Carbamazepine idiosyncratic drug. Medical search. Frequent questions

In 1940, phenytoin (PHT) was found to be an effective drug for the treatment of epilepsy, and since then it has become a major first-line antiepileptic drug (AED) in the treatment of partial and secondarily generalized seizures. (medscape.com)
5) pattern is associated with drugs such as carbamazepine, lamotrigine, phenytoin and sulfonamides (4). (bsg.org.uk)
Lamotrigine was equally effective but better tolerated than phenytoin and carbamazepine in several somewhat under-powered studies. (pocketdrugguide.com)
If the patient is receiving valproate at the time of initiation, starting doses and doses during titration should be cut in half, whereas if they are receiving enzyme-inducing anti-epileptic drugs such as phenytoin, carbamazepine or phenobarbital, doses can be doubled. (pocketdrugguide.com)
The metabolism of bazedoxifene may be increased by concomitant use of substances known to induce UGTs, such as rifampin, phenobarbital, carbamazepine, and phenytoin. (pfizermedicalinformation.com)

In 1910, phenobarbital (PHB), which then was used to induce sleep, was found to have antiseizure activity and became the drug of choice for many years. (medscape.com)
Inducers of CYP3A4, such as St. John's Wort (Hypericum perforatum) preparations, phenobarbital, carbamazepine, and rifampin, may reduce plasma concentrations of some estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. (pfizermedicalinformation.com)

All penicillins - idiosyncratic Sulfonamide antibiotics - idiosyncratic Tricyclic antidepressants - idiosyncratic Mycotoxins Hepatotoxicity Nephrotoxicity Neurotoxicity Ototoxicity Vardanyan, R. S., and Victor J. Hruby. (wikipedia.org)
Caution should be used if [NT005 trade name] is given to patients with liver disease, since albendazole is metabolised by the liver and has been associated with idiosyncratic hepatotoxicity. (who.int)
The LiverTox site is meant as a resource for both physicians and patients as well as for clinical academicians and researchers who specialize in idiosyncratic drug induced hepatotoxicity. (nih.gov)
Review Hepatotoxicity by Drugs: The Most Common Implicated Agents. (nih.gov)

Idiosyncratic (type B) hepatotoxic reactions are unpredictable, independent of dose, and appear to be determined by the individual exposed. (wikipedia.org)
The use of diethylcarbamazine eye drops for treatment of ocular onchocerciasis produces dose-related inflammatory reactions similar to those seen with systemic use of the drug. (entokey.com)
9 Only three drugs - paracetamol, erythromycin and carbamazepine - have been associated with overdose pancreatitis in children, while most of the reactions appear to be idiosyncratic and therefore unpredictable, non-dose-dependent and with low incidence. (pharmaco-vigilance.eu)
Clinical diagnosis of adverse drug reactions and patient management are complex, interwoven processes. (springer.com)
Clinical information and experiences about individual patients will aid prevention of adverse drug reactions. (springer.com)
Adverse effects and adverse drug reactions constitute major morbidity and sometimes mortality, but how to make a diagnosis and manage adverse drug effects in an individual to avoid or reduce serious harm does not receive much attention. (springer.com)
In some more unusual instances, adverse drug reactions may be more commonly related to drug or chemical exposure than to alternative possible causes (such as agranulocytosis or Stevens-Johnson syndrome), making the diagnostic challenge somewhat easier. (springer.com)
Pharmacogenetics to prevent hypersensitivity reactions to antiepileptic drugs: is testing performed when indicated? (cdc.gov)
Updates on the immunopathology and genomics of severe cutaneous adverse drug reactions. (cdc.gov)
A Comprehensive Review of HLA and Severe Cutaneous Adverse Drug Reactions: Implication for Clinical Pharmacogenomics and Precision Medicine. (cdc.gov)
Genotyping HLA alleles to predict the development of Severe cutaneous adverse drug reactions (SCARs): state-of-the-art. (cdc.gov)
Pharmacogenetic Testing for Prevention of Severe Cutaneous Adverse Drug Reactions. (cdc.gov)
Genetic Variants Associated with T-Cell Mediated Cutaneous Adverse Drug Reactions: A Prisma-Compliant Systematic Review - an EAACI Position Paper. (cdc.gov)
Pharmacogenomic Advances in the Prediction and Prevention of Cutaneous Idiosyncratic Drug Reactions. (cdc.gov)
Association of HLA-A*31:01 Screening With the Incidence of Carbamazepine-Induced Cutaneous Adverse Reactions in a Japanese Population. (cdc.gov)
This was designed to detect genetic components of clinically important disorders that require an environmental trigger to occur, e.g. severe drug reactions, pain syndromes occurring after an injury, and susceptibility to infection. (biomedcentral.com)
Rare, idiosyncratic reactions may deter patients from getting an otherwise useful drug, especially when the population at risk cannot be accurately defined. (veracuity.com)
Most medication reactions occur in the first 2-6 weeks of taking the drug. (goldenberglaw.com)
Although there is not yet a consensus in the scientific community about exactly what happens in the body as a person develops SJS, one theory suggests that the cutaneous (skin) reactions account for the majority of the effects after an idiosyncratic reaction (adverse reactions that develop mostly unpredictably) to a medication has occurred. (goldenberglaw.com)

