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3 results

  • Chemotherapeutic drugs that penetrate the blood–brain barrier affect the development of hyperactive delirium in cancer patients

  • Hiromichi Matsuoka, Kazuhiro Yoshiuchi, Atsuko Koyama, Masatomo Otsuka, Kazuhiko Nakagawa
  • Journal:
    Palliative & Supportive Care / Volume 13 / Issue 4 / August 2015
    Published online by Cambridge University Press:
    26 June 2014, pp. 859-864
    • Article
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  • Objective:

    Delirium is a frequently encountered psychiatric disease in terminal cancer patients. However, the mechanism of delirium is unclear. The aim of our study was to investigate the relationship between administration of chemotherapy drugs that penetrate the blood–brain barrier (BBB) and the development of delirium in cancer patients.

    Method:

    We retrospectively analyzed 166 cancer patients (97 males, 69 females) continuously who died between September of 2007 and January of 2010 using a review of medical charts. Multiple logistic regression analysis was employed to investigate the effects of antineoplastic drugs penetrating the BBB on development of delirium in cancer patients with control for other risk factors.

    Results:

    In multivariate analysis, antineoplastic drugs that penetrated the BBB were significantly associated with development of delirium (OR = 18.92, CI95 = 1.08–333.04, p < 0.001).

    Significance of results:

    The use of chemotherapy drugs that penetrate the BBB may be a risk factor for delirium. This information may allow palliative care doctors and medical oncologists to predict which patients are at increased risk for delirium.

  • Chapter 87 - Alzheimer disease and other neurodegenerative diseases

  • from Section 3 - Symptomatic epilepsy
  • Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
  • Book:
    The Causes of Epilepsy
    Published online:
    05 March 2012
    Print publication:
    14 April 2011, pp 618-624

  • Summary

    This chapter addresses the topic of brain tumors as causes of epilepsy. It focuses on secondary brain tumors, commonly referred to as solid metastatic brain tumors, and neoplastic meningitis. Epileptic seizures in patients with cerebral metastatic disease are most likely multifactorial, however, a number of factors are considered to be contributing to the development and continuation of these seizures in a subgroup of individuals. Antiepileptic drugs are known to reduce the activity of chemotherapeutic drugs. The treatment of epilepsy in patients with secondary brain tumors should involve a multidisciplinary team that is knowledgeable about all the surgical, radiation, and therapeutic options in the management of these patients. Research needs to be focused on the best antiepileptic drug (AED) or drug combination to use in these patients so that new practice guidelines can be developed to improve patient care.

  • 14 - Antiepileptic drug interactions in children

  • from Part IV - Drug interactions in specific patient populations and special conditions
  • Edited by Jerzy Majkowski, Blaise F. D. Bourgeois, Harvard University, Massachusetts, Philip N. Patsalos, Institute of Neurology, London, Richard H. Mattson, Yale University, Connecticut
  • Book:
    Antiepileptic Drugs
    Published online:
    07 September 2009
    Print publication:
    26 May 2005, pp 257-272

  • Summary

    This chapter reviews the characteristics of the various interactions between the various antiepileptic drugs (AEDs), including those that are in development and what is presently known regarding their mechanism. It highlights the benefits this knowledge can offer to optimize the treatment for each type of epilepsy in children. A number of AEDs have been shown to be effective as monotherapy for various types of epilepsy, in which they may therefore be administered as first-line drug. In infancy, Dravet syndrome may worsen with the addition of carbamazepine (CBZ), phenobarbital (PB), lamotrigine (LTG), or vigabatrin (VGB). The coadministration of AED and chemotherapeutic drugs (CTD) may lead either to reduced activity or increased toxicity of an AED. Although the rule of monotherapy as the strategy of choice clearly applies to the majority of pediatric patients suffering from epilepsy, it remains difficult to maintain it for patients with pharmacoresistant epilepsy.