Hexazinone is a post-emergence herbicide/arboricides, and its acute poisoning has rarely been reported. Hexazinone is low-toxic to humans, but mass intake of hexazinone would still lead to organ impairment. This article analyzes a case of acute hexazinone poisoning from the poisoning treatment center of our hospital, and summarizes the symptoms and treatment effects of hexazinone poisoning, which is aimed at improving the comprehension, diagnosis and treatment of the disease.
Administration, Oral ; Herbicides ; Humans ; Poisoning ; Triazines

BACKGROUND: Chronic administration of morphine leads to the development of tolerance. We investigated the effects of intrathecal lamotrigine on the spinal morphine tolerance in rats that are undergoing tail flick tests. METHODS: Sprague-Dawley rats were given intrathecal injections of saline 10 microl, lamotrigine 300 microg, morphine 15 microg or lamotrigine plus morphine combinations for 7 days (lamotrigine was given for days 1-7, days 1-3 or days 5-7). The acute and chronic nociceptive sensitivities were assessed using a tail flick test in which the distal 5 cm of the tail was dipped into warm water before and 30 minutes after the drug injection. With successive injections of morphine on day 8, a cumulative antinociceptive dose-response curve was constructed and the 50% effective dose (ED50) was calculated for each study group. RESULTS: The coinjection group of lamotrigine with morphine blocked the development of tolerance, as was shown by the preservation of morphine antinociception over 7 days and the concomitant decrease in the ED50 values on day 8, as compared with the morphine-alone group. Coinjection of lamotrigine blocked the development of morphine tolerance, as shown by the preservation of morphine antinociception over 7 days and the concomitant decrease in the ED50 values on day 8, as compared with the morphine-alone group. CONCLUSIONS: This study suggests that lamotrigine augments the antinociceptive action of both acute and chronic morphine therapy, and it also attenuates the antinociceptive morphine tolerance in rats.
Animals ; Injections, Spinal ; Morphine ; Rats ; Rats, Sprague-Dawley ; Triazines ; Water

BACKGROUND: The purpose of this study was to quantitatively assess the subclinical balance dysfunction in elderly people taking antiepileptic drugs. METHODS: We recruited sixty-three patients who were at least 50 years old, without complaint of dizziness or imbalance, and on a stable dose of carbamazepine, lamotrigine or levetiracetam. Their balance scores were compared with those of newly diagnosed untreated age- and sex-matched epilepsy patients (n=21). All the subjects underwent balance measurements that included an activities-specific balance confidence scale, quantitative caloric and rotational chair testing and posturography. The spectral frequency analysis of body sway while standing upright was also investigated. Sensory organization (SOT) and motor control tests were done by computerized dynamic posturography (CDP). RESULTS: The sway distance and area of center of pressure significantly increased in the patients treated with carbamazepine. Spectral frequency analysis of this group showed a significantly increased spectral power at low and middle frequencies on the antero-posterior (Y) plane and at low frequencies on the lateral (X) plane. CDP showed no significant differences in SOT results among the groups. However, motor control test revealed increased latencies and slowed adaptations in the carbamazepine group. CONCLUSIONS: These findings suggest that newer drugs such as lamotrigine or levetiracetam may induce less disequilibrium than carbamazepine in older people on monotherapy for epilepsy. The disturbance is likely related to slowed central postural reflexes.
Aged ; Anticonvulsants ; Carbamazepine ; Cytidine Diphosphate ; Dizziness ; Epilepsy ; Humans ; Piracetam ; Triazines

Last year, an epidemic of infantile urinary stone disease developed in China. Investigation revealed that melamine-tainted diary product caused urinary stone in these infants. Young infants were susceptible to the melamine toxicity and dehydration or other stone-prone factors aggravated the toxicity. Melamine-related urinary stones were small, multiple, and mainly composed of uric acid, thus conservative treatment of hydration and urine alkalinization worked well in majority of the patients.
China ; Dehydration ; Humans ; Infant ; Triazines ; Uric Acid ; Urinary Calculi