reported that 13.5% of pancreatitis cases (7/52) were attributable to drugs, 4 of which were treated with valproic acid. (pharmaco-vigilance.eu)
Drugs with this characteristic include valproic acid, carbamazepine, and the beta-lactam antibiotics. (orthopedicshealth.com)
Valproic acid has long proven to be an effective drug for treating epilepsy and has been prescribed to pregnant women with epilepsy ever since. (ashdin.com)
Concerns about valproic acid and its teratogenic risks has led many women to discontinue their antiepileptic medication either before pregnancy or early in their pregnancy Even though it is highly recommended to minimize or even discontinue valproic acid use in pregnancy, but in some cases, the risks of discontinuing this drug may outweigh the benefits. (ashdin.com)
Using valproic acid during pregnancy for epilepsy patients is a growing problem where patients and doctors will be faced with a situation where they must consider in detail the benefits and risks of using this drug. (ashdin.com)
The Food and Drug Administration (FDA) authorized valproic acid in 1978 as a monotherapy and as an additional therapy for various types of seizures which can also be used to treat bipolar disorder and prevent migraines [ 2 ]. (ashdin.com)
A study in the United Kingdom showed that out of all antiepileptic drugs that have been prescribed to pregnant women, about 25% are valproic acid [ 8 ]. (ashdin.com)
Despite being aware of its teratogenic risk, valproic acid was still prescribed to 20% of pregnant epileptic women between the year 1999 and 2004, according to data from EURAP (International Registry of Anti-Epileptic Drugs and Pregnancy) [ 9 , 10 ]. (ashdin.com)

Idiosyncratic drug-induced liver injury (DILI) is an unpredictable type of liver injury following exposure to medication within the recommended dose which is distinctive from liver injury caused by drug overdosage, commonly caused by paracetamol overdose (POD). (bsg.org.uk)

Idiosyncratic toxicities, on the other hand, are much less predictable and much more insidious. (veracuity.com)
This approach avoids potential drug side effects and toxicities and has shown long-term persistence in treating chronic insomnia that can be superior to results obtained using drug therapies (Morin 2005 ). (springer.com)

Practice guideline update: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy. (msdmanuals.com)
If seizures are intractable (refractory to an adequate trial of ≥ 2 drugs), patients should be referred to an epilepsy center to determine whether they are candidates for surgery. (msdmanuals.com)
See also Seizure Disorders in Pregnancy , Women's Health and Epilepsy , Antiepileptic Drugs , and Neural Tube Defects . (medscape.com)
Aim: The incidence of pediatric epilepsy ranges between 1-3%, and various anticonvulsant drugs are used in its treatment. (jsurgmed.com)
Guerrini R, Zaccara G, la Marca G, Rosati A. Safety and tolerability of antiepileptic drug treatment in children with epilepsy. (jsurgmed.com)
Lamotrigine is a broad-spectrum anti-epileptic drug that has been widely accepted as a first-line drug for both partial and generalized epilepsy syndromes. (pocketdrugguide.com)
A recent very large, randomized open-label study indicated that lamotrigine might be the drug of choice in patients with partial epilepsy, as it was equally effective but better tolerated, but in a companion study it was substantially less effective than valproate in patients with generalized or unclassified epilepsy. (pocketdrugguide.com)
Cost-effectiveness of screening for HLA-B*1502 prior to initiation of carbamazepine in epilepsy patients of Asian ancestry in the United States. (cdc.gov)

