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  • Chaplin, John, 1955 (författare)
  • Vocational assessment and intervention for people with epilepsy
  • 2005
  • Ingår i: Epilepsia. - : Wiley-Blackwell. ; 46:s1, s. 55-56
  • Tidskriftsartikel (refereegranskat)abstract
    • Employment restrictions have been experienced by many people with epilepsy. In many cases, the restrictions are unjustified and based on stigma or a stereotypical image of the person with epilepsy. Unjustifiable restrictions are a form of discrimination and lead to unemployment and underemployment. Unfortunately, much of the research in this area has been difficult to interpret because of differences in the definition of "people with epilepsy" and differences in the definition of "employment restrictions or problems." I report on an attempt to develop a classification structure and examine some survey results collected by the IBE Employment Commission from professionals and people with epilepsy concerning the sources of employment restrictions and possible methods to overcome these restrictions.
  • Ben-Menachem, Elinor, 1945 (författare)
  • Pregabalin pharmacology and its relevance to clinical practice.
  • 2004
  • Ingår i: Epilepsia. - 0013-9580. ; 45 Suppl 6, s. 13-8
  • Forskningsöversikt (refereegranskat)abstract
    • Pregabalin is a potent ligand for the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system that exhibits potent anticonvulsant, analgesic, and anxiolytic activity in a range of animal models. In addition, pregabalin has been shown to be a highly effective adjunctive therapy for partial seizures in clinical trials. Potent binding to the alpha-2-delta site reduces depolarization-induced calcium influx with a consequential modulation in excitatory neurotransmitter release. Pregabalin has no demonstrated effects on GABAergic mechanisms. Pregabalin demonstrates highly predictable and linear pharmacokinetics, a profile that makes it easy to use in clinical practice. Absorption is extensive, rapid, and proportional to dose. Time to maximal plasma concentration is approximately 1 h and steady state is achieved within 24-48 h. These characteristics reflect the observed onset of efficacy as early as day two in clinical trials. High bioavailability, a mean elimination half life (t(1/2)) of 6.3 h, and dose-proportional maximal plasma concentrations and total exposures predict a dose-response relationship in clinical practice and allow an effective starting dose of 150 mg/day in clinical practice without need for titration. Administration with food has no clinically relevant effect on the amount of pregabalin absorbed, providing for a dosing regimen uncomplicated by meals. Pregabalin does not bind to plasma proteins and is excreted virtually unchanged (<2% metabolism) by the kidneys. It is not subject to hepatic metabolism and does not induce or inhibit liver enzymes such as the cytochrome P450 system. Therefore, pregabalin is unlikely to cause, or be subject to, pharmacokinetic drug-drug interactions--an expectation that has been confirmed in clinical pharmacokinetic studies. However, dose adjustment may be necessary in patients with renal insufficiency. Thus, the pharmacological and pharmacokinetic profiles of pregabalin provide a predictable basis for its use in clinical practice.
  • Kimland, Elin, et al. (författare)
  • Levetiracetam-induced thrombocytopenia
  • 2004
  • Ingår i: Epilepsia. - : Wiley-Blackwell. - 0013-9580 .- 1528-1167. ; 45:7, s. 877-878
  • Tidskriftsartikel (refereegranskat)
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