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Valproic Acid Toxicity

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143. Acute Pain Management: Scientific Evidence

4.4.3 Local anaesthetic toxicity 109 4.5 Inhalational agents 111 4.5.1 Nitrous oxide 111 4.5.2 Methoxyflurane 114 4.6 NMDA-receptor antagonists 116 4.6.1 Systemic NMDA-receptor antagonists 116 4.6.2 Regional NMDA-receptor antagonists 121 4.7 Antidepressant medicines 122 4.7.1 Acute pain 122 4.7.2 Chronic pain 123 4.7.3 Specific pain conditions 123 4.8 Anticonvulsant medicines 125 4.8.1 Acute pain 125 4.8.2 Chronic pain 126 4.9 Alpha-2 agonists 127 4.9.1 Systemic alpha-2 agonists 127 4.9.2 Regional

2015 Clinical Practice Guidelines Portal

144. DNA Polymerase Gamma (POLG)-related disorders

controlling eye movement), and progressive intellectual disability. In addition, hepatopathy (liver dysfunction) may occur in affected individuals. Importantly, the use of valproic acid (sodium valproate) in the treatment of seizures is known to precipitate liver failure (often rapidly and with fatal consequences) in those with POLG gene variants. Liver dysfunction may also occur in the absence of an exposure to valproic acid. With regard to the diagnosis of POLG-related disorders, affected individuals (...) POLG-positive patients, particularly in the early stages of the disease. In addition, each of these findings may be evident in individuals with other mitochondrial conditions. At the present time, the care for patients with POLG gene variants is symptom specific and primarily supportive in nature, with the goals of managing symptoms and preventing secondary complications (e.g., medication-induced liver toxicity). Final publication URL The report may be purchased from: Indexing Status Subject

2013 Health Technology Assessment (HTA) Database.

145. Atopic dermatitis – Treatment with phototherapy and systemic agents Full Text available with Trip Pro

. Guidelines of care for the management of psoriasis and psoriatic arthritis, section 5: guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol . 2010 ; 62 : 114–135 | | | | | , x 19 Morison, W.L., Baughman, R.D., Day, R.M., Forbes, P.D., Hoenigsmann, H., Krueger, G.G. et al. Consensus workshop on the toxic effects of long-term PUVA therapy. Arch Dermatol . 1998 ; 134 : 595–598 | | | , x 22 Uetsu, N. and Horio, T. Treatment of persistent severe atopic (...) arthritis, section 5: guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol . 2010 ; 62 : 114–135 | | | | | , x 19 Morison, W.L., Baughman, R.D., Day, R.M., Forbes, P.D., Hoenigsmann, H., Krueger, G.G. et al. Consensus workshop on the toxic effects of long-term PUVA therapy. Arch Dermatol . 1998 ; 134 : 595–598 | | | , x 20 Goldsmith LK, Katz SI, Gilchrest B, Paller A, Lefell D, Wolff K. Fitzpatrick's dermatology in general medicine. 8th ed. New

2014 American Academy of Dermatology

147. Autism

signi?cant response c for repetitive behavior and stereotypy on risperidone Risperidone vs. haloperidol b Miral et al., 2008 126 behavior, social, sensory, language 0.01-0.08 mg/kg/d 30 children 8-18 y old EPS, weight gain, gynecomastia risperidone reported superior to haloperidol only on ABC total score, no subscales reported Mood stabilizers Valproic acid Hellings et al., 2005 127 irritability 20 mg/kg/d, average level 75-78 30 subjects 6-20 y old increased appetite, skin rash no signi?cant (...) .,homocystinuria), traumatic (e.g., head injury), toxic (e.g., fetal alcohol syndrome), 4 or genetic (e.g., chromosomal abnormality). Certain developmental disorders, most notably Landau-Kleffner syndrome, also should be ruled out. In this condition, a highly distinctive EEG abnormality is present and asso- ciated with development of a marked aphasia. 71 Genetic or neurologic consultation, neuroimaging, EEG, and additional laboratory tests should be obtained when relevant, based on examination or history(e.g

2014 American Academy of Child and Adolescent Psychiatry

148. Maintaining mood stability in bipolar disorder: a clinical perspective on pharmacotherapy Full Text available with Trip Pro

