Antiepileptic drug utilization Author: Kateřina Stuchlíková Supervisor: PharmDr. Eva Zimčíková, Ph.D. Department of Social and Clinical Pharmacy Faculty of Pharmacy in Hradec Králové, Charles University, Czech Republic Introduction: Antiepileptics (AEDs) are drugs that prevent the development of epileptic seizures. Objective: The objective of this diploma thesis was to evaluate the utilization of AEDs in the Czech Republic in the period from 01. 01. 2004 to 31. 12. 2018 using data from the State Institute for Drug Control (SIDC). Methods: Retrospective analysis of drug utilization data. Data on the utilization of antiepileptic drugs were received from the SIDC database and included all AEDs that were distributed to medical facilities during the reporting period. The relative comparative unit DID was calculated - the number of defined daily doses per 1000 inhabitants per day. The data on the number of residents were obtained from the Czech Statistical Office. Results: Consumption of antiepileptics has increasing trend. During the period it increased from 7.43 DID to 15.87 DID. Especially in the group of new antiepileptics an increase was observed, where 1.15 DID raised to 10.59 DID, while in the classical antiepileptic group this value decreased from 6.28 DID to 5.28 DID. The most frequently used...

In mehreren Studien wurden Veränderungen des Medikamentenmetabolismus von Psychopharmaka durch entzündliche Prozesse beschrieben. Diese Effekte können zu Therapieversagen oder sogar gravierenderen unerwünschten Arzneimittelwirkungen führen. Aus diesem Grund haben wir untersucht, ob im Laufe inflammatorischer Prozesse eine Veränderung der Medikamentenserumkonzentration der Stimmungsstabilisatoren Valproat (VPA), Lamotrigin (LTG) oder Carbamazepin (CBZ) auftritt. / Alterations in drug metabolism due to inflammation are reported for several psychotropic drugs. These effects may lead to treatment failure or even severe side effects. Therefore, we investigated whether there are alterations in drug serum concentration of the mood stabilizers valproate (VPA), lamotrigine (LTG) and carbamazepine (CBZ) during inflammatory activity.

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Lucie Chaloupková Supervisor: Prof. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Treatment of epilepsy Epilepsy is a serious chronic disease affecting all ages which can be characterized by recurrent epileptic attacks. It affects about 1,3-4 % of the population and endangers the patient's life at every incoming attack. Long-term treatment must be preceded by thorough diagnosis and classification of the disease, which can be very difficult. The aim of the treatment is to prevent recurrent epileptic attacks, or at least mitigate them while minimizing the side effects of the treatment and reducing the negative impact on the quality of life. When choosing a suitable drug for an adult, the doctor usually decides individually depending on the type of epileptic attack. In children, the choice of the treatment often depends on the diagnosed type of syndrome, which appears more in the lower age category than in adult patients. The doctor should follow expert standards of the treatment of epilepsy, and also their own most recent experience and knowledge gained during the course of lifelong learning. The therapy begins with monotherapy, and only when not successful, it is necessary to...

Analysis of spontaneous adverse events reports of antiepileptic drugs Author: Ivana Šoborová Supervisor: PharmDr. Eva Zimčíková, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction: Epilepsy is one of the most common neurological diseases, which occurs worldwide. Antiepileptic drugs (AED) suppress the onset of an epileptic seizure. Analysis of spontaneous adverse drug reactions (ADRs) analysis is important data source for generating the potential risks signals in pharmacotherapy. Objective: The aim of this work was to analyse spontaneous reports of ADRs from the Czech Central Database of ADRs of the State Institute for Drug Control (SÚKL) in the period from June 2004 to October 2017. The analyses of potential drug interactions of all medicinal products mentioned in the reports and the assessment of the reported ADRs expectability was the secondary goal. Methods: Retrospective analyses of the spontaneous ADR reports of antiepileptic drugs obtained from the SÚKL in the given period. Anonymized data was processed using the descriptive statistics in MS Excel. For example, the patient characteristics or seriousness and expectability of the ADRs were evaluated. The specific adverse drug reactions were divided according to the system...

Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Biological and medicinal sciences Candidate Karolína Arnošová Consultant doc.MUDr. Josef Herink DrSc. Title of thesis Adverse effects of epilepsy medication in children The aim of this thesis was to determine the most commonly used antiepileptics in children, its adverse effects and to compare these results with the adult epileptology. In the theoretical part there are etiopathogenesis, pathophysiology, clinical manifestation, types of the seizures and epileptic syndromes described. The specifics of epilepsy treatment in children, not only pharmacotherapy, but also non-pharmacological treatment options, were documented as well. In the study there was exact half of patients treated with monotherapy and the other half with combined therapy which is not in line with the original hypothesis that assumed a predominance of monotherapy. The most commonly used antiepileptics in children were valproate (62,5 %), lamotrigine (25 %), topiramate and levetiracetame (both in 18,75 %). The hypothesis assuming a higher incidence of adverse effects in combination therapy has been confirmed. The most common adverse effects in children were the effects on total daily activity, occuring in 83,33 %, even with the mildest score on average....

Bakgrund: I Sverige förekommer epilepsi hos 1-2 % av alla hundar. De första anfallen visar sig oftast när hunden är mellan ett och sex år gammal. Det nuvarande förstahands­preparatet är fenobarbital, en substans som ökar tröskeln för elektrisk stimulering av motorcortex samt minskar monosynaptisk transmission som leder till minskad neuronal retbarhet. I februari 2013 registrerades ett nytt antiepileptikum med det verksamma äm­net imepitoin. Imepitoin är en partiell agonist som binder till bensodiazepinsätet på GABAA-receptorn. Det förstärker de GABAA-receptormedierade effekterna på neuro­nen samt har en svag kalciumblockerande verkan. Syfte: Arbetets syfte var att undersöka om imepitoin har förutsättningar att bli det nya förstahandspreparatet vid behandling av idiopatisk epilepsi. Vidare var syftet att under­söka i vilken utsträckning imepitoin fungerar som antiepileptikum samt vilken biverk­ningsprofil det har. Resultat: Behandling med imepitoin gav en sänkning av antalet epileptiska anfall per månad (MSF), liknande den som erhölls vid fenobarbitalbehandling. Imepitoin sänkte MSF både som monoterapi och i kombination med fenobarbital eller kaliumbromid. Biverkningsprofilen var överlag skonsammare för imepitoin jämfört med fenobarbital. Fenobarbital visade en leverpåverkan medan imepitoin påverkade kolesterolvärdet. Slutsats: Imepitoin har en antiepileptisk effekt, liknande den som fås vid behandling med fenobarbital. Behandling med imepitoin kan ske både som mono- samt kombina­tionsterapi. Den mildare biverkningsprofilen talar för användning av imepitoin. Samti­digt har fenobarbital använts under en längre tid så biverkningar vid långtids­användning är mer välkända än de vid imepitoinanvändning. / Background: In Sweden, approximately 1-2 % of all dogs suffer from epilepsy. The first seizures often occur when the dog is between one and six years old. In Sweden the first-line drug is phenobarbital, a substance which increases the threshold of electrical stimulation in the motor cortex. It also decreases synaptic transmission which leads to decreased neuronal excitability. In February 2013 a new antiepileptic drug was regis­tered with imepitoin as active substance. Imepitoin is a partial agonist which binds to the benzodiazepine binding site at the GABAA receptor and amplifies the effects medi­ated by GABAA receptors at the neurons. Additionally, imepitoin has a weak calcium channel blocking effect. Objective: The main aim of the study was to examine if imepitoin should be the first-line drug instead of phenobarbital when treating dogs diagnosed with idiopathic epi­lepsy. A further aim was to look into which effect imepitoin had in controlling the epilepsy and which adverse effects were experienced when dogs are treated with imepitoin. Results: Treatment with imepitoin resulted in a decrease in monthly seizure frequency (MSF), similar to the decrease seen upon treatment with phenobarbital. Imepitoin was decreasing MSF both when used as monotherapy and in combination with phenobarbital or potassium bromide. The adverse effects were in general less severe with imepitoin than with phenobarbital. Treatment with phenobarbital affected the liver while treatment with imepitoin affected the cholesterol levels. Conclusion: Imepitoin has a good antiepileptic effect, similar to that of phenobarbital. Treatment with imepitoin can be used both as monotherapy and in combination with other antiepileptic drugs. Less severe adverse effects makes imepitoin a possible choice for treating idiopathic epilepsy in dogs. On the other hand, phenobarbital has been used during a long period of time and adverse effects of long term use are therefore better known than for imepitoin.

