[e-farmacos] Barbexaclona (cont.)

["Martín Cañás" <macanas@netverk.com.ar>]

Estimado Pedro Vasconcelos,

Una busqueda en Pubmed con texto libre arrojo 18 citas, la aplicacion de filtros metodologicos para ensayos clinicos no arrojo ningun resultado. 

La utilizacion de descriptores mesh para barbexaclone y epilepsy arrojo 10
citas que transcribo abajo. La base de datos Sietes no tiene ningun registro. 

La busqueda de articulos en otras bases de datos remite a los 18 articulos citados por pubmed.

Espero que la informacion le sea de utilidad.

Un saludo cordial,

Martin

Martin Canas
GAPURMED
La Plata
(Argentina)
macanas@netverk.com.ar

1: Yaris F, Kadioglu M, Kesim M, Ulku C, Yaris E, Kalyoncu NI. Barbexaclone
use in pregnancy. Saudi Med J. 2004 Feb;25(2):245-6. Esta disponible en: http://www.smj.org.sa/PDFFiles/Feb04/AgeofMenarche.pdf

2: Steinhoff BJ, Stodieck SR. Temporary abolition of seizure activity by
flumazenil in a case of valproate-induced non-convulsive status epilepticus.
Seizure. 1993 Sep;2(3):261-5.

We report on a 33-year-old female suffering from frequent complex-partial
seizures who developed a non-convulsive status epilepticus after one week of
antiepileptic therapy with valproate (VPA) which had been added to a basic medication with barbexaclone (BBC) in rapidly increasing dosage. The electroencephalogram (EEG) showed continuous rhythmic generalized sharp and slow wave activity with a frontal maximum. Intravenous administration of 3.0
mg of the benzodiazepine (BZ) receptor antagonist flumazenil under monitoring with video-EEG led to an immediate and marked electroclinical
improvement, whereas 6.0 mg of the BZ receptor agonist midazolam was followed by a deterioration both clinically and in the EEG. We discuss the
concept of VPA-encephalopathy and the possible mechanisms of the action of
flumazenil on VPA-induced as well as on other toxic and metabolic encephalopathies. Flumazenil might antagonize increased benzodiazepine
receptor activity with agonistic and even convulsive properties in these encephalopathic syndromes. Further investigations are needed concerning the relation of drug-induced or metabolic encephalopathies and central  benzodiazepine receptor activity. We recommend a therapeutic trial with flumazenil, if stupor or decreased seizure control develop in patients treated with valproate.

3: Borromei A, Caramelli R, Cipriani G, Giancola LC, Guerra L, Lozito A.
[Neurotraumatology and post-traumatic epilepsy. Prevention, treatment and
long-term follow-up. Barbexaclone + phenobarbital (maliasin) versus
diphenylhydantoin, phenobarbital, primidone, carbamazepine] Minerva Med. 1987 Nov 30;78(22):1687-705. [Article in Italian]

A report is presented on 58 patients (46 males, 12 females) all suffering
from post-traumatic epilepsy (PTE) and followed up for a minimum of 1 year
to maximum of 23 years after the injury (mean 6.3 years). The type and site
of the head injury, the nature of the brain lesions, the time elapsing before the first critical manifestation, the clinical character of the  epileptic attacks, EEG, cerebral CAT and RMN data were performed are given
for all patients. The therapeutic and prophylactic strategies adopted are
then described in detail with particular emphasis on the use of diphenylhydantoin (DPH) and barbexaclone. The latter drug, used for the last 3 years was found to be particularly useful in the treatment of patients suffering from a post-traumatic psycho-organic syndrome in addition to the PTE.