Use of multiple drugs should be avoided if possible because incidence of adverse effects, poor adherence, and drug interactions increases significantly. (msdmanuals.com)
Adding a second drug helps about 10% of patients, but incidence of adverse effects more than doubles. (msdmanuals.com)
It is not considered to be a first-line drug because of its potential for serious idiosyncratic side-effects, including potentially fatal aplastic anaemia (incidence of 1 in 3000) and hepatic failure (incidence of 1 in 10000). (pocketdrugguide.com)

Acquired agranulocytosis is a rare, drug-induced blood disorder that is characterized by a severe reduction in the number of white blood cells (granulocytes) in the circulating blood. (orthopedicshealth.com)
Acquired agranulocytosis may be caused by a variety of drugs. (orthopedicshealth.com)
Acquired agranulocytosis is almost invariably caused by exposure to drugs and/or chemicals. (orthopedicshealth.com)
A variety of drugs can cause acquired agranulocytosis and neutropenia by destroying special cells in the bone marrow that later mature and become granulocytes (precursors). (orthopedicshealth.com)
In rare cases of acute acquired agranulocytosis, destructive action of certain white blood cell antibodies (leukocyte isoantibodies) may be induced by certain drugs such as phenylbutazone, gold salts, sulfapyridine, aminopyrine, meralluride, and dipyrine. (orthopedicshealth.com)
The treatment of acquired agranulocytosis includes the identification and elimination of drugs or other agents that induce this disorder. (orthopedicshealth.com)

No single drug controls all types of seizures, and different patients require different drugs. (msdmanuals.com)
A single drug, usually the first or second one tried, controls epileptic seizures in about 60% of patients. (msdmanuals.com)
If seizures are difficult to control from the outset (in 30 to 40% of patients), ≥ 2 drugs may eventually be required. (msdmanuals.com)
The appropriate dose of any drug is the lowest dose that stops all seizures and has the fewest adverse effects, regardless of blood drug level. (msdmanuals.com)
Determine the drug dose using clinical criteria (the lowest dose that stops seizures and has the fewest adverse effects), regardless of blood levels. (msdmanuals.com)
Then, another drug is added at a low dose, which is gradually increased until seizures are controlled. (msdmanuals.com)
Once seizures are controlled, the drug should be continued without interruption until patients have been seizure-free for at least 2 years. (msdmanuals.com)
Ethosuximide has been used since 1958 as a first-choice drug for the treatment of absence seizures without generalized tonic-clonic seizures. (medscape.com)
It became the drug of choice in primary generalized epilepsies and in the mid 1990s was approved for treatment of partial seizures. (medscape.com)
Yet, felbamate may still be an important drug in the armamentarium for refractory patients, because it may control seizures when other drugs fail, and tends to be alerting rather than sedating. (pocketdrugguide.com)
Drugs used to prevent SEIZURES or reduce their severity. (childrensmercy.org)

Risk is increased for children under 16, and is also more common with concomitant valproate use, and in patients who have experienced rash on other anti-epileptic drugs. (pocketdrugguide.com)
e.g. concomitant use of carbamazepine and CLZ, two drugs recognized to induce neutropenia). (dot1linhibitor.com)
Concomitant use may enhance drug efficacy by mobilizing hepatic stores and elevating plasma concentrations, particularly in very-low-birth-weight (VLBW) neonates with bronchopulmonary dysplasia. (interactionsguide.com)

Several studies indicated that lamotrigine is better tolerated than carbamazepine in the elderly. (pocketdrugguide.com)
Initiation of lamotrigine is somewhat more complex than for other drugs. (pocketdrugguide.com)

