kinetic time resolved assay improves prediction for non-metabolism mediated toxicity using Hep G2 cells as indicated by a sensitivity ratio of 1. The drugs with EC50 values 100 μM or lower were considered toxic. The difference in the sensitivity of the two cell systems to carbamazepine which causes toxicity via reactive metabolites emphasizes the importance of human cell based in-vitro assays. Using the described system, primary rat hepatocytes do not offer advantage over the Hep G2 cells in parent compound toxicity evaluation. Moreover, respiration method is non invasive, highly sensitive and allows following the time course of toxicity. Respiration assay could serve as early indicator of changes that subsequently lead to toxicity.

  7. The benefits of powdered activated carbon recirculation for micropollutant removal in advanced wastewater treatment.

    Science.gov (United States)

    Meinel, F; Zietzschmann, F; Ruhl, A S; Sperlich, A; Jekel, M

    2016-03-15

    PAC adsorption is a widespread option for the removal of organic micropollutants (OMP) from secondary effluent. For an optimal exploitation of the adsorption capacity, PAC recirculation is nowadays a common practice, although the mechanistic interrelations of the complex recirculation process are not fully resolved. In this work, extensive multi-stage batch adsorption testing with repeated PAC and coagulant dosage was performed to evaluate the continuous-flow recirculation system. Partly loaded PAC showed a distinct amount of remaining capacity, as OMP and DOC removals considerably increased with each additional adsorption stage. At a low PAC dose of 10 mg PAC L(-1), removals of benzotriazole and carbamazepine were shown to rise from 80% in the 11th stage at 30 min adsorption time per stage. At a high PAC dose of 30 mg PAC L(-1), OMP and DOC removals were significantly higher and reached 98% (for benzotriazole and carbamazepine) after 11 stages. Coagulant dosage showed no influence on OMP removal, whereas a major part of DOC removal can be attributed to coagulation. Multi-stage adsorption is particularly beneficial for small PAC doses and significant PAC savings are feasible. A new model approach for predicting multi-stage OMP adsorption on the basis of a single-stage adsorption experiment was developed. It proved to predict OMP removals and PAC loadings accurately and thus contributes towards understanding the PAC recirculation process. PMID:26773491

  8. Temperature dependent redox zonation and attenuation of wastewater-derived organic micropollutants in the hyporheic zone.

    Science.gov (United States)

    Burke, Victoria; Greskowiak, Janek; Asmuß, Tina; Bremermann, Rebecca; Taute, Thomas; Massmann, Gudrun

    2014-06-01

    The hyporheic zone - a spatially fluctuating ecotone connecting surface water and groundwater - is considered to be highly reactive with regard to the attenuation of organic micropollutants. In the course of the presented study an undisturbed sediment core was taken from the infiltration zone of a bank filtration site in Berlin and operated under controlled laboratory conditions with wastewater-influenced surface water at two different temperatures, simulating winter and summer conditions. The aim was to evaluate the fate of site-relevant micropollutants, namely metoprolol, iopromide, diclofenac, carbamazepine, acesulfame, tolyltriazole, benzotriazole, phenazone and two phenazone type metabolites, within the first meter of infiltration dependent on the prevailing temperature. A change in temperature resulted in a development of significantly distinct redox conditions. Both temperature dependencies and related redox dependencies were identified for all micropollutants except for benzotriazole and carbamazepine, which behaved persistent under all conditions. For the remaining compounds degradation rate constants generally decreased from warm and oxic/penoxic/suboxic over cold and oxic/penoxic to warm and manganese reducing (transition zone). Individual degradation rate constants ranged from 0 (e.g. diclofenac, acesulfame and tolyltriazole in the transition zone) to 1.4×10(-4)s(-1) for metoprolol under warm conditions within the oxic to suboxic zone. PMID:24642095

  9. Solar photo-Fenton using peroxymonosulfate for organic micropollutants removal from domestic wastewater: comparison with heterogeneous TiO₂ photocatalysis.

    Science.gov (United States)

    Ahmed, Moussa Mahdi; Brienza, Monica; Goetz, Vincent; Chiron, Serge

    2014-12-01

    This work aims at decontaminating biologically treated domestic wastewater effluents from organic micropollutants by sulfate radical based (SO4(-)) homogeneous photo-Fenton involving peroxymonosulfate as an oxidant, ferrous iron (Fe(II)) as a catalyst and simulated solar irradiation as a light source. This oxidative system was evaluated by using several probe compounds belonging to pesticides (bifenthrin, mesotrione and clothianidin) and pharmaceuticals (diclofenac, sulfamethoxazole and carbamazepine) classes and its kinetic efficiency was compared to that to the well known UV-Vis/TiO2 heterogeneous photocatalysis. Except for carbamazepine, apparent kinetic rate constants were always 10 times higher in PMS/Fe(II)/UV-Vis than in TiO2/UV-Vis system and more than 70% of total organic carbon abatement was reached in less than one hour treatment. Hydroxyl radical (OH) and SO4(-) reactivity was investigated using mesotrione as a probe compound through by-products identification by liquid chromatography-high resolution-mass spectrometry and transformation pathways elucidation. In addition to two OH based transformation pathways, a specific SO4(-) transformation pathway which first involved degradation through one electron transfer oxidation processes followed by decarboxylation were probably responsible for mesotrione degradation kinetic improvement upon UV-Vis/PMS/Fe(II) system in comparison to UVVis/TiO2 system. PMID:25108605

  10. Degradation of PPCPs in activated sludge from different WWTPs in Denmark.

    Science.gov (United States)

    Chen, Xijuan; Vollertsen, Jes; Nielsen, Jeppe Lund; Dall, Agnieszka Gieraltowska; Bester, Kai

    2015-12-01

    Pharmaceuticals and Personal care products (PPCPs) are often found in effluents from wastewater treatment plants (WWTPs) due to insufficient removal during wastewater treatment processes. To understand the factors affecting the removal of PPCPs in classical activated sludge WWTPs, the present study was performed to assess the removal of frequently occurring pharmaceuticals (Naproxen, Fenoprofen, Ketoprofen, Dichlofenac, Carbamazepine) and the biocide Triclosan in activated sludge from four different Danish WWTPs. The respective degradation constants were compared to operational parameters previous shown to be of importance for degradation of micropollutants such as biomass concentration, and sludge retention time (SRT). The most rapid degradation, was observed for NSAID pharmaceuticals (55-90% for Fenoprofen, 77-94% for Ketoprofen and 46-90% for Naproxen), followed by Triclosan (61-91%), while Dichlofenac and Carbamazepine were found to be persistent in the systems. Degradation rate constants were calculated as 0.0026-0.0407 for NSAID pharmaceuticals and 0.0022-0.0065 for triclosan. No relationships were observed between degradation rates and biomass concentrations in the diverse sludges. However, for the investigated PPCPs, the optimal SRT was within 14-20 days (for these values degradation of these PPCPs was the most efficient). Though all of these parameters influence the degradation rate, none of them seems to be overall decisive. These observations indicate that the biological composition of the sludge is more important than the design parameters of the respective treatment plant. PMID:26407712

  11. Pharmaceuticals, Their Metabolites, and Other Polar Pollutants in Field-Grown Vegetables Irrigated with Treated Municipal Wastewater.