. Vieta E , Günther O , Locklear J , et al . Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder: a meta-analysis of randomized controlled trials . Cipriani A , Reid K , Young AH , et al . Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder (review) . (accessed 23 Jul 2014 ). Malhi GS , Tanious M , Das P , et al . The science and practice of lithium therapy . Birch N , Gallichio V , Becker R Grof P . Excellent lithium responders (...) planning pregnancy, while older patients may be at greater risk for acute or chronic toxicity and renal dysfunction. Naturally, different medications require separate schedules for monitoring side-effects or toxicity, and given that polypharmacy is common, patients may require quite frequent investigations and follow-up. summarises recommended schedules for review. View this table: Table 2 Assessment frequency for reviewing health effects of bipolar medications Patient diversity: disease and individual

2015 Evidence-Based Mental Health

149. Osteoporosis: Prevention and Treatment

) • Thiazolidinediones (pioglitazone/Actos®, rosiglitazone/Avandia®) Miscellaneous • Anticonvulsants (phenytoin or phenobarbital > carbamazepine or valproic acid) b • Heparins (unfractionated > low molecular weight) Possible risk Miscellaneous • Lithium • Selective serotonin reuptake inhibitors • Antipsychotics (may cause hyperprolactinemia) • Excessive supplemental fluoride • Proton pump inhibitors • Topiramate >, greater than; >>, much greater than. a Inhaled beclomethasone (>1600 µg gaily) is associated with risk (...) acid, teriparatide, or denosumab; fractures occurring despite treatment; considering discontinuation of therapy; etc. b Lowest T-score from femoral neck, total hip, or combination of lumbar vertebra. Wards triangle is not predictive of fracture risk [D]. c If patient has had fracture without significant trauma, consider other causes of bone abnormality, e.g., malignancy. d Lifestyle = ensure appropriate intake of calcium and vitamin D, along with weight bearing exercise. 3 UMHS Osteoporosis

2013 University of Michigan Health System

151. Assessment of new HDAC inhibitors for immunotherapy of malignant pleural mesothelioma Full Text available with Trip Pro

of cancer cells. We previously showed that a hypomethylating agent (decitabine) and a histone deacetylase inhibitor (HDACi) (valproic acid (VPA)) combination was immunogenic and led to the induction of an anti-tumor immune response in a mice model of mesothelioma. However, VPA is not very specific, is active at millimolar concentrations and is responsible for side effects in clinic. To improve this approach, we studied four newly synthetized HDACi, two hydroxamates (ODH and NODH) and two benzamides (ODB (...) and NODB), in comparison with VPA and SAHA. We evaluated their toxicity on immune cells and their immunogenicity on MPM cells in combination with decitabine.All the tested HDACi were toxic for immune cells at high concentrations. Combination with decitabine increased toxicity of HDACi only towards T-cell clone. A decrease in the proportion of regulatory T cells and natural killer cells was observed in particular with VPA and ODH. In MPM cells, all HDACi combinations induced NY-ESO-1 cancer testis

2018 Clinical epigenetics

152. Anticonvulsant and reproductive toxicological studies of the imidazole-based histamine H3R antagonist 2-18 in mice Full Text available with Trip Pro

Anticonvulsant and reproductive toxicological studies of the imidazole-based histamine H3R antagonist 2-18 in mice The imidazole-based H3R antagonist 2-18 with high in vitro H3R antagonist affinity, excellent in vitro selectivity profile, and high in vivo H3R antagonist potency was tested for its anticonvulsant effect in maximal electroshock (MES)-induced convulsions in mice having valproic acid (VPA) as a reference antiepileptic drug (AED). Additionally, H3R antagonist 2-18 was evaluated (...) for its reproductive toxicity in the same animal species. The results show that acute systemic administration (intraperitoneal; i.p.) of H3R antagonist 2-18 (7.5, 15, 30, and 60 mg/kg, i.p.) significantly and dose dependently protected male as well as female mice against MES-induced convulsion. The protective action observed for H3R antagonist 2-18 in both mice sexes was comparable to that of VPA and was reversed when mice were pretreated with the selective H3R agonist (R)-alpha-methylhistamine (RAMH