Drug-induced death of the filaria can result in a severe allergic reaction due to the release of foreign protein. (entokey.com)
Provision of adverse drug reaction information must be timely, and relevant to support busy health professionals in their consultations. (springer.com)
An 'adverse drug reaction' (ADR) is the clinical response of a patient to a drug, defined here as "An appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention or specific treatment, or alteration of the drug regimen, or withdrawal of the product" [ 1 ]. (springer.com)
Some drugs cause this reaction in anyone given large enough doses. (orthopedicshealth.com)
Other drugs may cause the reaction in one person but not in another (idiosyncratic). (orthopedicshealth.com)

Other serious idiosyncratic adverse events include rash and Stevens-Johnson syndrome. (pocketdrugguide.com)
However, may get SJS/idiosyncratic rash. (erexam.org)
Genetic testing for prevention of severe drug-induced skin rash. (cdc.gov)

Pearls of antiepileptic drug use and management. (medscape.com)

Drugs that are highly protein bound (e.g. sulfonamides/warfarin) will displace it. (erexam.org)

While this is a limited-use drug and most of the data are from the older literature, the basic ingredient in ipecac is emetine hydrochloride, which is used off label to induce vomiting in patients with anorexia nervosa. (entokey.com)
Other drugs that interfere with, or inhibit, granulocyte colony formation may induce agranulocytosis. (orthopedicshealth.com)
Sleep hygiene refers to environmental factors, dietary approaches, drugs, and a lack of required sleep facilitating approaches that can induce insomnia. (springer.com)

Physicians should be aware of all potential drug-drug interactions before prescribing a new drug. (msdmanuals.com)
Antiepileptic drugs should be used carefully, with consideration of medication interactions and potential side effects. (medscape.com)
Due to system maintenance, the drug interactions feature you are attempting to access is temporarily unavailable. (medscape.com)

Once drug response is known, following the clinical course is more useful than measuring blood levels. (msdmanuals.com)
It is important to understand the mechanisms of action and the pharmacokinetics of antiepileptic drugs (AEDs) so that these agents can be used effectively in clinical practice, especially in multidrug regimens (see the image below). (medscape.com)
Liver biopsy and HLA genotyping can help clinical management by differentiating DILI from AIH and excluding DILI secondary to certain drugs. (bsg.org.uk)
I. Drugs in preclinical and early clinical development. (jsurgmed.com)
Real-time clinical note monitoring to detect conditions for rapid follow-up: A case study of clinical trial enrollment in drug-induced torsades de pointes and Stevens-Johnson syndrome. (cdc.gov)
Clinical trials cannot detect all adverse drug events due to the limited population in which the drugs are being tested and the incomplete definition of an adverse safety outcome that would be clinically predictive. (veracuity.com)
As the cost of genomic testing decreases, routine screening for genes responsible for drug toxicity should become a routine part of clinical practice. (veracuity.com)
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. (nih.gov)

The mechanisms of damage can be different: immune-mediated or hypersensitivity, direct drug, inflammatory or mitochondrial toxicity. (pharmaco-vigilance.eu)

Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. (nih.gov)

Pathways of carbamazepine bioactivation in vitro. (childrensmercy.org)
In vitro data suggest that bazedoxifene is unlikely to interact with co-administered drugs via CYP-mediated metabolism. (pfizermedicalinformation.com)

Some drugs become toxic when co-administered with enzyme inhibitors. (veracuity.com)

Her physicians should review her current medications for their teratogenic potential, and drugs that pose a significant teratogenic risk should be discontinued if possible. (medscape.com)
At least 2 systems are used to classify the risk associated with specific medications: the US Food and Drug Administration (FDA) system and the automated Teratogen Information System (TERIS). (medscape.com)
However, among the drugs to which a patient may be sensitive are several used in the treatment of cancer (cancer chemotherapeutic agents) and others used as antipsychotic medications (e.g., clozapine). (orthopedicshealth.com)
Sedatives and other medications used off-label for sedative side-effects are a contributing factor to drug induced hypersomnolence, a factor in more than 30% of motor accident deaths. (springer.com)