4: Bretas AD, de Lemos Neto M. [Effects of barbexaclone on the electroencephalogram, motor activity and experimental convulsions] Arq
Neuropsiquiatr. 1983 Dec;41(4):356-66.  [Article in Spanish]

We made a comparative study between the action of barbexaclone and Phenobarbital on the electroencephalographic pattern, on the convulsive
threshold in rats submitted to continuous venous infusion of 4 mg/kg/min of
cardiazol (CDZ) and on the motor activity on the mouse. The barbexaclone
didn't alter the electroencephalographic pattern of the rat and its anticonvulsive activity was demonstrated by the increase of the convulsive
threshold from 66.0 +/- 8.3 mg/kg to 111.2 +/- 12.75 mg/kg. This increase
was similar to that produced by 3.0 mg/kg of phenobarbital. Because the
relation between the anticonvulsive doses is of 1:1,4 and in 100 mg of
barbexaclone there are only 60 mg of phenylethylbarbituric acid, we conclude
that barbexaclone has an equivalent anticonvulsive effect as phenobarbital,
with less alterations of the motor activity.

5: Berendes K, Mattes W, Dorstelmann D.[Drug treatment of reading epilepsy]
Nervenarzt. 1983 Aug;54(8):435-6. [Article in German]

6: Visintini D, Calzetti S, Mancia D.  [Barbexaclone in the treatment of the
epilepsies (author's transl)]  Riv Patol Nerv Ment. 1981 Jan-Feb;102(1):29-37. [Article in Italian]

Chronic administration of barbiturates in the treatment of the epilepsies
causes sedation. The association of C.N.S. stimulant agents appears to offer
a possible advantage. 19 epileptic outpatients were followed up during an
"open" trial of barbexaclone (L-1-cyclohexyl-2-methylaminopropan-phenyl-ethyl-barbiturate) over a period
of about one year. The drug was effective in primary and secondarily generalized epilepsies, and to a lesser extent in partial complex seizures.
The tolerability was good and a reduction of the side-effects due to previous treatment with phenobarbitone has been noticed. The mean dosage of
barbexaclone was lower in patients who improved than in those who remained
unchanged.

7: Fichsel H.  [Effect of barbexaclone treatment on thyroid function in
epileptic children and juveniles (author's transl)] Nervenarzt. 1980
Oct;51(10):633-4.  [Article in German]

8: Cabral Filho G, Mariani MD, Fonseca LF, Soares Neto V, Bolina ND.
[Clinical and laboratory experience in the treatment of epilepsy with
barbexaclone. Considerations on 29 cases] Arq Neuropsiquiatr. 1980
Sep;38(3):269-77. [Article in Portuguese]

Twenty nine patients were treated with barbexaclone for 6-41 months. Eighteen of these patients suffered from grand-mal epilepsy and complete
control of the crises was achieved in 16 of them. No alterations were noted
in the hemogram, liver or renal function tests. Side effects were minimal
and didn't necessitate discontinuing the drug. 25% of the patients also
showed a psychological improvement on the medication.

9: Reis TT, Maia Filho PC, Cechini PC. [Clinical evaluation of the
therapeutic value of barbexaclone including determination of plasma levels of the barbiturate] [Article in Portuguese] Arq Neuropsiquiatr. 1980 Mar;38(1):93-8.

The results of the use of barbexaclone (ciclo-hexil-aminopropan) in association with fenil-etil-barbiturate, as a single anticonvulsant drug in
a clinical and therapeutic trial are reported. Seventy patients, 36 women
and 34 men, 52 children and 18 adults, all of them with two or more epileptic grand-mal seizures at the beginning of treatment, were selected.
In 53 patients a complete 18 months follow-up observation was performed. In
this group of patients, 96% of them were free of seizures during the observation time. In 20 patients the barbiturate plasma concentration was
measured. For these patients, the effectiveness of the treatment was up to
89%, in terms of complete control of convulsive crises. The measurements of
the plasma level of anticonvulsants has shown to be most useful and a safe
therapeutic guide in the treatment of epilepsies.

10: de Lima JM, Oliveira C, Duro LA, Poiares Nde M.  [Effect of barbexaclone
in convulsive crisis difficult to control] Arq Neuropsiquiatr. 1980 Mar;38(1):89-92. [Article in Portuguese]

A therapeutic trial using barbexaclone in uncontrolled seizures was undertaken showing favourable results. Special reference to the association
of barbexaclone with acetazolamide with good results in many cases is made.
Collateral effects are minimal in pacients using barbexaclone.