Lamotrigine

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拉莫三嗪

Lamotrigine

A phenyltriazine compound, sodium and calcium channel blocker that is used for the treatment of SEIZURES and BIPOLAR DISORDER.

A synthetic phenyltriazine with antiepileptic and analgesic properties. Lamotrigine enhances the action of gamma-aminobutyric acid, an inhibitory neurotransmitter, which may result in a reduction of pain-related transmission of signals along nerve fibers. This agent may also inhibit voltage-gated sodium channels, suppress glutamate release, and inhibit serotonin reuptake. (NCI04)

Discuss with women and girls who are taking lamotrigine that the simultaneous use of any oestrogen-based contraceptive can result in a significant reduction of lamotrigine levels and lead to loss of seizure control. When a woman or girl starts or stops taking these contraceptives, the dose of lamotrigine may need to be adjusted.[new 2012] 应当告知使用拉莫三嗪的女性，任何基于雌激素的避孕药的同时使用都可能使拉莫三嗪水平的显著下降，导致癫痫发作失控。当其开始或停止使用此类避孕药时，拉莫三嗪的剂量或需调整。 Do not routinely monitor AED levels during pregnancy. If seizures increase or are likely to increase, monitoring AED levels (particularly levels of lamotrigine and phenytoin, which may be particularly affected in pregnancy) may be useful when making dose adjustments. [new 2012] 怀孕期间不要常规监测抗癫痫药物水平。如果癫痫发作增加或可能增加，监测 AED 水平（尤其是拉莫三嗪和苯妥英的水平，其在怀孕期间可能受到特别影响）在调整剂量时可能有用。 [2012年新] nice.org.uk/guidance/cg137

Lamotrigine

[GRADES OF RECOMMENDATION:C] Based on limited evidence, in utero exposure to carbamazepine and lamotrigine does not appear to adversely affect neurodevelopment of the offspring. There is very little evidence for levetiracetam and phenytoin. Parents should be informed that evidence on long-term outcomes is based on small numbers of children. 【推荐等级：C】应告知WWE及其伴侣，关于宫内暴露于AEDs产生的长期神经发育结果是基于少数儿童的。有限的证据表示，宫内接触CBZ和LTG似乎不会影响后代神经生长发育；使用LEV和PHT的证据很少。 https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/epilepsy-in-pregnancy-green-top-guideline-no-68/

[GRADES OF RECOMMENDATION:C] Women taking lamotrigine monotherapy and oestrogen-containing contraceptives should be informed of the potential increase in seizures due to a fall in the levels of lamotrigine. 【推荐等级：C】应告知同时服用拉莫三嗪（单一疗法）和含雌激素避孕药的WWE，由于拉莫三嗪水平的下降，癫痫发作的风险增加。 https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/epilepsy-in-pregnancy-green-top-guideline-no-68/

[GRADES OF RECOMMENDATION:D] Parents should be made aware of signs of toxicity in infants of breastfeeding women taking antiepileptic drugs. The possibility of sedation should be considered in infants of mothers taking high dose antiepileptic drugs, polytherapy, or regimens including primidone, levetiracetam, gabapentin, lamotrigine and topiramate. D级推荐：应告知女性癫痫患者及其伴侣，哺乳期服用AEDs可能对新生儿/婴儿有不良影响。服用大剂量AEDs、综合疗法或采用包含扑米酮、左乙拉西坦、加巴喷丁、拉莫三嗪和托吡酯在内的治疗方案的哺乳期母亲婴儿可能会有镇静的副作用。 Scottish Intercollegiate Guidelines Network.Diagnosis and management of epilepsy in adults. SIGN 143. Edinburgh, SIGN, 2015. Available at: www.sign.ac.uk/guidelines/fulltext/143/index.html

[GRADES OF RECOMMENDATION:D] Women with epilepsy receiving lamotrigine: D级推荐：对于接受LTG治疗的妇女： can use progestogen-only contraceptives without restriction. These women should be made aware of signs and symptoms of lamotrigine toxicity, and have the lamotrigine dose reduced if these occur. 可不受限制地使用仅含有孕激素的避孕药（但应注意LTG中毒的临床表现，若中毒，应减少LTG剂量）； and combined hormonal contraceptives should be counselled about the reduction in circulating lamotrigine concentrations and the potential for, and consequences of, increased seizure activity. The healthcare professional should also discuss the possibility of increasing the lamotrigine dose with the patient. 若联合使用激素类避孕药，可能会降低血浆LTG浓度，可能导致癫痫发作次数增加，需要增加LTG剂量； and combined hormonal contraceptives should be warned about signs and symptoms of lamotrigine toxicity if the contraceptive is withdrawn. A reduction in lamotrigine dosing may be necessary at this time. 联合使用LTG和组合避孕药，应警惕LTG中毒症状，此时可能需要降低LTG剂量。 Scottish Intercollegiate Guidelines Network.Diagnosis and management of epilepsy in adults. SIGN 143. Edinburgh, SIGN, 2015. Available at: www.sign.ac.uk/guidelines/fulltext/143/index.html

Lamictal Lamotrigine 35-diamino-6-(23-dichlorophenyl)-124-triazine Lamiktal 124-Triazine-35-diamine 6-(23-dichlorophenyl)- Lamotrigina Lamotrigine-containing product Product containing lamotrigine (medicinal product) Lamotrigine (substance) Lamotriginum 35-Diamino-6-(23-dichlorophenyl)-as-triazine Labileno BW430C BW 430C Crisomet BW-430C

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