Some adverse drug events are a predictable consequence of therapeutic, especially dosing failures. (veracuity.com)

Verrotti A, Coppola G, Parisi P. Bone and calcium metabolism and antiepileptic drugs. (jsurgmed.com)
Felbamate has a complex metabolism and elimination, by both the hepatic and renal routes, and inhibits the metabolism of some drugs while inducing others. (pocketdrugguide.com)
Treatment of moderate to severe vasomotor symptoms due to menopause )  Treatment of moderate to severe symptoms of vulvar and vaginal atrophy due to Limitation of Use: When prescribing solely for the treatment of moderate to severe Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism. (gotomydoctor.com)

The initial drug is then slowly tapered and eventually withdrawn completely. (msdmanuals.com)

[ 3 ] Major causes of acquired neutropenia are infection, drugs (through direct toxicity or immune effects), and autoimmunity. (medscape.com)

Drug-induced liver injury should be considered in any acute liver injury or jaundice without evidence of biliary obstruction. (bsg.org.uk)
Following a large national audit in the UK of 881 consecutive patients admitted with jaundice, where a biliary obstruction was ruled out by imaging, idiosyncratic DILI was the second most common cause of liver injury (15% of cases) after alcoholic liver disease (2). (bsg.org.uk)
Another common strategy is regular monitoring of liver function tests to prevent drug-induced liver injury. (veracuity.com)
An electronic medical records-based approach to identify idiosyncratic drug-induced liver injury in children. (childrensmercy.org)
Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. (nih.gov)
The information in LiverTox is not meant as a substitute for FDA approved product labeling and professional judgment in the diagnosis and treatment of drug induced liver injury. (nih.gov)
Review The Evolving Profile of Idiosyncratic Drug-Induced Liver Injury. (nih.gov)

Drug levels maybe useful, and serum concentrations of 30-80mg/1 are recommended. (pocketdrugguide.com)

Because long-term quinolone exposure has been shown to result in accumulation of the drug in pigmented tissues, retinal degenerative changes may be observed. (entokey.com)
Emetine hydrochloride is somewhat unique in that somewhere between 4-10 hours after exposure in humans, the drug is probably secreted in the tears to give significant bilateral foreign-body sensation, epiphoria, photophobia, lid edema, blepharospasm and conjunctival hyperemia. (entokey.com)
It is much more difficult to decide on the diagnosis in an individual when other causal probabilities are more likely than a drug, and when actual evidence that exposure to a particular drug has occurred, in what dose and when, may be difficult to ascertain. (springer.com)

Insomnia inducing drugs include caffeine, nicotine, weight loss preparations, and activating agents of both prescription and abuse. (springer.com)

A blood count and liver function tests are required if therapy with carbamazepine is contemplated. (medscape.com)
It proposes that diagnosis is complicated and is also supported by carefully observed management of changes in drug therapy. (springer.com)
A Novel Real-Time PCR Assay for Detection of HLA-A*31:01 in Individuals Being Considered for Carbamazepine Therapy. (cdc.gov)

Therapeutic error, unexpected failure of effect (perhaps related to a substandard/counterfeit product), drug abuse, accidental or suicidal self-administration, and homicidal use of drugs are all also adverse drug effects, which the wise clinician needs to bear in mind. (springer.com)
Individuals on CLZ remedy are typically on this drug as the final therapeutic choice, providing them using a pharmacological lifeline. (dot1linhibitor.com)

4,5 Among the latter, drugs are very important, contributing in more than a quarter of cases and being associated with other risk factors in at least a third of patients. (pharmaco-vigilance.eu)
Often the drug is implicated as concause in the presence of other risk factors, typically genetic (this is the case with thiopurins) or for other underlying diseases (this is the case with Crohn's disease). (pharmaco-vigilance.eu)

Treatment is given to the entire eligible population in endemic areas through a mass drug administration programme. (who.int)

