Analysis of Adverse Drug Reactions with Carbamazepine and Oxcarbazepine at a Tertiary Care Hospital

Lee, Jung Eun; Min, Kang Ryul; Kim, Soo Hyun; Kim, Alec Hyungtack; Kim, Seong Taek

doi:10.3349/ymj.2020.61.10.875

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…The main limitations of carbamazepine are potential drug interactions and the risk of severe adverse reactions, such as Stevens–Johnson syndrome. Oxcarbazepine has a similar structure and efficacy but a better safety profile (though it can cause severe skin reactions) ( 29 ). Its use slightly increased during the 6 years.…”

Section: Discussionmentioning

confidence: 99%

Anti-seizure Medication Prescription in Adult Outpatients With Epilepsy in China, 2013–2018

Zhu

Xiao

et al. 2021

Front. Neurol.

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This study aimed to assess the national trends in anti-seizure medication (ASM) prescription in Chinese adult outpatients with epilepsy over a 6-year period from 2013 to 2018. Prescriptions for adult outpatients with epilepsy from hospitals in six major cities were extracted from the database of the Hospital Prescription Analysis Cooperative Project. Trends in the annual prescriptions and expenditure of ASM were analyzed. Prescription patterns (monotherapy or combination therapy) were also assessed. A total of 225,767 prescriptions from 60 hospitals were eligible and extracted for analysis. The number of ASM prescriptions increased from 28,360 in 2013 to 44,110 in 2018, and the corresponding cost increased from 9,452,990 Chinese Yuan (CNY) in 2013 to 14,627,865 CNY in 2018. The share of newer ASM use increased continuously, accounting for 56.75% of prescriptions and 85.03% of expenditure in 2018. The most frequently prescribed ASMs were sodium valproate and levetiracetam. The proportion of sodium valproate use decreased, while the proportion of levetiracetam use increased dramatically in terms of both ASM prescriptions and expenditure. Monotherapy was more frequent than combination therapy. The three most common combination therapies were sodium valproate/lamotrigine, levetiracetam/oxcarbazepine, and sodium valproate/levetiracetam. In summary, ASM use increased rapidly in terms of the number of ASM prescriptions and cost during the 6-year period, which raises concern regarding the rational use and pharma-economic profiles of ASMs. In place of valproate, levetiracetam became the most frequently used ASM. The development of ASM prescription is in line with therapy guidelines and reflects the current state of research in China.

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Section: Discussionmentioning

confidence: 99%

Anti-seizure Medication Prescription in Adult Outpatients With Epilepsy in China, 2013–2018

Zhu

Xiao

et al. 2021

Front. Neurol.

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“…Among the psychotropic drugs carbamazepine was causally linked to DRESS syndrome the most frequently in the past: recent systematic review of published case reports and other types of observational studies involving patients with DRESS syndrome found that carbamazepine, lamotrigine, phenytoin, valproate, and phenobarbital were the most implicated drugs [8]. Carbamazepine, lamotrigine, phenytoin and phenobarbital share a commonality in their molecular structure that could be important for pathophysiological mechanism of the events underlying the DRESS syndrome -aromaticity [9]. Why aromatic antiepileptic drugs are more prone to cause DRESS syndrome is not known but one of the published case series showed that patients who experienced DRESS syndrome after taking one of the aromatic antiepileptic drugs tolerated non-aromatic anticonvulsants well later on [10].…”

Section: Discussionmentioning

confidence: 99%

“…9 /l)/(%)1.48/ 52.13 4.44 / 78,38 5.0 / 73.93 4.9/ 41.2 4.4/ 27.14 3.51 / 39.73 Lymphocytes (10 9 /l)/(%) 1.09/ 38.42 0.…”

mentioning

confidence: 99%

DRESS syndrome without eosinophilia induced by Carbamazepine: A case report

Janković¹,

Jovicić²,

Pavlović³

et al. 2021

Hosp Pharm Int Multi J

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Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare, severe, systemic, drug-induced hypersensitivity syndrome, the most frequently associated with anticonvulsants. Case Report: A 35-years-old woman with a history of depression and hypothyroidism developed fever 39.5°C, enlarged, painful neck and axillary lymph nodes, slight facial edema around the mouth, confluent maculopapular rash, and laboratory signs of hepatocellular injury, leukocytosis and lymphopenia, but with normal eosinophil count. The syndrome was evident two weeks after starting carbamazepine, and gradually decreased after withdrawal of this drug and introduction of corticosteroid therapy. Conclusion: If a patient is taking carbamazepine and develops skin rash as well as fever and swollen lymph nodes, the physician should always check for internal organ damage and possible DRESS syndrome.

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“…The Food and Drug Administration of the United States recommended the labeling of the drug as to be screened for this genetic marker before its use [ 10 ]. Oxcarbazepine is a newer antiepileptic drug that has shown fewer adverse drug reactions [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

Hwang

Gomez-Marroquin

Enciso

et al. 2020

J Dent Anesth Pain Med

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Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

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Analysis of Adverse Drug Reactions with Carbamazepine and Oxcarbazepine at a Tertiary Care Hospital

Cited by 6 publications

References 19 publications

Anti-seizure Medication Prescription in Adult Outpatients With Epilepsy in China, 2013–2018

Anti-seizure Medication Prescription in Adult Outpatients With Epilepsy in China, 2013–2018

DRESS syndrome without eosinophilia induced by Carbamazepine: A case report

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

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