Phenobarbital: missing in action

Ilangaratne, Neshan B; Mannakkara, Nilanka N; Bell, Gail S.; Sander, Josemir W.

doi:10.2471/blt.12.113183

Cited by 32 publications

(25 citation statements)

References 10 publications

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“…11 Phenobarbital is another medication recommended by the World Health Organization for the treatment of certain types of epilepsy in developing countries (Fig. 12 Merbarone was a derivative of barbituric acid and represented a unique class of antineoplastic agents which showed curative activity against L1210 leukemia and also possessed important activity against some other murine tumors ( Fig. 12 Merbarone was a derivative of barbituric acid and represented a unique class of antineoplastic agents which showed curative activity against L1210 leukemia and also possessed important activity against some other murine tumors ( Fig.…”

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confidence: 99%

Recent applications of barbituric acid in multicomponent reactions

2016

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Barbituric acid has been utilized in design and synthesis of diverse types of heterocyclic and carbocyclic compounds and considered as an important building block in organic synthesis.There is a wide range of multicomponent reactions that include barbituric acid as starting material. This article aims to review the chemistry of barbituric acids employed in design and synthesis of different types of compounds during the period from 2011 to 2015.

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confidence: 99%

Recent applications of barbituric acid in multicomponent reactions

2016

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“…Historically, phenobarbitone has been the mainstay of epilepsy management in SSA, having the advantages of broad spectrum coverage (although with poor efficacy in absence and myoclonic epilepsy) and a simple dosing regimen at a very low cost. In the past decade, the introduction and expansion of drug regulatory activities and enforcement have significantly increased the cost of phenobarbitone and diminished the overall availability, leading to significant negative effects on the treatment of epilepsy, particularly in remote areas where phenobarbitone is the only accessible AED . The disappearance of phenobarbitone further escalates the need for electrodiagnostic insights at the individual and population level in SSA.…”

Section: Discussionmentioning

confidence: 99%

A retrospective observational study of EEG findings and antiepileptic drug use among children referred for EEG to Zambia's University Teaching Hospital

et al. 2018

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SummaryObjectiveDespite the heavy burden of epilepsy in Sub‐Saharan Africa, there remains a relative paucity of neurophysiology services and limited published data on electroencephalography (EEG) features among African children. The aim of this study was to describe clinical characteristics, EEG findings, and antiepileptic drug (AED) use among children referred for EEG to the University Teaching Hospital in Zambia.Methods EEG referrals and reports from 2013–2015 were reviewed. Within the context of routine care, EEG studies were interpreted by readers with advanced training in child neurology and clinical neurophysiology. Clinical data provided in the referral including seizure semiology and EEG findings were systematically extracted and analyzed.ResultsA total of 1,217 EEG reports were reviewed, with 1,187 included in the analysis. Median age was 7 years (interquartile range [IQR] 3–11) and 57% were male. Seventy‐three percent of 554 had documented seizure onset before 5 years of age. Among the 23% with seizure etiology documented, 78% were associated with perinatal injuries and central nervous system (CNS) infections. EEG abnormalities were found in 75% of the studies. Clinical semiology per referral identified focal seizures in 29%, but EEG findings increased this proportion to 63% (p = 0.004). Sixty‐two percent were taking AEDs, with 85% on monotherapy. The most commonly used AED was carbamazepine (49%).There was no association between the choice of AED and clinical semiology (all p's > 0.05).SignificanceThis tertiary care center study identified >60% of referred children to have localization‐related epilepsies, with at least 18% of epilepsies being from potentially preventable causes. These findings are consistent with multi‐country, population‐based data from elsewhere in Africa. Seizure semiology assessed in routine, nonspecialist care does not predict AED choice, and the presence of focality is underestimated in routine care.

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“…The World Health Organization recommends PHB as a fi rst-line medication for partial and generalized tonic-clonic seizures in developing countries. 2 PHB inhibits seizures by potentiation of synaptic inhibition through an action on the GABA A receptor.…”

Section: Discussionmentioning

confidence: 99%

“…1 The World Health Organization recommends PHB as a fi rst-line medication for partial and generalized tonic-clonic seizures in developing countries. 2 The most important adverse effects of PHB are behavioral and cognitive alterations. PHB has been reported, from the early fi fties, to be associated with adverse effects like exfoliative dermatitis, morbilliform or scarlatiniform rash.…”

Section: Introductionmentioning

confidence: 99%