OBJECTIVE: The pharmacotherapy of bipolar disorder not otherwise specified (BP-NOS) has been insufficiently studied. The aim of this prospective naturalistic study was to explore the effectiveness of lamotrigine adjunctive treatment in patients with BP-NOS. METHODS: Data from 50 patients diagnosed with BP-NOS were analyzed. On the basis of the prospective mood chart methodology, the efficacy of lamotrigine adjunctive treatment was assessed by changes in the mean Clinical Global Impressions-Bipolar Version (CGI-BP) depression scores. A paired t-test was used to test the statistical significance of the changes in CGI-BP depression scores. Repeated-measures analysis of variance (RM ANOVA) with simple effect analysis was performed to explore the sequential changes during a 52-week period. Cohen's d was calculated to measure the magnitude of the treatment effects on the changes in depression severity. Time to lamotrigine discontinuation was also calculated using the Kaplan-Meier estimates. Lamotrigine-associated adverse events were monitored every two weeks. RESULTS: A significant decrease, with a large effect size (Cohen's d=1.6), in the mean CGI-BP depression scores was associated with lamotrigine adjunctive treatment in intent-to-treat analysis (t=8.7, df=49, p<0.001). Twenty-four patients (48.0%) completed 52-week lamotrigine adjunctive treatment. Analysis of the data obtained from those completing the treatment revealed a large effect (Cohen's d=4.0) on improvement in the severity of depression (t=16.8, df=32, p<0.001). Sixty percent of patients achieved remission (n=30), and 64% of patients (n=32) showed some clinical response to lamotrigine adjunctive treatment. The mean time to lamotrigine discontinuation was 31.3+/-3.1 weeks (CI=25.2-37.4). Lamotrigine adjunctive treatment was well tolerated, with no serious rashes reported. CONCLUSION: Lamotrigine seems to be effective in the management of depressive symptoms in BP-NOS. Long-term use of lamotrigine was generally safe and well tolerated. Large-scale controlled trials might be needed to confirm the findings of this naturalistic study.
Bipolar Disorder ; Depression ; Exanthema ; Humans ; Prospective Studies ; Triazines

Alveolitis, Extrinsic Allergic ; chemically induced ; Humans ; Triazines ; adverse effects

Lamotrigine is a newer anti-epileptic drug for adjunctive treatment of refractory epilepsy, partial seizures, generalized tonic-clonic seizures, and bipolar disorder. Lamotrigine overdose causes serious central nervous and cardiovascular problems, but reports are uncommon. Few lamotrigine overdoses have been described because anti-epileptic drug use is limited and usually used with combination of other anti-epileptic drugs. In addition, most patients visit emergency departments with multi-drug overdoses, so few cases of lamotrigine poisoning alone exist. We had a female patient visit our emergency department a couple of hours after a lamotrigine overdose treated with intravenous hydration and urine alkalization by NaHCO3. She recovered successfully without any evidence of renal injury. However, she developed profound rhabdomyolysis, a previously unreported complication of this medication. We suggest that serial creatine kinase levels should be measured after lamotrigine poisoning.
Bipolar Disorder ; Creatine Kinase ; Emergencies ; Epilepsies, Partial ; Female ; Humans ; Rhabdomyolysis ; Seizures ; Triazines

PURPOSE: This study was conducted for evaluation of the effects of new antiepileptic drugs on bone mineral density in children with epilepsy. METHODS: The study group consisted of 35 age and gender matched controls and 35 epileptic children taking new antiepileptic drugs: 14 on topiramate, 10 on lamotrigine, and 11 on oxcarbazepine in monotherapy. All patients were treated for more than one year and all were normally ambulatory children. We measured serum levels of calcium, alkaline phosphatase, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine regions L1-L4. RESULTS: Vitamin D levels of the oxcarbazepine group (25-hydroxyvitamin D: 40.3+/-10.5 ng/mL and 1,25-dihydroxyvitamin D: 57.9+/-15.2 pg/mL) were significantly lower than in controls (44.6+/-11.5 ng/mL, 66.2+/-10.5 pg/mL, P<0.05); however, they did not differ significantly in the topiramate and lamotrigine groups. The bone mineral density value was significantly lower in the oxcarbazepine (L1-L4: 0.73+/-0.11 g/cm2) group, compared with the controls (0.84+/-0.06 g/cm2, P<0.05) or patients taking topiramate or lamotrigine. CONCLUSION: Monitoring of bone metabolism is recommended for patients treated with new antiepileptic drugs, particularly oxcarbazepine.
Absorptiometry, Photon ; Alkaline Phosphatase ; Anticonvulsants ; Bone Density ; Calcium ; Carbamazepine ; Child ; Fructose ; Humans ; Spine ; Triazines ; Vitamin D