    Science.gov (United States)

    Riemenschneider, Christina; Al-Raggad, Marwan; Moeder, Monika; Seiwert, Bettina; Salameh, Elias; Reemtsma, Thorsten

    2016-07-27

    The reuse of treated municipal wastewater for crop irrigation is a necessity in arid and semiarid regions but a potential entrance for emerging contaminants into the food chain. However, little attention has yet been paid to the detection of micropollutants and possible metabolites in vegetables grown under realistic field conditions. In this study, the uptake of 28 micropollutants and carbamazepine metabolites in 10 different field-grown vegetable species (among them carrot, lettuce, potato, and zucchini) from Jordan was studied. A total of 12 micropollutants and six carbamazepine metabolites, four of which have never been analyzed before in plant-uptake studies, could be detected in all of the samples in concentrations ranging from 1.7 to 216 ng per g of dry weight. In edible tissues, the total concentration of micropollutants decreased in the order of leafy (247-533) > root (73-126) > fruit-bearing (5-76 ng per g of dry weight) vegetables. A preliminary health-risk assessment for nine compounds according to the TTC concept shows no risk for seven of the micropollutats; for ciprofloxacin and 10,11-epoxycarbamazepine, however, more-specific toxicity data would be required for a refined risk assessment. PMID:27378214

  12. Anticonvulsants in the treatment of aggression in the demented elderly: an update

    Directory of Open Access Journals (Sweden)

    Gonzalez-Pinto Ana

    2009-06-01

    Full Text Available Abstract Introduction Complex psychopathological and behavioral symptoms, such as delusions and aggression against care providers, are often the primary cause of acute hospital admissions of elderly patients to emergency units and psychiatric departments. This issue resembles an interdisciplinary clinically highly relevant diagnostic and therapeutic challenge across many medical subjects and general practice. At least 50% of the dramatically growing number of patients with dementia exerts aggressive and agitated symptoms during the course of clinical progression, particularly at moderate clinical severity. Methods Commonly used rating scales for agitation and aggression are reviewed and discussed. Furthermore, we focus in this article on benefits and limitations of all available data of anticonvulsants published in this specific indication, such as valproate, carbamazepine, oxcarbazepine, lamotrigine, gabapentin and topiramate. Results To date, most positive and robust data are available for carbamazepine, however, pharmacokinetic interactions with secondary enzyme induction limit its use. Controlled data of valproate do not seem to support the use in this population. For oxcarbazepine only one controlled but negative trial is available. Positive small series and case reports have been reported for lamotrigine, gabapentin and topiramate. Conclusion So far, data of anticonvulsants in demented patients with behavioral disturbances are not convincing. Controlled clinical trials using specific, valid and psychometrically sound instruments of newer anticonvulsants with a better tolerability profile are mandatory to verify whether they can contribute as treatment option in this indication.

  13. Behavior of selected pharmaceuticals in topsoil of Greyic Phaeozem

    Science.gov (United States)

    Kodesova, Radka; Klement, Ales; Kocarek, Martin; Fer, Miroslav; Golovko, Oksana; Grabic, Roman; Jaksik, Ondrej

    2014-05-01

    It has been documented in several studies that soil may be contaminated by human or veterinary pharmaceuticals. Some of pharmaceutical ingredient may be retained in soils. The rest can be transported to the surface and groundwater through surface runoff and infiltration. Mobility of contaminants in soils is dependent on many soil and pharmaceutical properties (e.g. pharmaceutical adsorption on soil particles and pharmaceutical degradation). The goals of this study were: (1) to measure adsorption isotherms of selected pharmaceuticals in one soil; (2) to evaluate degradation of selected pharmaceuticals in this soil, and (3) to evaluate impact of applied pharmaceuticals on biological activity in soil, which influences pharmaceutical decomposition. Batch sorption tests were performed for 7 selected pharmaceuticals (beta blockers Atenolol and Metoprolol, anticonvulsant Carbamazepin, and antibiotics Clarithromycin, Clindamycin, Trimetoprim and Sulfamethoxazol) and one soil (topsoil of Greyic Phaeozem from Čáslav). The same concentrations (0.5, 1, 2.5, 5 and 10 mg/l) were used for almost all pharmaceuticals except Clarithromycin (0.033, 0.08, 0.165, 0.25, 0.33 mg/l). The Freundlich equations were used to describe adsorption isotherms. Degradation of all 7 pharmaceuticals was also studied. Solutes of different pharmaceuticals (concentration of 8.3 mg/l) were added into the plastic bottles (one pharmaceutical per bottle) with soil. Concentrations of pharmaceuticals remaining in soil 1, 2, 5, 12, 23, 40 and 61 days after the pharmaceutical application were analyzed. Colony forming unites were evaluated to describe microbial activity in time affected by different pharmaceuticals. Adsorption of studied pharmaceuticals on soil particles decreasing as follows: Clarithromycin, Trimetoprim, Metoprolol, Clindamycin, Atenolol, Carbamazepin, Sulfamethoxazol. Degradation rates in some degree reflected adsorption of studied pharmaceuticals on soil particles and increased with

  14. Transport of four pharmaceuticals in different horizons of three soil types

    Science.gov (United States)

    Kodesova, Radka; Svatkova, Paula; Klement, Ales; Jaksik, Ondrej; Golovko, Oksana; Fer, Miroslav; Kocarek, Martin; Nikodem, Antonin; Grabic, Roman

    2015-04-01

    Soil structure, which varies in different soil types and the horizons of these soil types, has a significant impact on water flow and contaminant transport in soils. Transport of many contaminants is in addition strongly influenced by their sorption on soil particles. Transport of four pharmaceuticals (sulfamethoxazole, trimethoprim, atenolol and carbamazepine) was studied in soil columns (a diameter of 10.5 cm and a height of 13 cm) taken from all diagnostic horizons of three different soil types (Haplic Luvisol, Greyic Phaeozem and Haplic Cambisol). The irrigation by water contaminated by a mixture of all four compounds followed by ponding infiltration of distilled water was simulated and water outflow and solute concentrations from the bottom of the soil sample was monitored in time. The highest infiltration rates were observed for soil samples from the Bt horizons of the Greyic Phaeozem that exhibited prismatic structure, followed by rates observed in the Ap horizons of the Haplic Luvisol, Greyic Phaeozem and Haplic Cambisol (due to their granular soil structure and presence of root channels). The lowest infiltration rate was measured for the Bw horizon of the Haplic Cambisol, which had a poorly developed soil structure and a low fraction of macropores. Compound discharge was however also highly affected by their sorption on solids. The highest mobility was observed for sulfamethoxazole followed by carbamazepine atenolol and trimethoprim, which corresponds to measured sorption isotherms. Mobility of ionizable compounds in different soil samples was influenced by pH (i.e. degree and form of their ionization) and sites available for absorption. Mobility of sulfamethoxazole decreased with decreasing pH (i.e. the largest sorption measured in horizons of the Haplic Cambisol). While mobility of atenolol and trimethoprim decreased with increasing base cation saturation, and with increasing organic matter content for carbamazepine. As result of both affects (i.e. soil

  15. An investigation into the acute and chronic toxicity of eleven pharmaceuticals (and their solvents) found in wastewater effluent on the cnidarian, Hydra attenuata.

    Science.gov (United States)

    Quinn, Brian; Gagné, François; Blaise, Christian

    2008-01-25

    Pharmaceuticals previously identified in the effluent from the wastewater treatment plant (WWTP) in Montreal discharging into the St. Lawrence river, were tested for acute and chronic toxicity using the cnidarian Hydra attenuata. Acute toxicity was based on the established technique looking at morphological changes in the Hydra, while recently developed endpoints of feeding behaviour, attachment and growth (hydranth number) were used to measure chronic effects. The compounds under investigation (ibuprofen, naproxen, gemfibrozil, bezafibrate, carbamazepine, sulfamethoxazole, sulfapyridine, oxytetracycline, novobiocin, trimethoprim and caffeine) were tested individually in controlled laboratory exposures with LC(50) and EC(50) results calculated. All compounds tested had relatively high LC(50) values with gemfibrozil, ibuprofen and naproxen having the lowest at 22.36 mg/L and EC(50) values based on morphology of 1.18 to 2.62 mg/L (all concentrations are nominal). The EC(50) values based on feeding were similar to those based on morphology but with increased sensitivity for carbamazepine, bezafibrate and novobiocin. A trend of a reduction in feeding with deterioration in morphology was observed in the Hydra, with the exception of novobiocin, where a lower than expected EC(50) of 13.53 mg/L was found with no negative effect on morphology. Significant reductions in attachment and hydranth number were seen at concentrations of 1 and 5 mg/L for gemfibrozil and ibuprofen respectively. A toxicity threshold (TT) of 320 microg/L was calculated for ibuprofen, only a factor of 10(2) or 10 higher than the concentration found in the effluent in the present study (1.19 mug/L) and in other Canadian effluents studied (22 microg/L [Brun GL, Bernier M, Losier R, Doe K, Jackman P, Lee HB, Pharmaceutically active compounds in Atlantic Canadian sewage treatment plant effluents and receiving waters and potential for environmental effects as measured by acute and chronic aquatic toxicity

  16. Accumulation of pharmaceuticals, Enterococcus, and resistance genes in soils irrigated with wastewater for zero to 100 years in central Mexico.

