RESUMO
This is a case report of a 15-year-old boy who developed benign intracranial hypertension after 3 weeks of levofloxacin intake. The headache, diplopia, and papilledema resolved within a week after levofloxacin was withdrawn. Physicians must be aware that quinolone antibiotics can potentially cause intracranial hypertension.
Assuntos
Antibacterianos/efeitos adversos , Hipertensão Intracraniana/induzido quimicamente , Levofloxacino , Ofloxacino/efeitos adversos , Adolescente , Diplopia/etiologia , Cefaleia/etiologia , Humanos , Masculino , Fraturas Orbitárias/tratamento farmacológicoAssuntos
Erros de Medicação , Fenitoína/efeitos adversos , Fenitoína/farmacocinética , Adulto , Hidrocarboneto de Aril Hidroxilases/genética , Hidrocarboneto de Aril Hidroxilases/metabolismo , Causalidade , Simulação por Computador , Citocromo P-450 CYP2C9 , Relação Dose-Resposta a Droga , Feminino , Humanos , Erros de Medicação/efeitos adversos , Erros de Medicação/prevenção & controle , Modelos Teóricos , Fenitoína/metabolismo , Intoxicação/etiologia , Intoxicação/genética , Polimorfismo GenéticoRESUMO
The authors report the first case of propofol use for the control of non-epileptic involuntary movements in a patient with postviral encephalitis. The withdrawal from propofol was associated with re-emergence of involuntary movements. The patient was maintained on propofol infusion for 6 months while a series of medications were used in an attempt to control the movements. The movements were finally controlled with high doses of phenobarbital, diazepam, and olanzapine, and the propofol was slowly weaned.
Assuntos
Anticonvulsivantes/uso terapêutico , Discinesias/tratamento farmacológico , Propofol/uso terapêutico , Adulto , Discinesias/etiologia , Encefalite Viral/complicações , Feminino , HumanosRESUMO
PURPOSE: To investigate the tolerability and pharmacokinetics of oral loading with lamotrigine (LTG) among epilepsy patients after temporary drug discontinuation in an epilepsy monitoring unit. METHODS: We conducted a pilot study among epilepsy patients (18 years or older) receiving maintenance doses of LTG. LTG was discontinued on admission and restarted at the end of epilepsy monitoring. LTG was given as a single oral dose calculated based on the population expected volume of distribution (Vd, 1.0 L/kg) and target blood level on admission. Baseline and serial blood levels of LTG were determined hourly for 10 to 12 h after the loading dose. OUTCOME MEASURES: (a) frequency of patients with side effects; (b) time to maximum concentration (Tmax), maximum concentration (Cmax), actual volume of distribution, and half-life. RESULTS: Twenty-four patients received a single oral load of LTG (mean, 6.5 +/- 2.7 mg/kg). Overall, LTG loading was well tolerated with no serious adverse events or skin rash observed. Two patients had transient and mild nausea 1 to 2 h after the oral load. The mean estimated pharmacokinetic parameters are as follows: Tmax, 3.1 +/- 2.1 h; Cmax, 8.2 +/- 6.5 mg/L; Vd, 1.1 +/- 1.0 L/kg; clearance, 0.08 +/- 0.08 mg/L/h; half-life, 22 +/- 30 h. All patients reached their target blood levels. CONCLUSIONS: Epilepsy patients temporarily discontinued from LTG can be restarted with a single oral loading dose. This was well tolerated, and therapeutic levels can be achieved within 1 to 3 h.
