[A clinico-pharmacological basis for optimizing the treatment of therapy-resistant forms of epilepsy]. / Kliniko-farmakologicheskoe obosnovanie optimizatsii lecheniia rezistentnykh k terapii form épilepsii.

On 44 epileptic patients antiepileptic phenobarbital, finlepsin, diphenine, hexamidine were studied. The alterations in the level of free and bound fractions under the drug application in maximal tolerance daily doses, depending on changes in the administration frequency during the day, were recorded. It was established that level fluctuations of the total preparation occur mainly owing to level alterations in the fraction not bound to serum proteins. An increase in the drug administration frequency under the constant daily dose leads to a distinct reduction in the free fraction level fluctuations between doses, to a decrease in the intensity or removal of side effects, and makes it possible to further build up the daily dose to obtain the required effect.

[The results of the therapeutic monitoring of piracetam in parturients and newborn infants]. / Rezul'taty terapevticheskogo monitoringa piratsetama u rozhenits i novorozhdennykh detei.

Overall 30 women in childbirth with preeclampsia and fetoplacental dysfunction received piracetam solution which was given initially in a dose of 5 g by intravenous drip, rapidly since the onset of labour and then every 2 hours till the end of labour in a dose of 2 g by jet injection. This made it possible to increase fetus resistance to hypoxic conditions. The concentrations of piracetam within the range of 60-80 g/l in the blood of women in childbirth should be viewed as minimum therapeutic. A single daily intramuscular injection of piracetam (50 mg/kg) into neonates with encephalopathies may build up blood concentrations equal to 25-60 mg/l after 2 hours. The drug is not detectable in the blood by the moment the next injection is given.

[The effect of hemosorption on the kinetics of theophylline in children with bronchial asthma]. / Vliianie gemosorbtsii na kinetiku teofillina u detei s bronkhial'noi astmoi.

Despite complete absorption of theophylline by CKH-4H and phi AC sorbents from the blood of patients one hour after hemosorption the blood drug level reached the values corresponding to the usual level of theophylline elimination. It is concluded that no correction of theophylline dosage is needed during treatment of patients with bronchial asthma by hemosorption, however, the initial blood content of the drug should be between medium and maximum drug level capable of causing therapeutic effect.

[Therapeutic and pharmacological monitoring of individual monotherapy of epilepsy with hexamidine]. / Terapevticheskii i farmakologicheskii monitoring pri individualizatsii monoterapii geksamidinom bol'nykh épilepsiei.

The treatment with primidone alone of 53 epileptic patients with generalized tonic-clonic seizures, partial attacks with elementary symptomatology, and partial fits with complex symptomatology removed them completely in 75, 64.2, and 36.9% of the patients, respectively. The number of attacks was decreased as a result by 50% and over in 90, 78.6, and 73.7% of the patients, respectively. The attainment of such high efficacy of the monotherapy (called by the author intensive in contrast to routine or inadequate therapy carried out, as a rule, in standard doses) appeared possible only under the conditions of individualization of the drug doses which ranged within 250-2500 mg/day. The concentration of phenobarbital, the main end metabolite of primidone, in the blood serum of patients, in whom the attacks were completely arrested and who developed no clinical side effects with no toxic action on the internal organs, ranged from 14 to 59.1 mg/l. In partial fits with complex symptomatology, primidone appeared least effective for those types of fits in the treatment of which it was viewed as most adequate.

[The effect of almagel on euphylline absorption in children with bronchial asthma]. / Vliianie almagelia na vsasyvanie éufillina u detei s bronkhial'noi astmoi.

The study of almagel effect on euphylline absorption in children with bronchial asthma showed a decrease of theophylline concentration by 10-15% ten days after the combined administration of the drugs. The absence of the change in the blood theophylline concentration three days after administration of almagel against the background of euphylline indicates that the reason for a decrease of euphylline absorption is not the absorbing and lubricating properties of almagel but probably almagel-induced reduction of the inflammation of the gastrointestinal tract mucosa (hyperemia, increased vascular permeability) caused by euphylline.

[Peripheral mechanism of the phenomenon of fenibut habituation]. / Perifericheskii mekhanizm fenomena pruvykaniia k fenibutu.

In spite of the appearance of the tolerance to phenibut in white rats at days 11-12 of its intraperitoneal administration (250 mg/kg), the drug injections (25 micrograms) into the lateral ventricles of the brain via permanent cannulas evoked, as before, a fall in the body temperature and synchronization of the electrocorticogram in rats. The tolerance to phenibut did not occur when the drug was injected daily (12 days) into the brain ventricles. A conclusion is made that the tolerance to phenibut has a peripheral character.