    Directory of Open Access Journals (Sweden)

    Philipp Dalkmann

    Full Text Available Irrigation with wastewater releases pharmaceuticals, pathogenic bacteria, and resistance genes, but little is known about the accumulation of these contaminants in the environment when wastewater is applied for decades. We sampled a chronosequence of soils that were variously irrigated with wastewater from zero up to 100 years in the Mezquital Valley, Mexico, and investigated the accumulation of ciprofloxacin, enrofloxacin, sulfamethoxazole, trimethoprim, clarithromycin, carbamazepine, bezafibrate, naproxen, diclofenac, as well as the occurrence of Enterococcus spp., and sul and qnr resistance genes. Total concentrations of ciprofloxacin, sulfamethoxazole, and carbamazepine increased with irrigation duration reaching 95% of their upper limit of 1.4 µg/kg (ciprofloxacin, 4.3 µg/kg (sulfamethoxazole, and 5.4 µg/kg (carbamazepine in soils irrigated for 19-28 years. Accumulation was soil-type-specific, with largest accumulation rates in Leptosols and no time-trend in Vertisols. Acidic pharmaceuticals (diclofenac, naproxen, bezafibrate were not retained and thus did not accumulate in soils. We did not detect qnrA genes, but qnrS and qnrB genes were found in two of the irrigated soils. Relative concentrations of sul1 genes in irrigated soils were two orders of magnitude larger (3.15 × 10(-3 ± 0.22 × 10(-3 copies/16S rDNA than in non-irrigated soils (4.35 × 10(-5± 1.00 × 10(-5 copies/16S rDNA, while those of sul2 exceeded the ones in non-irrigated soils still by a factor of 22 (6.61 × 10(-4 ± 0.59 × 10(-4 versus 2.99 × 10(-5 ± 0.26 × 10(-5 copies/16S rDNA. Absolute numbers of sul genes continued to increase with prolonging irrigation together with Enterococcus spp. 23S rDNA and total 16S rDNA contents. Increasing total concentrations of antibiotics in soil are not accompanied by increasing relative abundances of resistance genes. Nevertheless, wastewater irrigation enlarges the absolute concentration of resistance genes in soils due to a

  17. Cocrystal formation in solution: Inducing phase transition by manipulating the amount of cocrystallizing agent

    Science.gov (United States)

    Gagniere, Emilie; Mangin, Denis; Puel, François; Valour, Jean-Pierre; Klein, Jean-Paul; Monnier, Olivier

    2011-02-01

    The purpose of this work was to assess the possibility of inducing solution mediated phase transition (SMPT) by manipulating the amount of the cocrystallizing agent. The cocrystal, composed of an active pharmaceutical ingredient (carbamazepine, CBZ) and its cocrystallizing agent (a vitamin—nicotinamide, NCT), was selected as a model compound. Batch experiments were performed in a stirred vessel. The solute concentrations of both CBZ and NCT were monitored using in situ ATR-FTIR spectroscopy. The introduction of NCT in dry form allowed a shift in the phase diagram, leading to an SMPT from CBZ crystals toward cocrystals. The concentration profiles gave information on the phase transition kinetics, i.e., the kinetics of nucleation, growth and dissolution mechanisms of the solid phases involved. Several situations were analyzed. This procedure could also be used to correct a process deviation that led to CBZ crystals instead of cocrystals.

  18. Decomposition of persistent pharmaceuticals in wastewater by ionizing radiation

    Science.gov (United States)

    Kimura, Atsushi; Osawa, Misako; Taguchi, Mitsumasa

    2012-09-01

    Pharmaceuticals in wastewater were treated by the combined method of activated sludge and ionizing radiation in laboratory scale. Oseltamivir, aspirin, and ibuprofen at 5 μmol dm-3 in wastewater were decomposed by the activated sludge at reaction time for 4 h. Carbamazepine, ketoprofen, mefenamic acid, clofibric acid, and diclofenac were not biodegraded completely, but were eliminated by γ-ray irradiation at 2 kGy. The rate constants of the reactions of these pharmaceuticals with hydroxyl radicals were estimated by the competition reaction method to be 4.0-10×109 mol-1 dm3 s-1. Decompositions of the pharmaceuticals in wastewater by ionizing radiation were simulated by use of the rate constants and the amount of total organic carbon as parameters. Simulation curves of concentrations of these pharmaceuticals as a function of dose described the experimental data, and the required dose for the elimination of them in wastewater by ionizing radiation can be estimated by this simulation.

  19. Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria.

    Science.gov (United States)

    Ibekwe, Roland Chidi; Ndukuba, Appolos Chidi; Aronu, Ann Ebele; Eke, Christopher Bismarck; Ibekwe, MaryAnn Ugochi; Ojinnaka, Ngozi Chinyelu

    2016-01-01

    Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason. PMID:26997756

  20. Occurrence and fate of pharmaceutically active compounds in the environment, a case study: Hoeje River in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Bendz, David [Swedish Geotechnical Institute, Department of Environmental Technology, Hospitalsgatan 16A, S-211 33 Malmoe (Sweden)]. E-mail: David.Bendz@swedgeo.se; Paxeus, Nicklas A. [Gryaab, Karl IX:s vaeg, S-418 34 Gothenburg (Sweden); Ginn, Timothy R. [University of California, Department of Civil and Environmental Engineering, 1 Shields Avenue, 2001 Engineering III, Davis, CA 95616 (United States); Loge, Frank J. [University of California, Department of Civil and Environmental Engineering, 1 Shields Avenue, 2001 Engineering III, Davis, CA 95616 (United States)

    2005-07-15

    Pharmaceutically active compounds (PhACs) in the environment lately have been acknowledged to constitute a health risk for humans and terrestrial and aquatic ecosystems. Human and veterinary applications are the main sources of PhACs in the environment and the major pathways are excretion and discharge to the environment through sewage treatment plants (STPs). In this study, the occurrence and fate of selected human PhACs belonging to different therapeutic classes (non-steroidal anti-inflammatory drugs, lipid regulators, anti-epileptics, antibiotics and {beta}-blockers) were investigated in a small river in the very south of Sweden. The objectives of the study were to evaluate the impact of a high and rather constant load in sewage influent on downstream concentrations and whether substances that are metabolized to a high degree in humans also show a low persistency in a natural aquatic environment. Water samples were collected from the influent and effluent of the STP, in a series of dammed reservoirs leading to discharge into the Hoeje River in Sweden, and at several locations in the river downstream of the outfall. After enrichment by solid-phase extraction, the compounds were analyzed using GC-MS (methylated derivatives) or LC-MS/MS. In addition to the targeted pharmaceuticals, GC-MS analysis of the samples revealed the presence of other sewage-related pollutants (triclosan, caffeine, flame-retardants, antioxidants) and these results where included for comparison. Removal efficiencies were calculated in the STP and found to display a wide range with numerous species surviving treatment at greater than half their influent concentrations, including diclofenac, the anti-epileptic carbamazepine, a {beta}-blocker (propanolol), and antibiotics trimetoprim and sulfamethoxazole. Low removals were also observed for Tris(2-chloroisopropyl)phosphate (flame retardant), BHT-aldehyde (oxidation product of BHT) and synthetic musk (HHCB). The concentrations of chloride (Cl

  1. Antiepileptic drugs and intrauterine death

    DEFF Research Database (Denmark)

    Tomson, Torbjörn; Battino, Dina; Bonizzoni, Erminio;

    2015-01-01

    ) after prenatal AED exposure. Using EURAP data, we prospectively monitored pregnancies exposed to the 6 most common AED monotherapies and to polytherapy. Intrauterine death (spontaneous abortion and stillbirth combined) was the primary endpoint. RESULTS: Of 7,055 pregnancies exposed to monotherapy with...... lamotrigine (n = 1,910), carbamazepine (n = 1,713), valproic acid (n = 1,171), levetiracetam (n = 324), oxcarbazepine (n = 262), or phenobarbital (n = 260), and to polytherapy (n = 1,415), 632 ended in intrauterine deaths (592 spontaneous abortions and 40 stillbirths). Rates of intrauterine death were similar...... that the risk was greater with polytherapy vs monotherapy (risk ratio [RR] 1.38; 95% CI 1.14-1.66), parental history of MCMs (RR 1.92; 1.20-3.07), maternal age (RR 1.06; 1.04-1.07), and number of previous intrauterine deaths (RR 1.09; 1.00-1.19). The risk was greater with early enrollment and decreased...