2018 Drug design, development and therapy

153. Rechallenge of lamotrigine after development of rash Full Text available with Trip Pro

Rechallenge of lamotrigine after development of rash Lamotrigine (LTG) is associated with the potential for a life-threatening rash (eg, Stevens-Johnson syndrome or toxic epidermal necrolysis). The incidence has been linked to rapid titration and an interaction with valproic acid that can increase the level of LTG. Providers often have difficulty discriminating between serious versus benign rashes, and the package insert recommends discontinuing the medication at the first sign of a rash

2018 The Mental Health Clinician

154. Image-guided Targeted Doxorubicin Delivery With Hyperthermia to Optimize Loco-regional Control in Breast Cancer

, cyclosporine, carbamazepine, phenytoin, valproic acid, paclitaxel, trastuzumab and other liposomal drugs (Abelect, Ambisome, Nyotran, etc.) or lipid-complexed drugs. Caution will be exercised with all the medications mentioned in appendix C, for interactions are theoretically possible. Contraindications to MR imaging (e.g., pacemaker in situ, severe claustrophobia, metal implants incompatible with the MRI-scan, body size incompatible with MR bore). Contraindications to gadolinium-based contrast agent (...) that by substituting doxorubicin (A) in the AC-chemotherapy regimen for the combination of LTLD and MR-HIFU induced hyperthermia, optimal local tumour control can be achieved without compromising systemic toxicity or efficacy. This will be the first study to evaluate LTLD with MR-HIFU hyperthermia in breast cancer patients. Condition or disease Intervention/treatment Phase Metastatic Breast Cancer Breast Cancer Breast Neoplasms Stage IV Breast Cancer Metastatic Cancer Invasive Ductal Carcinoma of Female Breast

2018 Clinical Trials

155. Valproate serum concentrations in patients with hypoalbuminemia and medical complications Full Text available with Trip Pro

Valproate serum concentrations in patients with hypoalbuminemia and medical complications Valproic acid (VPA) and its derivatives are highly protein bound with free fraction increasing with dose and serum concentration. Consensus guidelines regarding dose adjustment for hypoalbuminemia are not available.A literature search was performed using PubMed to identify articles with the following key terms: "valproate," "valproic acid," "protein binding," "albumin," and "hypoalbuminemia." We report our (...) , age, serum creatinine, or dose). Female patients with similar albumin had higher free fractions than the 1 male patient.Due to the variability in pharmacokinetic impact of hypoalbuminemia, it is important to monitor patients closely for signs of VPA toxicity in cases involving altered albumin levels. It would be prudent to use free serum VPA concentrations when patients experience fluctuations in albumin or have unexpected response to medication.

2018 The Mental Health Clinician

156. Randomized, Phase II Clinical Trial of Sulforaphane in Bladder Cancer Chemoprevention

systemic chemotherapy for any other cancer, excluding non-melanoma skin cancer; Any treatment for the bladder tumor other than intravesical therapy; Prior treatment with a known histone deacetylase inhibitor (including but not limited to valproic acid, suberoylanilide hydroxamic acid (SAHA), Panobinostat (LBH589), etc.) within 6 months prior to starting study treatment or while on study therapy; Current treatment with warfarin; Use of dietary supplements or herbal remedies which may affect the study (...) /adjacent cells. Occurrence of Adverse Events per Study Arm [ Time Frame: End of study, approximately 30 days ] Safety of SFN at this dose (vs. Placebo) as indicated by incidence of adverse events and toxicities, monitored using Common Toxicity Criteria version 5.0, complete blood count (CBC), and complete metabolic panel (CMP) from baseline at mid-point and at end of trial. Mid-study Bioavailability of Sulforaphane [ Time Frame: Mid-study, approximately 15 days ] Bioavailability, of SFN at this dose vs

