Abstract:
:Background Valproate is a widely prescribed antiepileptic drug for generalized epilepsies, due to the extensive knowledge on its efficacy since it is on the market for many decades. However, a large number of new antiepileptic medicines was introduced into clinical practice and may be better options for treatment, considering that these medicines differ in terms of efficacy spectrum. Despite extensive research, questions regarding which medicine would constitute the first option for the monotherapy treatment of generalized epilepsy remain. Aim of the Review To compare the relative efficacy of all available antiepileptic drugs in the monotherapy treatment of generalized epileptic seizures; and also to compare all antiepoileptig drugs with valproate, which is the current first-line treatment for generalized epilepsy. Methods A systematic review for randomized controlled clinical trials was performed. Network meta-analyses used Bayesian random effects model. Sensitivity analyses determined the results´ robustness. The relative probability of two efficacy outcomes ("Seizure free" and "Therapeutic inefficacy") to happen for each medcicine was calculated using the Surface Under the Cumulative Ranking Curve. Results Seven papers (1809 patients) studied the efficacy of valproate, lamotrigine, phenytoin, carbamazepine, topiramate, levetiracetam, and phenobarbital in the treatment of generalized tonicclonic, tonic, and clonic seizures. Phenytoin demonstrated to be inferior to valproate in leaving the patient free of these seizures types [OR: 0.50 (95% CrI 0.27, 0.87)]. Lamotrigine (61%) showed the highest probability of presenting the outcome "Seizure free", followed by levetiracetam (47%), topiramate (44%), and valproate (38%) in the treatment of generalized tonic-clonic, tonic, and clonic seizures. Meanwhile, valproate exhibited greater chance of presenting the outcome "Therapeutic inefficacy" (62%). Regarding absence seizures itself, there was no difference in the efficacy of lamotrigine and ethosuximide when compared to valproate. However, the ranking indicates that ethosuximide (52%) and valproate (47%) are both more likely than lamotrigine to keep the patient free of seizures. Conclusions Lamotrigine, levetiracetam, and topiramate are as effective as valproate for treating generalized tonic-clonic, tonic, and clonic seizures. Meanwhile, valproate and ethosuximide are the best options for the treatment of absence seizures promoting better control of seizures, which is the primary goal of pharmacotherapy.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Campos MSA,Ayres LR,Morelo MRS,Carizio FAM,Pereira LRLdoi
10.1007/s11096-018-0641-9subject
Has Abstractpub_date
2018-06-01 00:00:00pages
589-598issue
3eissn
2210-7703issn
2210-7711pii
10.1007/s11096-018-0641-9journal_volume
40pub_type
杂志文章,meta分析abstract::Background In most scenarios, anaesthesiologists titrate opioids to control nociceptive surgical stress based on intraoperative haemodynamic changes. Remifentanil was reported to cause more profound cardiovascular depression than sufentanil. A concern is that this direct cardiovascular depression might counteract the ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01094-1
更新日期:2020-10-01 00:00:00
abstract::Background Chronic pain is a prevalent and debilitating condition for many people. Globally it is the greatest contributor to years lived with disability. Management often includes pharmacotherapy and pharmacists are therefore well placed to contribute to chronic pain management. Objective To explore chronic pain mana...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01198-8
更新日期:2020-11-27 00:00:00
abstract:BACKGROUND:The previous Thai version of the 8-item Morisky Medication Adherence Scale (8-item MMAS) showed poor sensitivity and unacceptable internal consistency reliability. OBJECTIVES:To develop and test the psychometric properties of a new medication taking behavior measure for Thai patients (MTB-Thai) including pr...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-016-0275-8
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Evidence suggests that consumers potentially put themselves at risk when purchasing medicines on-line. Whilst logos provided by regulators may provide some level of reassurance there may be other indicators which could be used by consumers to identify those websites which may be safely used. OBJECTIVES:Iden...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-0056-1
更新日期:2015-02-01 00:00:00
abstract:UNLABELLED:Sequential antimicrobial therapy is an important part of antimicrobial stewardship and intends to improve the timeliness of switch to oral antimicrobials. The aim of this study was to assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials. SETTING:The study was...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9475-9
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The variability in the clinical response to clopidogrel treatment has been attributed to genetic factors, but the specific genes and other risk factors remain unclear. OBJECTIVE:To investigate the incidence of high on-treatment platelet reactivity in coronary heart disease patients following clopidogrel the...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00953-w
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Linezolid represents an important advance in the treatment of methicillinresistant staphylococci. Its effectiveness should be preserved by appropriate uses. The aims of this survey were to describe the use of linezolid in clinical practice and to assess its overall safety. METHODS:This retrospective observat...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9576-0
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To generate, validate and establish a web-based individualised opioid conversion calculator at the University Hospital Basel and to analyse its value and significance. SETTING:A 700-bed university hospital. METHOD:Published data were screened by a Medline search using the keywords: opioid, rotation, switchi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9464-z
更新日期:2011-02-01 00:00:00
abstract::Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists' (CPs) involvement. Objective To determine CPs' awareness of and involvement with IC services, perceptions of the transfer of patients' medication inf...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0377-3
更新日期:2016-12-01 00:00:00
abstract::Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the c...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-014-9954-5
更新日期:2014-08-01 00:00:00
abstract::Background Medication errors are the most common types of medical errors that occur in health care organisations; however, these errors are largely underreported. Objective This study assessed knowledge on medication error reporting, perceived barriers to reporting medication errors, motivations for reporting medicati...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01041-0