  2. Corrosion inhibitors from expired drugs.

    Science.gov (United States)

    Vaszilcsin, Nicolae; Ordodi, Valentin; Borza, Alexandra

    2012-07-15

    This paper presents a method of expired or unused drugs valorization as corrosion inhibitors for metals in various media. Cyclic voltammograms were drawn on platinum in order to assess the stability of pharmaceutically active substances from drugs at the metal-corrosive environment interface. Tafel slope method was used to determine corrosion rates of steel in the absence and presence of inhibitors. Expired Carbamazepine and Paracetamol tablets were used to obtain corrosion inhibitors. For the former, the corrosion inhibition of carbon steel in 0.1 mol L(-1) sulfuric acid solution was about 90%, whereas for the latter, the corrosion inhibition efficiency of the same material in the 0.25 mol L(-1) acetic acid-0.25 mol L(-1) sodium acetate buffer solution was about 85%. PMID:22561212

  3. Neurogenic muscle cramps.

    Science.gov (United States)

    Katzberg, Hans D

    2015-08-01

    Muscle cramps are sustained, painful contractions of muscle and are prevalent in patients with and without medical conditions. The objective of this review is to present updates on the mechanism, investigation and treatment of neurogenic muscle cramps. PubMed and Embase databases were queried between January 1980 and July 2014 for English-language human studies. The American Academy of Neurology classification of studies (classes I-IV) was used to assess levels of evidence. Mechanical disruption, ephaptic transmission, disruption of sensory afferents and persistent inward currents have been implicated in the pathogenesis of neurogenic cramps. Investigations are directed toward identifying physiological triggers or medical conditions predisposing to cramps. Although cramps can be self-limiting, disabling or sustained muscle cramps should prompt investigation for underlying medical conditions. Lifestyle modifications, treatment of underlying conditions, stretching, B-complex vitamins, diltiezam, mexiletine, carbamazepine, tetrahydrocannabinoid, leveteracitam and quinine sulfate have shown evidence for treatment. PMID:25673127

  4. pH-Triggered Molecular Alignment for Reproducible SERS Detection via an AuNP/Nanocellulose Platform

    Science.gov (United States)

    Wei, Haoran; Vikesland, Peter J.

    2015-12-01

    The low affinity of neutral and hydrophobic molecules towards noble metal surfaces hinders their detection by surface-enhanced Raman spectroscopy (SERS). Herein, we present a method to enhance gold nanoparticle (AuNP) surface affinity by lowering the suspension pH below the analyte pKa. We developed an AuNP/bacterial cellulose (BC) nanocomposite platform and applied it to two common pollutants, carbamazepine (CBZ) and atrazine (ATZ) with pKa values of 2.3 and 1.7, respectively. Simple mixing of the analytes with AuNP/BC at pH platform provides reproducible analyte detection and quantification while avoiding the uncontrolled aggregation and flocculation of AuNPs that often hinder low pH detection.

  5. Teratogenic potential of antiepileptic drugs in the zebrafish model.

    Science.gov (United States)

    Lee, Sung Hak; Kang, Jung Won; Lin, Tao; Lee, Jae Eun; Jin, Dong Il

    2013-01-01

    The zebrafish model is an attractive candidate for screening of developmental toxicity during early drug development. Antiepileptic drugs (AEDs) arouse concern for the risk of teratogenicity, but the data are limited. In this study, we evaluated the teratogenic potential of seven AEDs (carbamazepine (CBZ), ethosuximide (ETX), valproic acid (VPN), lamotrigine (LMT), lacosamide (LCM), levetiracetam (LVT), and topiramate (TPM)) in the zebrafish model. Zebrafish embryos were exposed to AEDs from initiation of gastrula (5.25 hours post-fertilization (hpf)) to termination of hatching (72 hpf) which mimic the mammalian teratogenic experimental design. The lethality and teratogenic index (TI) of AEDs were determined and the TI values of each drug were compared with the US FDA human pregnancy categories. Zebrafish model was useful screening model for teratogenic potential of antiepilepsy drugs and was in concordance with in vivo mammalian data and human clinical data. PMID:24324971

  6. Pharmaceuticals as indicators of anthropogenic influence on the groundwater of Ljubljansko polje and Ljubljansko barje aquifers

    Directory of Open Access Journals (Sweden)

    Karin Lah

    2009-12-01

    Full Text Available The attention of numerous researches has been recently focused on the determination of pharmaceuticals and other persistent chemicals in the environment. The substances enter groundwater either thorough direct discharge or indirectly (through surface or waste water. Pharmaceuticals in groundwater can be regarded as artificial tracers that enable the evaluation of general anthropogenic influence on the environment and identification of the most vulnerable areas of aquifers.The article presents the properties of distribution of caffeine, carbamazepine and propyphenazone in the area of Ljubljansko polje and Ljubljansko barje. Ljubljansko polje and Barje are important drinking water resources. These pollutants are indicators of sewage system efficiency,however,in urban areas without sewage they indicate the aquifer’s ability of natural attenuation.

  7. Biodegradation of trace pharmaceutical substances in wastewater by a membrane bioreactor

    Institute of Scientific and Technical Information of China (English)

    Longli BO; Taro URASE; Xiaochang WANG

    2009-01-01

    The biodegradation of selected pharmaceutical micropollutants, including two pharmaceuticals with argued biodegradation, was studied by a lab-scale membrane bioreactor. The reaction kinetics and affecting factors were also investigated in this paper. Clofibric acid (CA) with contradictive biodegradation reported was degraded almost completely at different hydraulic retention times (HRTs) after adaptation to microorganisms. The biodegradation of CA was disturbed at low pH operation,while the activity of microorganisms recovered again after pH adjustment to neutral condition. Ibuprofen (IBP)degraded under neutral and acidic conditions. Removals of IBP and CA were zero-order and first-order reactions under high and low initial concentrations, respectively. Carbamazepine and diclofenac were not degraded regardless of HRTs and pH.

  8. MRI 3D CISS– A Novel Imaging Modality in Diagnosing Trigeminal Neuralgia – A Review

    Science.gov (United States)

    Besta, Radhika; Shankar, Y. Uday; Kumar, Ashwini; Prakash, S. Bhanu

    2016-01-01

    Trigeminal Neuralgia (TN) is considered as one of the most painful neurologic disorders affecting oro-facial region. TN is often diagnosed clinically based on the patients complete history of pain (severity, duration, episodes etc), relief of pain on test dose of Carbamazepine, regional block of long acting anaesthetic. However, Magnetic Resonance Imaging (MRI) plays an important and confirmatory role in showing Neuro Vascular Conflict (NVC) which is the commonest causative factor for TN. This article reviews the effectiveness of three-dimensional constructive interference in steady-state (3D-CISS) MRI in diagnosing the exact location, degree of neurovascular conflict responsible for classical as well as atypical TN and possible pre-treatment evaluation and treatment outcome. PMID:27135019

  9. Small-fiber dysfunction in trigeminal neuralgia

    DEFF Research Database (Denmark)

    Cruccu, G.; Leandri, M.; Iannetti, G. D.;

    2001-01-01

    Background: In patients with trigeminal neuralgia, results of clinical examination of sensory function are normal. Reflex and evoked potential studies have already provided information on large-afferent (non-nociceptive) function. Using laser-evoked potentials (LEP), the authors sought information...... on small-afferent (nociceptive) function. Methods: The brain potentials evoked by CO2-laser pulses directed to the perioral and supraorbital regions were studied in 67 patients with idiopathic or symptomatic trigeminal neuralgia and 30 normal subjects. Of the 67 patients, 49 were receiving...... carbamazepine. Results: All patients with symptomatic and 51% of those with idiopathic trigeminal neuralgia had frankly abnormal LEP on the painful side. The mean latency was significantly higher and mean amplitude lower on the painful than the nonpainful side. However, even on the nonpainful side, the mean...

