Effects of carbamazepine on plasma concentrations of valproic acid and its toxic metabolite in epileptic patients / 药学学报

To investigate the effects of carbamazepine (CBZ) on the plasma concentrations of valproic acid (VPA) and its toxic metabolite 2-propyl-4-pentenoic acid (4-ene VPA) in epileptic patients, the plasma concentrations of VPA and 4-ene VPA were determined, and the effect of CBZ on pharmacokinetics of VPA was evaluated. All patients had been divided into two groups (VPA group, n = 87; and VPA+CBZ group, n = 19). As compared to VPA group, the combination of CBZ significantly (P < 0.01) decreased the trough concentration of VPA [VPA group, (69.5 +/- 28.8) microg x mL(-1); VPA+CBZ group, (46.3 +/- 25.6) microg x mL(-1)] and does-adjusted VPA trough concentration [VPA group, (4.89 +/- 2.21) microg x mL(-1) x mg(-1) x kg(-1); VPA+CBZ group, (3.14 +/- 1.74) microg x mL(-1) x mg(-1) x kg(-1)]. However, the addition of CBZ did not influence the concentration of 4-ene VPA. The present study revealed that coadministration of CBZ can reduce VPA plasma concentration and may impact VPA clinical effect, therefore therapeutic drug mornitoring of VPA should be used when combined use of CBZ and VPA.

Clinical and imaging characteristics of idiopathic hypertrophic pachymeningitis / 中华神经医学杂志

Objective To analyze clinical data of 6 cases of idiopathic hypertrophic pachymeningitis and review related literatures before, so as to offer a guidance for its clinical diagnosis and therapy. Methods We analyzed the clinical and imaging features and data of follow_up in the patients who were treated in our hospital 2005-2006. Results Idiopathic hypertrophic pachymeningitis was always accompanied by immune fimction abnormality to different degrees. The main clinical manifestation was headache which was found in every case. In these cases, headache was the onset and recur symptom. In addition to headache, various symptoms of nervous system dysfunction especially the cranial nerves could be found in some cases. In these cases, a localized or diffuse thickening of tentorium of cerebellum and/or falciform process of cerebrum was found in MRI, and intensification was presented in enhancement scanning. Corticosteroid was effective to all of the cases. Conclusions Idiopathic hypertrophic pachymeningitis may be an autoimmune disorder, of which the symptoms are various, and need to be discriminated from other diseases. MR/of cranium is important criteria for diagnosis.