During this period, safety monitoring consisting of liver function tests and blood counts is recommended with a frequency of up to twice monthly, despite lack of evidence that early detection of changes will prevent serious health problems, even if the drug is discontinued. (pocketdrugguide.com)

Chemotherapeutic agents interact with vitamin A in various ways, from adjunctive vitamin A for nutritive support and amelioration of adverse drug effects to cotherapy using retinoids as chemotherapeutic agents. (interactionsguide.com)

Rarely, an antiseizure drug that is effective for one seizure type may aggravate another seizure type. (msdmanuals.com)
Seizure type, effectiveness and side effects are important in drug selection. (jsurgmed.com)

The blood level of antiseizure drugs is altered by many other drugs, and vice versa. (msdmanuals.com)

The main groups include sodium channel blockers, calcium current inhibitors, gamma-aminobutyric acid (GABA) enhancers, glutamate blockers, carbonic anhydrase inhibitors, hormones, and drugs with unknown mechanisms of action (see the image below). (medscape.com)

The drug was contraindicated in patients who tested as CYP2D6 poor metabolizers because of a risk of a potentially fatal arrhythmia. (veracuity.com)

In these instances, pharmacogenomic testing is especially valuable as it can detect patients likely to develop adverse events when taking a specific drug based on their genetic information. (veracuity.com)

Antiepileptic drugs can be grouped according to their major mechanism of action. (medscape.com)
Some antiepileptic drugs work by acting on combination of channels or through some unknown mechanism of action. (medscape.com)

Newer drugs that kill the organism more slowly are being used, with fewer ocular side effects. (entokey.com)
Drug-related adverse effects may be due to the drug itself, though many are due to systematic errors occurring in the process from diagnosis of the primary treated condition, through prescribing and dispensing, to the way the drug is used by the patient. (springer.com)
There is a strengthening view that we have neglected this area of adverse effects related in some way to drug use. (springer.com)
Women planning to become pregnant should avoid all alcohol consumption, smoking, and use of illegal drugs (eg, cocaine) before and during the pregnancy, because these activities may have serious deleterious effects on the fetus. (medscape.com)
It is not known exactly how and how often the hematological side effects of antiepileptic drugs take place. (jsurgmed.com)
However, side-effects are also enhanced when the drugs are combined. (pocketdrugguide.com)

Drugs that produce chronic toxicity, such as antiretrovirals and antipsychotics, are manageable by regular monitoring drug levels in the blood. (veracuity.com)

Carbamazepine with the rare SNP allele of rs3909184 causing Stevens Johnson syndrome, and aminoglycosides with rs267606617 causing sensory neural deafness. (biomedcentral.com)

Asadipooya AA, Sperling MR. Antiepileptic drugs and hematological disorders. (jsurgmed.com)
There are only few prospective studies regarding this drug during pregnancy, however several cohort studies have shown that women taking it during the first trimester have an increased risk of congenital disorders such as spina bifida, craniosynostosis, cleft palate, hypospadias, and more. (ashdin.com)
major depression).Opioids are sought by drug abusers and people with addiction disorders and are subject to criminal diversion. (drugcentral.org)

Diseases13

Chemicals and Drugs17

Analytical, Diagnostic and Therapeutic Techniques and Equipment2

Psychiatry and Psychology1

Phenomena and Processes1

Phenytoin5

Phenobarbital2

Hepatotoxicity4

Reactions19

Valproic acid8

Paracetamol1

Toxicities2

Epilepsy8

Incidence3

Acquired agranulocytosis6

Seizures11

Concomitant3

Lamotrigine2

Reaction5

Rash3

Antiepileptic drug1

Sulfonamides1

Induce3

Interactions3

Clinical8

Hypersensitivity1

Severity1

Vitro2

Enzyme1

Medications4

Predictable1

Metabolism3

Withdrawn1

Neutropenia1

Injury7

Serum1

Exposure3

Preparations1

Therapy3

Therapeutic2

Factors2

Endemic areas1

Liver funct1

Adverse drug effects1

Seizure2

Antiseizure1

Acid1

Potentially1

Genetic1

Mechanism of act2

Effects6

Antipsychotics1

Rare1

Disorders3