  10. MRI 3D CISS- A Novel Imaging Modality in Diagnosing Trigeminal Neuralgia - A Review.

    Science.gov (United States)

    Besta, Radhika; Shankar, Y Uday; Kumar, Ashwini; Rajasekhar, E; Prakash, S Bhanu

    2016-03-01

    Trigeminal Neuralgia (TN) is considered as one of the most painful neurologic disorders affecting oro-facial region. TN is often diagnosed clinically based on the patients complete history of pain (severity, duration, episodes etc), relief of pain on test dose of Carbamazepine, regional block of long acting anaesthetic. However, Magnetic Resonance Imaging (MRI) plays an important and confirmatory role in showing Neuro Vascular Conflict (NVC) which is the commonest causative factor for TN. This article reviews the effectiveness of three-dimensional constructive interference in steady-state (3D-CISS) MRI in diagnosing the exact location, degree of neurovascular conflict responsible for classical as well as atypical TN and possible pre-treatment evaluation and treatment outcome. PMID:27135019

  11. Forty-two Cases of Greater Occipital Neuralgia Treated by Acupuncture plus Acupoint-Injection

    Institute of Scientific and Technical Information of China (English)

    Pan Changqing; Tan Guangbo

    2008-01-01

    Objective:To observe the therapeutic effect of acupuncture plus acupoint-injection on greater occipital neuralgia.Methods:The 84 cases of greater occipital neuralgia were randomly divided into two groups,with 42 cases in the treatment group treated bv acupuncture plus acupoint-injection.and 42 cases in the control group treated with oral administration of carbamazepine.Results:The total effective rate was 92.8% in the treatment group and 71.4% in the control group.The difrerence in the tohal effective rate was significant (P<0.05)between the two groups.Conclusions:Acupuncture plus acupoint-injection is eriective for greater occipital neuralgia,better than the routine western medication.

  12. Pharmacogenomic Testing for Neuropsychiatric Drugs: Current Status of Drug Labeling, Guidelines for Using Genetic Information, and Test Options

    Science.gov (United States)

    Drozda, Katarzyna; Müller, Daniel J.; Bishop, Jeffrey R.

    2014-01-01

    Advancements in pharmacogenomics have introduced an increasing number of opportunities to bring personalized medicine into clinical practice. Understanding how and when to use this technology to help guide pharmacotherapy used to treat neuropsychiatric conditions remains a challenge for many clinicians. Currently, guidelines exist to assist clinicians in the use of genetic information for drug selection and/or dosing for the tricyclic antidepressants, carbamazepine, and phenytoin. Additional language in the product labeling suggests that genetic information may also be useful for assessing the starting and target doses, as well as drug interaction potential, for a number of other medications used to treat psychiatric and neurological conditions. In this review, we outline the current status of pharmacogenomic testing for neuropsychiatric drugs as it pertains to information contained in drug labeling, consensus guidelines, and test panels, as well as considerations related to obtaining tests for patients. PMID:24523097

  13. Emerging organic contaminants in coastal waters: anthropogenic impact, environmental release and ecological risk.

    Science.gov (United States)

    Jiang, Jheng-Jie; Lee, Chon-Lin; Fang, Meng-Der

    2014-08-30

    This study provides a first estimate of the sources, distribution, and risk presented by emerging organic contaminants (EOCs) in coastal waters off southwestern Taiwan. Ten illicit drugs, seven nonsteroidal anti-inflammatory drugs (NSAIDs), five antibiotics, two blood lipid regulators, two antiepileptic drugs, two UV filters, caffeine, atenolol, and omeprazole were analyzed by solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry (SPE-LC-MS/MS). Thirteen EOCs were detected in coastal waters, including four NSAIDs (acetaminophen, ibuprofen, ketoprofen, and codeine), three antibiotics (ampicillin, erythromycin, and cefalexin), three illicit drugs (ketamine, pseudoephedrine, and MDMA), caffeine, carbamazepine, and gemfibrozil. The median concentrations for the 13 EOCs ranged from 1.47 ng/L to 156 ng/L. Spatial variation in concentration of the 13 EOCs suggests discharge into coastal waters via ocean outfall pipes and rivers. Codeine and ampicillin have significant pollution risk quotients (RQ>1), indicating potentially high risk to aquatic organisms in coastal waters. PMID:24439316

  14. Análise de fármacos em águas por SPE-UPLC-ESI-MS/MS

    Directory of Open Access Journals (Sweden)

    Vanessa de Jesus Gaffney

    2014-01-01

    Full Text Available A method was developed for the analysis of 31 pharmaceutical compounds in Lisbon's drinking water system, using solid-phase extraction (SPE and ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS. The method was validated through estimation of the linearity range, method detection and quantification limits, matrix effects, precision and accuracy. The method detection and quantification limit ranges were 0.009-10 and 0.03-33 ng/L, respectively. Analytes were quantified in water samples collected from the EPAL (Empresa Portuguesa das Águas Livres S.A. supply system. Carbamazepine, atenolol, sulfadiazine, sulfamethazine, sulfapyridine, sulfamethoxazole, acetaminophen, caffeine and erythromycin were quantified in the analysed samples.

  15. Homicide during postictal psychosis

    Directory of Open Access Journals (Sweden)

    Stephan Eisenschenk

    2014-01-01

    Full Text Available Postictal psychosis is characterized by a fluctuating combination of thought disorder, auditory and visual hallucinations, delusions, paranoia, affective change, and aggression including violent behavior. We present a case of homicide following a cluster of seizures. The patient's history and postictal behavior were his consistent with postictal psychosis. Contributing factors resulting in homicide may have included increased seizure frequency associated with a change in his AED regimen seizure frequency. The AED change to levetiracetam may also have increased impulsiveness with diminished mood regulation following discontinuation of carbamazepine. There is evidence that he had a cluster of seizures immediately prior to the murder which may have resulted in the postictal disinhibition of frontal lobe inhibitory systems. This homicide and other violent behaviors associated with postictal psychosis may be avoided with earlier recognition and treatment.

  16. Focal neuromyotonia as a presenting feature of lumbosacral radiculopathy

    Directory of Open Access Journals (Sweden)

    Tushar Premraj Raut

    2013-01-01

    Full Text Available Neuromyotonia is characterized by motor, sensory, and autonomic features along with characteristic electrophysiologic findings, resulting from hyperexcitability of the peripheral nerves. We describe the case of a 36-year-old man, who presented with the disabling symptoms suggestive of focal neuromyotonia involving both the lower limbs. His neurological examination revealed continuous rippling of both the calf muscles with normal power, reflexes, and sensory examination. Electrophysiology revealed spontaneous activity in the form of doublets, triplets, and neuromyotonic discharges along with the neurogenic motor unit potentials in bilateral L5, S1 innervated muscles. Magnetic resonance imaging lumbosacral spine revealed lumbar intervertebral disc protrusion with severe foraminal and spinal canal stenosis. Patient had good response to steroids and carbamazepine. The disabling focal neuromyotonia, occurring as a result of chronic active radiculopathy, brought the patient to medical attention. Patient responded to medical management.

