rifampin and Epilepsy

Nonselective antagonists of voltage-gated sodium (Na

Topics: Amides; Animals; Central Nervous System; Dogs; Epilepsy; Hep G2 Cells; Humans; Madin Darby Canine Kidney Cells; Mice; Models, Molecular; NAV1.6 Voltage-Gated Sodium Channel; Protein Domains; Protein Isoforms; Sodium Channel Blockers; Structure-Activity Relationship

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Anticonvulsants; Carbamazepine; Drug Interactions; Epilepsy; Female; Humans; Oxcarbazepine; Rifampin

Anti-epileptic drugs (AEDs) have a small therapeutic window, so it is important to monitor plasma levels. Inadequate plasma levels may lead to convulsions. Many AEDs are cleared hepatically, and there are many drug interactions that are known to lead to changes in plasma levels.. A 54-year-old woman with known epilepsy developed convulsions after using rifampicin and flucloxacillin, despite the use of maintenance treatment in the form of carbamazepine, valproic acid and clonazepam. Since rifampicin is known to induce several cytochrome P450 enzymes and clearance of the anti-epileptic drug used may be affected by this, it can be assumed that the convulsions were caused by rifampicin. This interaction is however not mentioned in the Dutch 'G-standard' database.. Rifampicin is known to be a strong inducer of various cytochrome P450 enzymes. This case description shows that the use of rifampicin may lead to convulsions. For this reason, these interactions should be included in the Dutch G-standard database.

Topics: Anticonvulsants; Carbamazepine; Clonazepam; Cytochrome P-450 Enzyme System; Drug Interactions; Epilepsy; Female; Floxacillin; Humans; Middle Aged; Rifampin; Seizures; Valproic Acid

A process has been developed by which ventriculoperitoneal hydrocephalus shunts, which are prone to bacterial colonisation, can be impregnated with antimicrobials in order to confer antibacterial activity. Concern that their use might be associated with an increased risk of postoperative seizures has been addressed here. Using two rat models, namely pentylenetetrazole (PTZ) and maximal electroconvulsive seizure (ECS) thresholds, the possible epileptogenic characteristics of the shunt catheters were determined. Animals implanted with impregnated catheters exhibited no significant difference in PTZ seizure threshold compared with controls. In contrast, the ECS threshold test showed an enhancement in seizure susceptibility in the non-impregnated catheter group, in accordance with that found in human subjects, but a significant reduction in the impregnated catheter group at 2 and 28 days, postoperatively. These data suggest that the use in human subjects of shunts impregnated with these antimicrobials will not increase the risk of postoperative seizures.

Topics: Animals; Clindamycin; Epilepsy; Hydrocephalus; Male; Pentylenetetrazole; Rats; Rats, Sprague-Dawley; Rifampin; Surgical Wound Infection; Ventriculoperitoneal Shunt

Topics: Chemical and Drug Induced Liver Injury; Child; Drug Interactions; Epilepsy; Female; Humans; Isoniazid; Phenytoin; Rifampin; Tuberculosis

Topics: Carbamazepine; Epilepsy; Humans; Immunodiffusion; Male; Orosomucoid; Rifampin; Sex Hormone-Binding Globulin; Time Factors

Topics: Adult; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Epilepsy; Female; Hepatic Encephalopathy; Humans; Isoniazid; Phenobarbital; Rifampin; Tuberculosis, Miliary

Topics: Binding Sites; Biotransformation; Drug Interactions; Enzyme Induction; Epilepsy; Humans; Liver; Liver Diseases; Phenobarbital; Phenytoin; Rifampin

Topics: Adult; Carbamazepine; Drug Interactions; Electroencephalography; Epilepsy; Ethambutol; Ethosuximide; Female; Humans; Isoniazid; Phenobarbital; Phenytoin; Rifampin