更新日期:2020-08-01 00:00:00
abstract::Background Coeliac disease affects 1% of the population, but 75% remain undiagnosed. Objective To conduct a case finding feasibility and efficacy study for the detection of coeliac disease in community pharmacies. Setting Six community pharmacies across Sheffield, UK. Method A prospective study was performed using a p...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00793-8
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:For patients accessing specialist palliative care day services, medication is prescribed routinely to manage acute symptoms, treat long-term conditions or prevent adverse events associated with these conditions. As such, the pharmacotherapeutic burden for these patients is high and polypharmacy is common. Co...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9932-y
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Medication errors are a potential major threat to patient's health, and allergic reactions occurring in patients with known allergies are an important preventable form of adverse drug event. The use of penicillin antibiotics in patients who are allergic to penicillin, in particular, is a major concern. AIM:...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9708-1
更新日期:2013-02-01 00:00:00
abstract::Background Medication reconciliation (MedRec) at discharge is a cumbersome but necessary process to reduce the risk of medication errors at transitions of care. The main barriers to implementing such a process are the large number of professionals involved and a lack of collaboration among caregivers. Objective This s...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0292-7
更新日期:2016-08-01 00:00:00
abstract::This article reviews the implications of off-label (OL) and unlicensed (UL) medicine use with respect to the legal duty to inform patients and the liability for failure to provide the patient with adequate information on benefits and risks. Informed consent is a legal prerequisite to any medical treatment and requires...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0646-4
更新日期:2018-06-01 00:00:00
abstract::Background Non-adherence to immunosuppressive medications following renal transplantation is a risk factor for rejection and graft loss. Despite the dire consequences, adherence lapses, both unintentional and intentional, are common and poorly understood. Objective The present study sets to compare the rates and deter...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0652-6
更新日期:2018-10-01 00:00:00
abstract:UNLABELLED:Background Potentially inappropriate medications (PIMs) are often found in high proportion among the elderly population. The STOPP criteria have been suggested to detect more PIMs in European elderly than the Beers criteria. Objective This study aimed to determine the prevalence of PIMs and potential prescri...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-016-0337-y
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The combined post-operative use of diuretics and/or renin-angiotensin-aldosterone system (RAAS) inhibitors may increase the risk of nonsteroidal anti-inflammatory drug (NSAID) associated renal failure because of a drug-drug interaction. OBJECTIVE:The aim of this study was to investigate the effect of the sh...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9631-5
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Underuse of medication considered beneficial is particularly common in elderly patients. A new Screening Tool to Alert Doctors to the Right Treatment (START) has been published to identify potential prescribing omissions. OBJECTIVE:To quantify and characterize potential prescribing omissions of cardiovascul...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9635-1
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:With increasing deregulation of prescription-only medicines and drive for self-care, pharmacists have greater scope to manage more conditions. This brings added responsibility to be competent healthcare professionals who deliver high quality evidence-based patient care. OBJECTIVE:This study sought to establ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9586-y
更新日期:2012-02-01 00:00:00
abstract::Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigate...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-017-0519-2
更新日期:2017-10-01 00:00:00
abstract::Background The survival rate of prostate cancer is relatively higher than other cancers, therefore, the health-related quality of life (HRQoL) becomes a critical issue for the patients. There are limited quality of life data evaluating the difference between androgen deprivation therapy and non-androgen deprivation th...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00854-y
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. OBJECTIVES:This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0264-y
更新日期:2016-04-01 00:00:00
abstract:CASE:We report a 32-year old relapse case of Visceral leishmaniasis, treated with Paromomycin who belonged from a endemic zone of Bihar state, India. After confirmation, he was treated with Amphotericin B, followed by Liposomal Amphotericin B in full course and even in higher dose. But after each therapy, the patient e...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9544-8
更新日期:2011-10-01 00:00:00
abstract::Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeut...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-016-0375-5
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Communication between hospital and community pharmacists when a patient is discharged from hospital can improve the accuracy of medication reconciliation, thus preventing unintentional changes and ensuring continuity of supply. It allows problems to be resolved before a patient requires a further supply of m...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9813-9
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The scope of pharmacist services for patients with pulmonary disease has primarily focused on drug related outcomes; however pharmacists have the ability to broaden the scope of clinical services by performing diagnostic testing including quality spirometry testing. Studies have demonstrated that pharmacists...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-015-0160-x
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Oral treatment in women with breast cancer has been increasingly used. However, a potentially negative side of oral medication is poor patient adherence and/or discontinuation, which reduces the treatment effectiveness, accelerating progression of the disease and reducing the patient survival rate. AIM OF T...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11096-013-9833-5
更新日期:2014-02-01 00:00:00
abstract:CASE (DESCRIPTION):We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0158-4
更新日期:2015-10-01 00:00:00