  17. The effect of medication adherence on health care utilization in bipolar disorder.

    Science.gov (United States)

    Lew, Kim H; Chang, Eunice Y; Rajagopalan, Krithika; Knoth, Russell L

    2006-09-01

    A retrospective analysis of electronic prescription and medical claims representing approximately 1.4 million managed care commercial health plan members with mental health benefits was conducted. The effect of patient adherence to traditional mood-stabilizer therapy (lithium, valproate, carbamazepine, lamotrigine, or oxcarbazepine) for bipolar disorder on mental health-related hospitalization was assessed among 1,399 patients (mean age, 42.9 yr; 66.3% female) studied. Reduced adherence to traditional mood-stabilizing therapy (< 80%) in patients with bipolar disorder was associated with significantly greater risk of mental health-related, emergency room visits (odds ratio, 1.98; 95% confidence interval, 1.38-2.84) and inpatient hospitalizations (odds ratio, 1.71; 95% confidence interval, 1.27-2.32), even after adjusting for age, gender, and comorbidity. PMID:17017312

  18. Acesulfame-K and pharmaceuticals as co-tracers of municipal wastewater in a receiving river.

    Science.gov (United States)

    Liu, YingYing; Blowes, David W; Groza, Laura; Sabourin, Michelle J; Ptacek, Carol J

    2014-12-01

    Wastewater treatment plant (WWTP) effluents are important sources of emerging contaminants at environmentally-relevant concentrations. In this study, water samples were collected from a river downstream of two WWTPs to identify practical tracers for tracking wastewater. The results of the study indicate elevated concentrations of Cl(-), nutrients (NH3-N and NO2(-)), the artificial sweetener acesulfame-K (ACE-K), and the pharmaceuticals carbamazepine (CBZ), caffeine (CAF), sulfamethoxazole (SMX), ibuprofen (IBU), gemfibrozil (GEM), and naproxen (NAP) in the river close to the WWTPs that decreased with distance downstream. A correlation analysis using the Spearman Rank method showed that ACE-K, CBZ, GEM, NAP, and Cl(-) were strongly correlated with each other over a 31 km stretch of the river in the study area. The strong correlations of these target compounds indicate that the artificial sweetener ACE-K and the pharmaceuticals CBZ, GEM, and NAP can potentially be used as co-tracers to track wastewater. PMID:25359282

  19. Recent Development of Eslicarbazepine Acetate, a New Drug against Epilepsy%治疗癫痫新药醋酸艾司利卡西平研究进展

    Institute of Scientific and Technical Information of China (English)

    饶志方; 王婉钢

    2015-01-01

    查阅国内外关于醋酸艾司利卡西平治疗癫痫的最新文献。文献结果表明,醋酸艾司利平口服吸收快、半衰期长、药物动力学呈线性,无明显的药物相互关系。与卡马西平、奥卡西平相比较,醋酸艾司利平治疗效果更加显著。%The latest literatures on eslicarbazepine acetate in the treatment of epilepsy from home and abroad were referred. The results showed that the oral absorption of eslicarbazepine acetate is quick with long half life, linear pharmacokinetics and low potential of drug-drug interactions. Compared with carbamazepine and oxcarbazepine, eslicarbazepine acetate is more effective against epilepsy.

  20. Comments on the Eslicarbazepine Acetate Section of the Article ‘Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications’

    Directory of Open Access Journals (Sweden)

    Patricio Soares-da-Silva

    2010-12-01

    Full Text Available The recent review of Matthew D. Krasowski on ‘Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications’ is a useful foundation of comparative interpretations on our current knowledge about therapeutic drug monitoring. Within the review, the statement that therapeutic drug monitoring has a minimal role in the therapeutic use of eslicarbazepine acetate due to its relatively predictable pharmacokinetics reflects the existing body of evidence although some information such as eslicarbazepine acetate’s chemical structure, proportions of its metabolites, their pharmacokinetics and chiral method of plasma level measurement need to be revised. These critical characteristics differentiate the novel compound from former dibenzazepines such as carbamazepine and oxcarbazepine in its clinical effects and needs for therapeutic drug monitoring.

  1. Comments on the Eslicarbazepine Acetate Section of the Article ‘Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications’

    Science.gov (United States)

    Öztiryaki, Ahmet H.; Soares-da-Silva, Patricio

    2010-01-01

    The recent review of Matthew D. Krasowski on ‘Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications’ is a useful foundation of comparative interpretations on our current knowledge about therapeutic drug monitoring. Within the review, the statement that therapeutic drug monitoring has a minimal role in the therapeutic use of eslicarbazepine acetate due to its relatively predictable pharmacokinetics reflects the existing body of evidence although some information such as eslicarbazepine acetate’s chemical structure, proportions of its metabolites, their pharmacokinetics and chiral method of plasma level measurement need to be revised. These critical characteristics differentiate the novel compound from former dibenzazepines such as carbamazepine and oxcarbazepine in its clinical effects and needs for therapeutic drug monitoring.

  2. Occurrence and fate of pharmaceutically active compounds in the environment, a case study: Hoeje River in Sweden

    International Nuclear Information System (INIS)

    Pharmaceutically active compounds (PhACs) in the environment lately have been acknowledged to constitute a health risk for humans and terrestrial and aquatic ecosystems. Human and veterinary applications are the main sources of PhACs in the environment and the major pathways are excretion and discharge to the environment through sewage treatment plants (STPs). In this study, the occurrence and fate of selected human PhACs belonging to different therapeutic classes (non-steroidal anti-inflammatory drugs, lipid regulators, anti-epileptics, antibiotics and β-blockers) were investigated in a small river in the very south of Sweden. The objectives of the study were to evaluate the impact of a high and rather constant load in sewage influent on downstream concentrations and whether substances that are metabolized to a high degree in humans also show a low persistency in a natural aquatic environment. Water samples were collected from the influent and effluent of the STP, in a series of dammed reservoirs leading to discharge into the Hoeje River in Sweden, and at several locations in the river downstream of the outfall. After enrichment by solid-phase extraction, the compounds were analyzed using GC-MS (methylated derivatives) or LC-MS/MS. In addition to the targeted pharmaceuticals, GC-MS analysis of the samples revealed the presence of other sewage-related pollutants (triclosan, caffeine, flame-retardants, antioxidants) and these results where included for comparison. Removal efficiencies were calculated in the STP and found to display a wide range with numerous species surviving treatment at greater than half their influent concentrations, including diclofenac, the anti-epileptic carbamazepine, a β-blocker (propanolol), and antibiotics trimetoprim and sulfamethoxazole. Low removals were also observed for Tris(2-chloroisopropyl)phosphate (flame retardant), BHT-aldehyde (oxidation product of BHT) and synthetic musk (HHCB). The concentrations of chloride (Cl-) and boron

  3. Use of psychotropic drugs during pregnancy and breast-feeding

    DEFF Research Database (Denmark)

    Larsen, E R; Damkier, P; Pedersen, L H;

    2015-01-01

    OBJECTIVE: To write clinical guidelines for the use of psychotropic drugs during pregnancy and breast-feeding for daily practice in psychiatry, obstetrics and paediatrics. METHOD: As we wanted a guideline with a high degree of consensus among health professionals treating pregnant women with a......: Sertraline and citalopram are first-line treatment among selective serotonin reuptake inhibitor for depression. It is recommended to use lithium for bipolar disorders if an overall assessment finds an indication for mood-stabilizing treatment during pregnancy. Lamotrigine can be used. Valproate and...... carbamazepin are contraindicated. Olanzapine, risperidone, quetiapine and clozapine can be used for bipolar disorders and schizophrenia. CONCLUSION: It is important that health professionals treating fertile women with a psychiatric disease discuss whether psychotropic drugs are needed during pregnancy and how...

  4. Preliminary screening of small-scale domestic wastewater treatment systems for removal of pharmaceutical and personal care products

    DEFF Research Database (Denmark)

    Matamoros, Victor; Arias, Carlos Alberto; Brix, Hans;

    2009-01-01

    Occurrence and removal efficiencies of 13 pharmaceuticals and personal care products (PPCPs) as well as BOD5, TSS and NH4þ were evaluated for the first time in thirteen onsite household secondary wastewater treatment systems, including two compact biofilters followed by Filtralite-P filter units......, two biological sand filters, five horizontal subsurface flow and four vertical flow constructed wetlands. As expected, all systems removed TSS and BOD5 efficiently (>95% removal). The PPCP removal efficiencies exceeded 80% with the exception of carbamazepine, diclofenac and ketoprofen because of their...... more recalcitrant characteristics. Despite no statistical differences in the PPCP removal were observed between the different systems evaluated, the vegetated vertical flow constructed wetlands which had unsaturated flow and hence better oxygenation, appeared consistently to perform better in terms of...