No description available.

Die Bedeutung des Immunsystems in der Pathophysiologie von bipolaren Erkrankungen und Epilepsie ist ein aktueller Gegenstand der neuropsychoimmunologischen Forschung. Eine erhöhte Produktion von Zytokinen aufgrund von oxidativem Stress wurde dabei wiederholt als für die Pathophysiologie von Epilepsie und Bipolarer Störung relevant angesehen. In Hinblick auf Veränderungen der Zytokine Interleukin (IL)-1ß, IL-2, IL-4, IL-6 und Tumornekrosefaktor-alpha (TNF-α) wurden z. T. überlappende Ergebnisse bei beiden Erkrankungen beschrieben. Inwiefern diese Zytokine durch Stimmungsstabilisierer und Antiepileptika beeinflusst werden, wurde bisher jedoch nicht systematisch untersucht. In dieser Studie wurden systematisch in-vitro die Konzentrationen von IL-1ß, IL-2, IL-4, IL-6, IL-17, IL-22 und TNF-α im stimulierten Blut 14 gesunder Frauen mittels Vollblutverfahren (whole blood assay) nach Zugabe von Stimmungsstabilisierern bzw. Antiepileptika gemessen. Es wurden dabei die Stimmungsstabilisierer bzw. Antiepileptika Primidon, Carbamazepin, Levetiracetam, Lamotrigin, Valproat, Oxcarbazepin, Topiramat, Phenobarbital und Lithium untersucht. Die Ergebnisse lassen darauf schließen, dass der Mechanismus von erwünschter und unerwünschter anderer Wirkung von Stimmungsstabilisierern und Antiepileptika mit der Regulation von IL-1ß, IL-2, IL-22 und TNF-α in Zusammenhang stehen könnte. Getrennt nach den im Vollblutverfahren verwendeten Stimulanzien – Toxic-Shock-Syndrome-Toxin-1 (TSST-1) vs. monoklonaler Antikörper gegen das CD3-Oberflächenantigen (OKT3) in Kombination mit dem 5C3-Antikörper gegen CD40 (OKT3/CD40) – wurden die Ergebnisse in zwei unterschiedlichen Publikationen berichtet, die dieser Promotion zugrunde liegen.

Jakub Žalud PhDr. Alena Javůrková Ph.D. adverse effects of antiepileptics, their classification and expression from the patient's subjective assumption was that the patient's experience of the adverse effects of antiepileptic drugs will significant overall (p˂0.05; R2 = 0.20). ts was not statistically significant (p˃0.05; R2 = 0.21). (p˃0.05; R2 = 0.16).

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Science Author: Marcela Čuchalová Supervisor: doc. MUDr. Josef Herink, DrSc. Title of diploma thesis: The hypothalamic - pituitary - gonadal axis and epilepsy: mutual relationships The content of the diploma thesis is an overview of the anatomy and physiology of the hypothalamic-pituitary-gonadal axis (HHG). Further chapters are devoted to the influence of epilepsy on HHG function, the effect of HHG hormones on epileptic activity itself. The effect of anti-epileptics on HHG functions will also be elucidated. The second part of the diploma thesis deals with separate chapters - catamenial epilepsy and epilepsy during pregnancy. Keywords: antiepileptic drugs, gonadotropin, hypothalamic-pituitary-gonadal axis, prolactin, sex hormones, temporal lobe epilepsy.