2018 Clinical Trials

157. LRAs United as a Novel Anti-HIV Strategy.

the size of the reservoir as measured by TILDA, HIV-DNA, HIV-RNA and level of acetylation/BAF expression after stimulation by pyrimethamine, valproic acid or both, and this will be correlated to these observed reservoir measurements outcomes in vivo at week 2 and week 6. Incidence of Treatment-Emergent Adverse Events [ Time Frame: 6 week ] The clinical and biochemical adverse events will be assessed by the Common Toxicity Criteria. Plasma HIV-RNA [ Time Frame: 6 week ] The proportion of subjects (...) , Erasmus Medical Center Study Details Study Description Go to Brief Summary: A translational proof of concept study in humans on the primary research question whether novel anti-human immunodeficiency virus (HIV) latency strategies, including a BAF inhibitor and a histone deacetylase inhibitor, result in HIV reservoir reduction in HIV patients on antiretroviral therapy. Condition or disease Intervention/treatment Phase HIV-1-infection Drug: Valproic Acid Drug: Pyrimethamine Phase 1 Phase 2 Detailed

2018 Clinical Trials

158. Entinostat Versus Placebo Combined With Endocrine Therapy in Chinese Patients With Advanced Breast Cancer in Chinese Patients With Hormone Receptor-Positive Advanced Breast Cancer

affect intake, transportation or absorption of oral administration of drugs (e.g., inability to swallow, chronic diarrhea, intestinal obstruction, etc.); Unrecovered toxicity resulted from previous medication or toxicity, evaluation score is still > grade 1 or baseline (except alopecia); Use of HDAC inhibitor (e.g., valproic acid, Entinostat, Vorinostat, chidamide, etc.) prior to enrollment or intended use of HDAC inhibitor during the study; Known allergic to Exemestane, Entinostat or other drugs (...) of Medicine related topics: related topics: available for: Arms and Interventions Go to Arm Intervention/treatment Active Comparator: ARM Entinostat+Exemestane Patients receive Exemestane orally (PO) once daily (QD) on days 1-28 and Entinostat PO on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Drug: Entinostat Entinostat will be repeatedly administered PO on days 1, 8, 15 and 22 of each treatment cycle. Exemestane PO once daily on day

2018 Clinical Trials

159. Epacadostat in Combination With Radiation Therapy and Avelumab in Patients With Recurrent Gliomas

screening through follow-up period, including acitretin, amitriptyline, androsterone, cyclosporine, dasatinib, diclofenac, diflunisal, efavirenz, erlotinib, estradiol (17-beta), flutamide, gefitinib, gemfibrozil, glycyrrhetinic acid, glycyrrhizin, imatinib, imipramine, ketoconazole, linoleic acid supplements, mefenamic acid, mycophenolic acid, niflumic acid, nilotinib, phenobarbital, phenylbutazone, phenytoin, probenecid, propofol, quinidine, ritonavir, sorafenib, sulfinpyrazone, valproic acid (...) blood at time of progression only; if no progression has occurred by this time point, the Cycle 12 will be the last collection). Outcome Measures Go to Primary Outcome Measures : Safety run-in only: Safety and tolerability of the regimen as measured by dose-limiting toxicities (DLTs) in cycle 1 [ Time Frame: Completion of cycle 1 for all patients in Safety Run-In (estimated to be 6 months) ] 6 patients will be enrolled at the 100 mg BID dose of epacadostat during the safety run-in DLT

2018 Clinical Trials

160. A Pilot Study of the Combination of Entinostat With Capecitabine in High Risk Breast Cancer After Neo-adjuvant Therapy

to study treatment. Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA. If female, is pregnant or breastfeeding. The following medications are prohibited while the patient is receiving entinostat: Any other HDAC Inhibitor, including valproic acid DNA methyltransferase inhibitors Any additional anticancer agents (excluding entinostat and capecitabine), such as chemotherapy, immunotherapy, targeted therapy, biological response (...) . Other Name: Xeloda Outcome Measures Go to Primary Outcome Measures : Identification of a maximum tolerated dose combination (MTDC) of entinostat and capecitabine [ Time Frame: During the first cycle of treatment (each cycle is 21 days) for each participant ] This will be defined based on the number of "dose limiting toxicities" in participants at each dose level. Frequency of adverse events (AEs) in participants with high-risk breast cancer after neo-adjuvant therapy [ Time Frame: AEs from consent

2018 Clinical Trials

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