  5. Identification and management of alcohol withdrawal syndrome.

    Science.gov (United States)

    Mirijello, Antonio; D'Angelo, Cristina; Ferrulli, Anna; Vassallo, Gabriele; Antonelli, Mariangela; Caputo, Fabio; Leggio, Lorenzo; Gasbarrini, Antonio; Addolorato, Giovanni

    2015-03-01

    Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as α2-agonists (clonidine and dexmetedomidine) and β-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptic agents can help control hallucinations. Finally, other medications for the treatment for AWS have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin and topiramate. The usefulness of these agents are discussed. PMID:25666543

  6. Treatment of anorexia nervosa with antidepressants.

    Science.gov (United States)

    Hudson, J I; Pope, H G; Jonas, J M; Yurgelun-Todd, D

    1985-02-01

    Nine patients with anorexia nervosa were treated with antidepressant medications from three classes: tricyclics, monoamine oxidase inhibitors, and triazolopyridines. A tenth patient was treated with the combination of lithium carbonate and carbamazepine. With either the initial or a subsequent medication trial, four patients had displayed significant improvement in weight and in other anorexic and bulimic symptoms. Three additional patients had a marked or moderate improvement in bulimic symptoms, one with moderate and two without any weight gain. Two other patients had moderate weight gain. Side effects were a significant problem in many of the patients. These preliminary results suggest that antidepressants may be of benefit in the treatment of some patients with anorexia nervosa. PMID:3919068

  7. Determinação simultânea de topiramato, carbamazepina, fenitoína e fenobarbital em plasma empregando cromatografia a gás com detector de nitrogênio e fósforo

    Directory of Open Access Journals (Sweden)

    Roberta Zilles Hahn

    2013-01-01

    Full Text Available Topiramate and the other frequently co-administered antiepileptic drugs carbamazepine, phenytoin and phenobarbital were determined in 100 µL plasma samples by gas chromatography with nitrogen phosphorus detection (GC-NPD, after a one-step liquid-liquid extraction with ethyl acetate, followed by flash methylation with trimethylphenylammonium hydroxide. Total chromatographic run time was 12.5 min. Intra-assay and inter-assay precision was 2.5-7.3% and 1.6-5.2%, respectively. Accuracy was 100.1-104.2%. The limit of quantitation was 1 µg mL-1 for all analytes, proving suitable for routine application in therapeutic drug monitoring of antiepileptic drugs.

  8. Multiple drugs poisoning resulting in ARDS

    Directory of Open Access Journals (Sweden)

    Ersagun Tuğcugil

    2014-09-01

    Full Text Available Inappropriate use of prescribed antidepressants and antipsychotics may frequently cause death due to cardiac complications. Lung complications are rare. We present a case of acute respiratory distress syndrome due to suicide attempt with quetiapine, carbamazepine, and clomipramine. The patient developed pulmonary edema and hypoxemia refractory to oxygen treatment. The patient died due to septic shock and multi-organ failure at the tenth day of intensive care treatment, despite recruitment maneuvers and lung-protective ventilation. Cases of allergic lung edema due to clomipramine are very rare in the literature. When considering the fact that all three drugs may elevate serum concentrations of each other, we are in opinion that the sinergistic effect of three drugs may be the cause. J Clin Exp Invest 2014; 5 (3: 466-468

  9. Microemulsion electrokinetic chromatography with on-line atmospheric pressure photoionization-mass spectrometric detection of medium polarity compounds.

    Science.gov (United States)

    Himmelsbach, Markus; Haunschmidt, Manuela; Buchberger, Wolfgang; Klampfl, Christian W

    2007-08-01

    In this paper, we present the determination of pharmaceuticals employing microemulsion electrokinetic chromatography (MEEKC) with atmospheric pressure photoionization-mass spectrometric (APPI-MS) detection. This recent hyphenated technique allows to overcome some disadvantages of MEEKC, namely its inherent incompatibility with MS detection. Important parameters like microemulsion (ME) composition, the composition of the sheath liquid and APPI-MS detection parameters have been investigated. Using the optimized set of parameters, the eight selected substances could be detected down to concentrations between 3 mg L(-1) (phenacetin) and 41 mg L(-1) (diltiazem). Switching to the MS2 mode, the use of specific transitions for the detection of each analyte provided improved detection limits in the range of 0.6 mg L(-1) (carbamazepine) to 6 mg L(-1) (metoprolol). Calibration curves were linear over one to two orders of magnitude with correlation coefficients better than 0.98. PMID:17416381

  10. The impact of onsite wastewater disposal systems on groundwater in areas inundated by Hurricane Sandy in New York and New Jersey.

    Science.gov (United States)

    Fisher, Irene J; Phillips, Patrick J; Colella, Kaitlyn M; Fisher, Shawn C; Tagliaferri, Tristen; Foreman, William T; Furlong, Edward T

    2016-06-30

    Coastal onsite wastewater disposal systems (OWDS) were inundated by Hurricane Sandy's storm tide. This study compares the shallow groundwater quality (nutrients, pharmaceuticals, and hormones) downgradient of OWDS before and after Hurricane Sandy, where available, and establishes a baseline for wastewater influence on groundwater in coastal communities inundated by Hurricane Sandy. Nutrients and contaminants of emerging concern (CECs) were detected in shallow groundwater downgradient of OWDS in two settings along the New Jersey and New York coastlines: 1) a single, centralized OWDS in a park; and 2) multiple OWDS (cesspools) in low-density residential and mixed-use/medium density residential areas. The most frequently detected pharmaceuticals were lidocaine (40%), carbamazepine (36%), and fexofenadine, bupropion, desvenlafaxine, meprobamate, and tramadol (24-32%). Increases in the number and total concentration of pharmaceuticals after Hurricane Sandy may reflect other factors (seasonality, usage) besides inundation, and demonstrate the importance of analyzing for a wide variety of CECs in regional studies. PMID:27261279

  11. A Case with Bilateral Periventricular Nodular Heterotopia Diagnosed as Depression

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2010-06-01

    Full Text Available Periventricular nodular heterotopia is a form of neuronal migration abnormality. Periventricular nodular heterotopia can easily be recognized by cranial magnetic resonance imaging. The most common clinical appearance is epileptic seizures. In some cases, symptoms are accompanied with psychiatric complaints. In this article, we report a 33-year-old female with complaints of left-sided paresthesia induced by emotional stress. She had been followed at an outpatient psychiatry clinic for about 10 years with the diagnosis of somatization disorder. Her electroencephalography recordings -awake as well as during sleep- were found to be normal. The cranial magnetic resonance imaging showed bilateral periventricular nodular heterotopia. Her seizures were controlled with carbamazepine treatment. Partial epileptic seizures might also be observed, even though the cerebral heterotopic lesions are bilateral. When a history is obtained from a patient with somatoform complaints, it should be kept in mind that these symptoms might be seizures, and the patient should be questioned accordingly.

  12. Evaluation of acute effects of four pharmaceuticals and their mixtures on the copepod Tisbe battagliai.

    Science.gov (United States)

    Trombini, Chiara; Hampel, Miriam; Blasco, Julián

    2016-07-01

    The individual and combined toxicities of acetaminophen, carbamazepine, diclofenac and ibuprofen have been examined in neonate nauplii (medium)/PNEC (predicted no effect concentration) ratios. Results suggest that, at environmental concentrations, none of the compounds is harmful for the aquatic environment (low or no risk). Toxicity data obtained for mixtures were compared with predictions derived from three different models: Concentration Addition (CA), Independent Action (IA) and Combination Index (CI). The classical modeling approaches CA and IA failed to predict the observed mixture toxicity, thus indicating that single compound toxicity data are not sufficient to predict toxicity of drug mixtures on Tisbe species. However, the use of the CI seems to provide better predictions of pharmaceutical toxicity. PMID:27135693

  13. The treatment of epilepsy in pregnancy: The neurodevelopmental risks associated with exposure to antiepileptic drugs.