BACKGROUND: Vardenafil is a phosphodiesterase type 5 inhibitor, used in erectile dysfunction. This study aimed to evaluate the pharmacokinetics and tolerability of vardenafil following a single oral administration in healthy male subjects. METHODS: A randomized, double-blind, placebo-controlled, single dosing, dose-escalation study was conducted in 30 healthy subjects. A single oral dose of vardenafil or placebo was given to 10 subjects (8 active + 2 placebo) in each dose group of 5, 10 and 20 mg. Serial blood and urine samples were obtained up to 48 hours for pharmacokinetic analysis. Vardenafil and its metabolite were detected by high performance liquid chromatography tandem mass spectrometry assay. RESULTS: A total of 45 adverse events (AE) were reported in 22 subjects, including 5 AEs from placebo treatment, and all the AEs were mild, except one case of moderate nasal stuffiness. Vardenafil was absorbed after a single oral dose, with the tmax of 0.5-1.0 hours. The Cmax and AUClast were 10.21 +/- 3.68 ug/L(mean +/- SD) and 18.08 +/- 7.44 ugxh/L in 5 mg dose group, 19.79 +/- 12.13 ug/L and 38.61 +/- 21.04 ugxh/L in 10 mg dose group and 53.16 +/- 37.01 ug/L and 110.05 +/- 69.65 ugxh/L in 20 mg dose group. Dose-linearity on AUClast and Cmax of vardenafil were observed in three dose groups. In all dose groups, the fraction excreted in urine was less than 1%. CONCLUSION: The vardenafil was tolerable over a single dose range of 5 - 20 mg. The pharmacokinetics of vardenfil after a single oral dose was explored and linear pharmacokinetic characteristics were observed over the dose range of 5 - 20 mg in healthy subjects.
Administration, Oral ; Chromatography, Liquid ; Erectile Dysfunction ; Humans ; Imidazoles ; Male ; Piperazines ; Sulfones ; Tandem Mass Spectrometry ; Triazines

PURPOSE: Paroxysmal kinesigenic dyskinesia (PKD) is one of the movement disorders in which dyskinesia occurs in a part of the body by a sudden movement after a rest under a tension or a stress. This study was aimed to evaluate the clinical features of children and adolescents with PKD in Korea via analysing the patients who have treated in Department of Pediatrics, Kyungpook National University Hospital. METHODS: A total of seven children with PKD was involved in the study and their medial records were retrospectively evaluated. RESULTS: The mean age of the 7 subjects was 15.7 years (10.0-21.4 years old). The male to female ratio was 6:1. They presented with dystonia with the average duration of 10.5 seconds (3.5-17.5 seconds), which triggered by various sudden movements. No accompanying cormorbidities were noted. Their laboratory findings were unremarkable. Six of the patients, except one who refused treatment with medicine, responded well to medication and remained symptom free. The average time response to medication was 3.4 weeks (0.95-7.81 weeks). They were of treated with either oxcarbazepine (n=4, 14.9+/-5.8 mg/kg/day) or lamotrigine (n=2, 1.5+/-0.9 mg/kg/day). There was no significant difference between two groups in terms of age, response, adverse events, and so on. CONCLUSION: This study showed that clinical features of Korean children with PKD are quite similar to those of other countries. They responded well to the medication. In addition, lamotrigine can be an alternative choice for the treatment.
Adolescent ; Carbamazepine ; Child ; Chorea ; Dyskinesias ; Dystonia ; Female ; Humans ; Korea ; Male ; Movement Disorders ; Pediatrics ; Retrospective Studies ; Triazines