PubMed · 11214159
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L Duley, B Farrell, J Neilson. 2001-01-27. Pre-eclampsia.. https://doi.org/10.1016/s0140-6736(05)71759-1
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Epilepsy is the most common serious neurological disorder and is one of the world's most prevalent noncommunicable diseases. As the understanding of its physical and social burden has increased it has moved higher up the world health agenda. Over four-fifths of the 50 million people with epilepsy are thought to be in developing countries; much of this condition results from preventable causes. Around 90% of people with epilepsy in developing countries are not receiving appropriate treatment. Consequently, people with epilepsy continue to be stigmatized and have a lower quality of life than people with other chronic illnesses. However, bridging the treatment gap and reducing the burden of epilepsy is not straightforward and faces many constraints. Cultural attitudes, a lack of prioritization, poor health system infrastructure, and inadequate supplies of antiepileptic drugs all conspire to hinder appropriate treatment. Nevertheless, there have been successful attempts to provide treatment, which have shown the importance of community-based approaches and also indicate that provision for sustained intervention over the long term is necessary in any treatment programme. Approaches being adopted in the demonstration projects of the Global Campaign Against Epilepsy--implemented by the International League Against Epilepsy, the International Bureau for Epilepsy, and the World Health Organization--may provide further advances. Much remains to be done but it is hoped that current efforts will lead to better treatment of people with epilepsy in developing countries.
The stability of the new chemical synthetic enaminone derivative (E118) was investigated using a stability-indicating high-performance liquid chromatography (HPLC) procedure. The examined samples were analyzed using a chiral HSA column and a mobile phase (pH 7.5) containing n-octanoic acid (5 mM), isopropyl alcohol and 100 mM disodium hydrogen phosphate solution (1:9 v/v) at a flow rate of 1 ml min(-1). The developed method was specific, accurate and reproducible. The HPLC chromatograms exhibited well-resolved peaks of E118 and the degradation products at retention times <5 min. The stability of E118 was performed in 0.1 M hydrochloric acid, 0.1 M sodium hydroxide, water/ethanol (1:1) and phosphate buffer (pH approximately 7.5) solutions. E118 was found to undergo fast hydrolysis in 0.1 M hydrochloric acid solution. The decomposition of E118 followed first order kinetics under the experimental conditions. The results confirmed that protonation of the enaminone system in the molecule enhanced the hydrolysis of E118 at degradation rate constant of 0.049 min(-1) and degradation half-life of 14.1 min at 25 degrees C. However, E118 was significantly stable in 0.1 M sodium hydroxide, physiological phosphate buffer (pH 7.5) and ethanol/water (1:1) solutions. The degradation rate constants and degradation half-lives were in the ranges 0.0023-0.0086 h(-1) and 80.6-150.6 h, respectively. Analysis of the acid-induced degraded solution of E118 by liquid chromatography-mass spectrometry (LC-MS) revealed at least two degradation products of E118 at m/z 213.1 and 113.1, respectively.
A high-performance liquid chromatographic method with UV detection for the simultaneous analysis of the antiepileptic drug carbamazepine and five of its metabolites in human plasma has been developed. The analysis was carried out on a reversed-phase column (C8, 150x4.6 mm I.D., 5 microm) using acetonitrile, methanol and a pH 1.9 phosphate buffer as the mobile phase. Under these chromatographic conditions, carbamazepine and its metabolites 10,11-dihydro-10,11-epoxycarbamazepine, 10,11-dihydro-10,11-dihydroxycarbamazepine, 2-hydroxycarbamazepine, 3-hydroxycarbamazepine and 10,11-dihydro-10-hydroxycarbamazepine are baseline separated in less than 18 min. The extraction of the analytes from plasma samples was performed by means of an original solid-phase extraction procedure using Oasis HLB cartridges. The method requires only 250 microl of plasma for one complete analysis. The repeatability (RSD%<2.4), intermediate precision (RSD%<3.5) and extraction yield (84.8-103.0%) were very good for all analytes. The method is suitable for reliable therapeutic drug monitoring of patients undergoing chronic treatment with carbamazepine and for kinetic-metabolic studies of this drug.