    Science.gov (United States)

    Bromley, R

    2016-09-01

    A number of antiepileptic drugs (AEDs) have been confirmed as teratogens due to their association with an increased malformation rate. The majority of research to date does not find an association between prenatal exposure to monotherapy carbamazepine, lamotrigine or phenytoin and neurodevelopmental outcome in comparison to control children and noted higher abilities in comparison to children exposed to valproate; but further work is needed before conclusions can be drawn. Data for levetiracetam was limited to one study, as was the evidence for topiramate. Sodium valproate exposure appeared to carry a dose dependent risk to the developing brain, with evidence of reduced levels of IQ, poorer verbal abilities and increased rate of autistic spectrum disorder both in comparison to control children and children exposed to other AEDs. The severity of the neurodevelopmental deficits associated with prenatal exposure to valproate highlight the critical need to consider neurodevelopmental outcomes as a central aspect of teratological research. PMID:27312074

  14. Cochlear implantation in a patient with grand mal epilepsy.

    Science.gov (United States)

    Szilvassy, J; Czigner, J; Somogyi, I; Jori, J; Kiss, J G; Szilvassy, Z

    1998-06-01

    A case is reported in which a Nucleus 22 channel intracochlear implant was used to treat a deaf Hungarian woman (aged 37 years) with a 34-year history of grand mal (GM) epilepsy maintained on carbamazepine-diazepam combination therapy who had not benefited from conventional hearing aids. Pre-operative electrical stimulation of the acoustic nerve, however, exhibited a good nerve function with no evidence of abnormal waveforms in the electroencephalogram (EEG). Successful intracochlear insertion of the 22 electrode resulted in a 40 dB hearing improvement at frequencies 250-2000 Hz in the implanted ear with no signs of pathologic wave activity at either the previously recognized epileptic focus (fronto-precentral region) or indeed, in other regions of the brain at use of the implant. We conclude that intracochlear implantation per se is not a hazardous intervention in patients with fronto-precentral epileptic foci. PMID:9764299

  15. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    International Nuclear Information System (INIS)

    A 9 1/2-year-old girl suffered from intermitting tremor and jitteriness of her left hand and oral muscles every 4 to 6 weeks with long lasting episodes. Clinically myoclonias and dystonic positioning of the left arm, hand and facial muscles were seen. No evidence of trauma, infection or inborn errors of metabolism was found. Successful therapy with carbamazepine was initiated while L-DOPA failed. An ictal 99m-Tc-HMPAO-SPECT showed severe asymmetry with focal hyperperfusion of the contralateral right thalamus and basal ganglia as well as of the bifrontal cortex, whereas no anatomical lesions were found by MRI. In contrast, an interictally performed 99m-Tc-HMPAO SPECT showed hypoperfusion or the right thalamus and normalisation of the frontal perfusion under medical treatment. These 99m-Tc-HMPAO-SPECT findings may provide new insights into the localisation and pathophysiological pathways of idiopathic childhood dystonia. (orig.)

  16. Plant uptake of pharmaceutical chemicals detected in recycled organic manure and reclaimed wastewater.

    Science.gov (United States)

    Tanoue, Rumi; Sato, Yuri; Motoyama, Miki; Nakagawa, Shuhei; Shinohara, Ryota; Nomiyama, Kei

    2012-10-17

    Land application of recycled manure produced from biosolids and reclaimed wastewater can transfer pharmaceutical chemicals to terrestrial environments, giving rise to potential accumulation of these residues in edible plants. In this study, the potential for plant uptake of 13 pharmaceutical chemicals, and the relation between the accumulation features within the plant and the physicochemical properties were examined by exposing pea and cucumber to an aqueous solution containing pharmaceutical chemicals. Ten of 13 compounds tested were detected in plant leaves and stems. Comparison of the plant uptake characteristics and the octanol-water partition coefficient of pharmaceutical chemicals showed that compounds with an intermediate polarity such as carbamazepine and crotamiton could be easily transported to plant shoots. Moreover, these results suggest the possibility of highly hydrophilic pharmaceutical chemicals such as trimethoprim and sulfonamides to be accumulated in plant roots owing to their low permeability in root cell membranes. PMID:23003104

  17. Non-chemotherapy drug-induced agranulocytosis.

    Science.gov (United States)

    Garbe, Edeltraut

    2007-05-01

    Acute agranulocytosis is a rare, potentially life-threatening condition, which is attributable to drugs in > 70% of cases. Agranulocytosis is characterised by a peripheral neutrophil count clozapine, ticlopidine, sulfasalazine, dipyrone, trimethoprim/sulfamethoxazole, carbamazepine and probably rituximab. Suspect drugs should be stopped immediately. In febrile patients, blood cultures and, where indicated, site-specific cultures should be obtained and treatment with empirical broad spectrum antibiotics started. Haematopoietic growth factors should be considered in patients with poor prognostic factors (e.g., a neutrophil count < 0.1 x 10(9)/l), severe clinical infection or severe underlying disease or comorbidity. Case fatality has decreased to ~ 5% in recent years, probably owing to improved intensive care treatment and increased alertness of physicians to this severe adverse reaction. PMID:17480181

  18. Drug interactions with selective serotonin reuptake inhibitors, especially with other psychotropics.

    Science.gov (United States)

    2001-02-01

    (1) Selective serotonin reuptake inhibitors (SSRIs) are involved in many drug interactions with potentially serious clinical consequences. (2) These interactions involve all SSRIs but particularly fluoxetine, which is the best-studied antidepressant in this family. (3) Because of their long elimination half-life (particularly fluoxetine) the risk of interactions persists for several days or even weeks after SSRI withdrawal. (4) Drug interactions with clinical consequences usually involve combinations of an SSRI with other psychotropics, especially monoamine oxidase inhibitor (MAOI) and tricyclic antidepressants, clozapine, lithium, methadone, etc. (5) The clinical consequences of drug interactions with SSRI are either due to overdosing of the drug combined, or to a serotonin syndrome with neuromuscular and vegetative (autonomic) symptoms. (6) Interactions with a number of other drugs have been reported, especially carbamazepine, phenytoin and oral anticoagulants, with a risk of overdose of these drugs. (7) The risk of hyponatraemia linked to SSRIs seems to be increased during concomitant treatment with diuretics. PMID:11503857

  19. [Psychopharmacological treatment of bipolar disease].

    Science.gov (United States)

    Licht, Rasmus W; Vestergaard, Per

    2002-05-01

    This paper gives an update on the psychopharmacological treatment of bipolar disorder. The antimanic efficacy of lithium is well documented. The same applies to valproate, which is also efficacious in mixed mania. Conventional antipsychotics act fast in mania and do not require blood tests, but they have considerable neurological side effects. The newer antipsychotics, olanzapine, risperidone, and ziprasidone, have also been shown to have antimanic efficacy. Clozapine is extremely effective, also when other treatment fails. For the treatment of bipolar depression, lithium, lamotrigine, and antidepressants all seem to work, but antidepressants may sometimes precipitate mania or worsen the course of illness. For prophylaxis, lithium is still to be considered the first drug of choice. However, for several reasons, for instance treatment failure or side effects, long-term treatment with antiepileptics may often be necessary. Among the antiepileptics, carbamazepine, valproate, and lamotrigine are the best studied. PMID:12025705

  20. A influência da piperina na biodisponibilidade de fármacos: uma abordagem molecular

    Directory of Open Access Journals (Sweden)

    Ramon G. de Oliveira

    2014-01-01

    Full Text Available Piperine is the major alkaloid of Piper nigrum Linn., used as a spice and in folk medicine. We present a molecular docking study supporting experimental data on the enhancement in bioavailability of propranolol, theophylline, phenytoin, nevirapine, nimesulide, pyrazinamide, carbamazepine, and spartein in the presence of piperine. The complex formed with piperine and CYP3A4 was shown to be the most stable of all, with a binding energy of -8.60 kcal/mol. This explains the related mechanism of drug-herb interaction, since the better anchoring of piperine in the active site of CYP3A4 can hinder the drug-enzyme interaction, thereby increasing the bioavailability of the drugs studied.