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Evaluation of fosphenytoin, levetiracetam, and propofol as treatments for nerve agent-induced seizures in pediatric and adult rats
Journal article   Peer reviewed

Evaluation of fosphenytoin, levetiracetam, and propofol as treatments for nerve agent-induced seizures in pediatric and adult rats

Emily N. Dunn, Liana M. Matson, Kari M. Haines, Kimberly A. Whitten, Robyn B. Lee-Stubbs, Kyle E. Berger, Hilary S. McCarren, Cherish E. Ardinger, Cecelia E. Jackson Piercy, Stephanie M. Miller-Smith, …
Neurotoxicology (Park Forest South), v 79(C), pp 58-66
01 Jul 2020
PMID: 32220603
url
https://doi.org/10.1016/j.neuro.2020.03.007View
Published, Version of Record (VoR) Restricted

Abstract

Age differences Anticonvulsants Chemical countermeasures Nerve agent Pediatric rats Sarin Sex differences Status epilepticus
•Male and female immature and adult rats were exposed to the nerve agents sarin or VX to elicit status epilepticus (SE) seizures.•The animals were treated with doses of fosphenytoin, levetiracetam or propofol, three drugs commonly used as second line treatment of SE.•Only propofol was very effective in terminating nerve agent-induced SE in all age groups and sexes.•Fosphenytoin and levetiracetam showed no evidence of modifying the seizures or protecting against seizure-induced neuropathology.•Propofol should be considered a treatment of choice for nerve agent-induced SE refractory to first line anticonvulsant treatment. Multiple recent instances of nerve agent (NA) exposure in civilian populations have occurred, resulting in a variety of negative effects and lethality in both adult and pediatric populations. Seizures are a prominent effect of NAs that can result in neurological damage and contribute to their lethality. Current anticonvulsant treatments for NAs are approved for adults, but no approved pediatric treatments exist. Further, the vast majority of NA-related research in animals has been conducted in adult male subjects. There is a need for research that includes female and pediatric populations in testing. In this project, adult and pediatric male and female rats were challenged with sarin or VX and then treated with fosphenytoin, levetiracetam, or propofol. In this study, fosphenytoin and levetiracetam failed to terminate seizure activity when animals were treated 5 min after seizure onset. Propofol was effective, exhibiting high efficacy and potency for terminating seizure activity quickly in pediatric and adult animals, suggesting it may be an effective anticonvulsant for NA-induced seizures in pediatric populations.

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Web of Science research areas
Neurosciences
Pharmacology & Pharmacy
Toxicology
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