Introduction: Antiepileptic drugs (AEDs) are administered orally for chronic use. Parenteral formulations might be necessary when the oral route is not feasible (e.g. an impairment of consciousness, trauma, dysphagia, gastrointestinal illness) or for treatment of seizure emergencies. At present, few intravenous (IV) formulations are available on the market. Areas covered: The purpose of this review is to summarize the pharmacological characteristics and clinical applications of IV medications that have been recently introduced to the armamentarium of epilepsy therapy or are currently being developed. Apart from AEDs, other compounds belonging to different pharmacological classes (e.g. diuretics, anesthetics), which have shown potential effectiveness in seizure control, are taken into consideration, and the pathophysiological premises supporting their use for epilepsy treatment are illustrated. The authors give particular focus to immunomodulatory and immunosuppressive agents, which have become the therapeutic cornerstones for immune-mediated epilepsies, despite regulatory obstacles. Expert opinion: In several circumstances, especially in the case of seizure-related emergencies, clinical practice seems not match literature-based evidence, and several IV AEDs are still used off-label. Strong evidence derived from randomized clinical trials (RCTs) is needed to support the effectiveness and tolerability of any therapeutic approach, however common and “accepted’ it may be, in order to guarantee patient safety and well-being.

Pharmacology of new and developing intravenous therapies for the management of seizures and epilepsy / Morano, A.; Iannone, L.; Palleria, C.; Fanella, M.; Giallonardo, A. T.; De Sarro, G.; Russo, E.; Di Bonaventura, C.. - In: EXPERT OPINION ON PHARMACOTHERAPY. - ISSN 1465-6566. - 20:1(2019), pp. 25-39. [10.1080/14656566.2018.1541349]

Pharmacology of new and developing intravenous therapies for the management of seizures and epilepsy

Morano A.;Iannone L.;Fanella M.;Giallonardo A. T.;De Sarro G.;Di Bonaventura C.
2019

Abstract

Introduction: Antiepileptic drugs (AEDs) are administered orally for chronic use. Parenteral formulations might be necessary when the oral route is not feasible (e.g. an impairment of consciousness, trauma, dysphagia, gastrointestinal illness) or for treatment of seizure emergencies. At present, few intravenous (IV) formulations are available on the market. Areas covered: The purpose of this review is to summarize the pharmacological characteristics and clinical applications of IV medications that have been recently introduced to the armamentarium of epilepsy therapy or are currently being developed. Apart from AEDs, other compounds belonging to different pharmacological classes (e.g. diuretics, anesthetics), which have shown potential effectiveness in seizure control, are taken into consideration, and the pathophysiological premises supporting their use for epilepsy treatment are illustrated. The authors give particular focus to immunomodulatory and immunosuppressive agents, which have become the therapeutic cornerstones for immune-mediated epilepsies, despite regulatory obstacles. Expert opinion: In several circumstances, especially in the case of seizure-related emergencies, clinical practice seems not match literature-based evidence, and several IV AEDs are still used off-label. Strong evidence derived from randomized clinical trials (RCTs) is needed to support the effectiveness and tolerability of any therapeutic approach, however common and “accepted’ it may be, in order to guarantee patient safety and well-being.
2019
Autoimmune encephalitis; immunotherapy; intravenous; parenteral; prophylaxis; replacement therapy; status epilepticus; Administration, Intravenous; Anticonvulsants; Epilepsy; Humans; Randomized Controlled Trials as Topic; Seizures
01 Pubblicazione su rivista::01a Articolo in rivista
Pharmacology of new and developing intravenous therapies for the management of seizures and epilepsy / Morano, A.; Iannone, L.; Palleria, C.; Fanella, M.; Giallonardo, A. T.; De Sarro, G.; Russo, E.; Di Bonaventura, C.. - In: EXPERT OPINION ON PHARMACOTHERAPY. - ISSN 1465-6566. - 20:1(2019), pp. 25-39. [10.1080/14656566.2018.1541349]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1282532
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