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Biomedical subjects

W Fröscher

Publications and source records attributed to W Fröscher.

At least 73 records · Page 4Linked to original sources
PubMed1981

A prospective randomised trial on the effect of monitoring plasma anticonvulsant levels in epilepsy.

To evaluated whether knowledge of plasma levels of anti-epileptic drugs has an effect on therapeutic outcome, 127 epileptic outpatients were randomly assigned to two groups (A and B). Plasma levels of group A were reported to the treating physician who attempted to keep the plasma levels within the "therapeutic range." The treating physician was not informed of the results of plasma level determinations of group B. Data from 105 patients were available for assessment at the end of the study year. Therapeutic results of groups A and B were not significantly different. The reduction in seizure frequency was associated with an increase in plasma concentrations of the anti-epileptic drugs. Thus, under the conditions of the study, knowledge of plasma levels of anti-epileptic drugs did not further improve therapeutic results.

Anticonvulsants↗
PubMed1980

[Activation of epilepsy-typical potentials in the EEG (author's transl)].

In the case of seizures which are difficult to diagnose, the demonstration of epilepsy-typical graphoelements in the EEG confirms the suspected presence of an epilepsy. Activation methods are employed, since epilepsy-typical potentials may be even absent in established cerebral convulsibility in the routine wake EEG. The purpose of these method is the activation of epilepsy-typical potentials in patients, whereas the activation should not be so strong that those potentials may also be activated in healthy persons - since they can be provoked by a sufficiently strong stimulation in any individual. Hyperventilation, photostimulation, sleep, sleep deprivation and, in addition, drug provocation with Bemergrid, have proved most effective in routine diagnostic procedures; the diagnostic significance of the latter is still most problematic. - The various activation methods show a variably marked effect in the different types of seizures.

Bemegride↗
PubMed1979

[Antiepileptic therapy with valproinic acid. Correlations of side effects and serum levels of valproinic acid].

The side effects and possible side effects of the therapy with valproic acid were documented in 66 outpatients with epilepsy over a period of one year. The serum levels of valproic acid were measured gaschromatographically over the same period. The majority of the patients received a combined medication. The occurrence of side effects or possible side effects of valproic acid led to a dosage reduction of discontinuation of the compound in 25% of the patients. Patients complaining of tiredness showed significantly higher serum valproic acid levels than patients without clinical side effects. The other comparisons between the serum valproic acid levels in the case of clinical side effects and changes in laboratory findings and the serum levels of patients without side effects or changes in laboratory findings did not indicate a definite difference.

Acne Vulgaris↗
PubMed1979

[The 4 c/sec rhythm (case report and differential diagnosis) (author's transl)].

Report on a female patient with a 3 c/sec rhythm. The 3 c/sec rhythm is a special case of the 4 +/- 1 c/sec rhythm. The characteristics of this variant are reviewed in tabulated form. The differential diagnosis has to take into consideration other slow posterior rhythms like the so-called delta-parenrhythmia and delta-parenrhythmia, abortive forms of spike and wave complexes and the abnormal delta-rhythms and sinusoidal delta-rhythms in the infantile EEG.

Adult↗
PubMed1978

[Valproic acid in the treatment of epilepsy with special emphasis on serum level determination (author's transl)].

Valproic acid has become a regular component of antiepileptic therapy. Generally it is used against genetically caused, primary generalized epilepsies with bilateral hypersynchronous neuronal discharges in the EEG. An improvement can also be observed by Valproic acid-treatment for secondary generalized and partial epilepsies. Therapeutic results could possibly be improved through a consideration of the serum concentration of valproic acid. Some of the commercial preparations contain the sodium salt of Valproic acid. The free acid which is quickly absorbed, is released in the stomach (tablet) or in the intestine (dragee). The half life is about 15 to 17 hours (one finds a range of 6 to 20 hours in the literature). In view of the half life, it is recommended that the daily dose should be divided into three single doses. About 84 to 95% of the substance is protein bound. Up to now, clinically relevant observations concerning the displacement of valproic acid from its protein binding are unknown. Recently in in vitro studies a decreased protein binding of valproic acid due to phenylbutazone, salicylic acid, and sulfadimethoxine and vice versa, a displacement of phenobarbital and phenytoin caused by valproic acid could be demonstrated. The therapeutic range of the serum level was between 50 and 120 mcg/ml. Individual patients showed that the dispensed dose did not reliably yield the expected serum levels. The necessary daily dose lies for adults between 600 and 2400 mg, in children between 15 and 150 mg/kg. The wide range of allowable dosis is dependent on whether or not valproic acid is to be given in conjunction with other antiepileptic drugs. When phenobarbital and valproic acid are given in conjunction one should be alert for a rise in the phenobarbital serum level. Results of studies in which valproic acid was combined with several other antiepileptic and psychotropic drugs are reported. The majority of the researchers determine a clear parallelism between clinical improvement and a normalization of the EEG in primary generalized epilepsies with bilateral synchronous 3/sec. spikes and waves. The background activity, determined by visual inspection, is not affected. Few workers discuss the correlation of the side effects of valproic acid and its serum level. Tiredness and impaired function of thrombocytes has been observed to be dependent on the valproic acid plasma level.

Blood Platelets↗
PubMed1977

Disposition of valproic acid in man.

The pharmacokinetics of valproic acid (VPA) have been studied in 6 healthy subjects following a single 600 mg dose, and after multiple doses over 12 days (1200 mg daily) of enteric-coated sodium valproate. A time lag before absorption of 1 to 2 h was observed in each subject, and then absorption was rapid, peak concentrations being recorded 3 to 4 h after administration of the dose. The plasma level decline was biphasic with a terminal half-life of 15.9 +/- 2.6 h in the single dose and 17.3 +/- 3.0 h in the multiple dose experiments. There was no evidence of dose dependent kinetics or autoinduction. Total plasma clearance was 0.0064 +/- 0.0011 l/kg X h. The apparent volume of distribution was small at 0.15 +/- 0.2 l/kg. The mean steady state plasma concentration (Css) reached after 4 days was 81.3 +/- 13.0 microgram/ml. Css observed was lower than Css predicted (99.2 +/- 14.7 microgram/ml) from single dose kinetics (p less than 0.001). The difference was probably due to a reduction in plasma protein binding at higher concentrations. VPA concentration in saliva was between 0.4 and 4.5% of the total plasma concentration and was not equal to the concentration of unbound drug in plasma (6.7 +/- 0.8% unbound). 3.2% of the dose was excreted in urine as the parent drug and 21.2% as conjugated metabolites.

Adult↗
PubMed1977

The bioavailability of phenytoin.

The bioavailability of three commercial products of phenytoin (Epanutin, sodium salt; Phenhydan, calcium salt; Zentropil, free acid) was studied relative to a standard solution of sodium phenytoin. Each preparation was given for 14 days in a daily dose of 300 mg according to a cross over design. The three brands tested were equivalent as to their bioavailability with respect to plasma concentrations during one dosing interval, the area under the plasma level time curve, the time of peak plasma concentration, and the urinary excretion of the primary metabolite. Therefore, these phenytoin brands are bioequivalent and exchangeable for antiepileptic treatment. The standard solution of sodium phenytoin had a higher bioavailability as compared to the commercial products.

Adult↗