卢非酰胺长期用药的副作用和相关处理措施？

The most common side effects of long-term use of rufinamide are headache, dizziness, fatigue, drowsiness, and nausea. Side effects such as mood changes, depression, dizziness, and drowsiness are also included. It's important to note that everyone reacts differently to medications. Therefore, some people may experience major side effects, while others experience almost no side effects.

Rufinamide

On January 16, 2007, it obtained marketing approval from the European Medicines Agency (EMA).

On November 14, 2008, it was approved by the U.S. Food and Drug Administration (FDA).

Rufinamid is indicated for the adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in pediatric patients 1 year of age and older and in adults.

Rufinamide’s mechanism of action

The mechanism of action of rufinamide in the treatment of epilepsy is not fully understood, but there are several possible pathways involved.

1. Sodium channel regulation: Rufinamide can inhibit sodium ion channels in nerves, reduce the influx of sodium ions, thereby inhibiting abnormal excitability.

2. Calcium ion channel regulation: Rufinamide can also inhibit high-voltage calcium ion channels in nerves, reduce the influx of calcium ions, and thereby inhibit excitatory conduction.

3. Enhanced GABA effect: Rufinamide may exert anti-epileptic effects by enhancing the inhibitory effect of the neurotransmitter γ-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter in the central nervous system and plays an important role in inhibiting the excitability of nerves.

4. Neuroprotective effect: Some studies have shown that rufinamide may have a neuroprotective effect and can reduce nerve damage and death.

Side effects of long-term use of rufinamide

1. Psychiatric symptoms: Mental symptoms such as mood changes, depression, anxiety, fatigue, and inability to concentrate may occur.

2. Decline in memory and cognitive functions: Long-term use of rufinamide may affect memory and cognitive functions, including attention, concentration and learning abilities.

3. Weight gain: Some patients may experience weight gain as a side effect when using rufinamide.

4. Dizziness and drowsiness: Rufinamide may cause dizziness and drowsiness, affecting patients’ daily activities and work.

5. Osteoporosis: Long-term use of rufinamide may increase the patient's risk of osteoporosis, and bone density needs to be closely monitored.

6. Abnormal liver function: A small number of patients may experience abnormal liver function, including elevated liver enzymes or liver damage, and liver function needs to be monitored regularly.

7. Skin reaction: A small number of patients may have allergic reactions to rufinamide, manifesting as rash, itching, urticaria, etc.

8. Others: such as headache, dizziness, fatigue, nausea, double vision, tremor, blurred vision, vomiting, constipation, indigestion, back pain, gait disorder, etc.

Treatment measures for rufinamide-related side effects

1. Mental symptoms such as mood changes, depression, and anxiety: Doctors may adjust drug dosages or recommend other treatments, such as psychotherapy or drug replacement.

2. Decline in memory and cognitive functions: You can try memory and cognitive exercises, such as puzzle games, memory training, etc.

3. Weight gain: Maintain healthy eating habits, control food intake, increase physical exercise, and promote metabolism. Seek your doctor's advice about possible alternatives.

4. Dizziness and drowsiness: Avoid getting up suddenly or changing positions quickly, move slowly, and avoid driving vehicles or operating dangerous machinery to avoid accidents.

5. Osteoporosis: It is recommended to conduct regular bone density examinations, supplement calcium and vitamin D, and increase moderate physical activities, such as walking, dancing, etc.

6. Abnormal liver function: Liver function tests should be performed regularly to detect any abnormalities in time. If liver function abnormalities occur, the drug dose may need to be adjusted or discontinued. Avoid alcohol and other drugs that may damage your liver.

7. Skin reaction: If allergic reactions such as rash, itching or urticaria occur, contact your doctor immediately. The doctor may recommend stopping the use of the drug and recommend other alternative drugs according to the situation.

of rufinamide

Use of rrufinamide as adjuvant therapy in patients with Lennox-Gastaut syndrome at an initial dose of 10 mg/kg/day and a target dose of 45 mg/kg/day reduced the median overall seizure frequency by 32.7% compared with 11.7% in the placebo group.

A similar reduction in overall seizure frequency was maintained during the extension phase of this study. Rufinamide also appears to improve partial seizures and refractory epilepsy in other studies, but further studies are needed to validate this observation and determine its clinical significance.

Summary

Not all patients taking rufinamide will experience the above side effects, and specific side effects may vary from individual to individual. The above treatment measures are for reference only. Specific treatment methods should be determined according to individual circumstances and doctor's recommendations.

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