Felbamate (marketed under the brand name Felbatol by MedPointe) is an anticonvulsant used in the treatment of epilepsy. It is used to treat partial seizures (with and without generalization) in adults and partial and generalized seizures associated with Lennox–Gastaut syndrome in children. However, an increased risk of potentially fatal aplastic anemia and/or liver failure limit the drugs usage to severe refractory epilepsy. Mechanism of action
Felbamate has been proposed to have a unique dual mechanism of action as a positive modulator of GABAA receptors and as a blocker of NMDA receptors, particularly isoforms containing the NR2B subunit. Although it is clear that felbamate does cause pharmacological inhibition of NMDA receptors, the relevance of NMDA receptor blockade as a strategy for the treatment of human epilepsy has been questioned. Therefore, the importance of the effects of felbamate on NMDA receptors to its therapeutic action in epilepsy is uncertain. Approval history
United States
August 1993. Felbamate was approved for partial seizures with and without secondary generalization in adults and for Lennox–Gastaut Syndrome, a serious form of childhood epilepsy. Over the following year 150,000 people were started on felbamate therapy and a third of these became established. August 1, 1994. It was urgently withdrawn after 10 cases of aplastic anemia. A "Dear Doctor" letter was sent to 240,000 physicians. September 27, 1994. Felbamate had a limited redemption in another "Dear Doctor" letter sent to 260,000 physicians.
Cheyletiella is a genus of mites that live on the skin surface of dogs, cats, and rabbits.The adult mites are about 0.385 millimeters long, have eight legs with combs instead of claws, and have palpi that end in prominent hooks. They do not burrow into the skin, but live in the keratin level. Their entire 21-day life cycle is on one host. They cannot survive off the host for more than 10 days. Cheyletiellosis
Cheyletiellosis (also known as Cheyletiella dermatitis)," is a mild dermatitis caused by mites of the genus Cheyletiella. It is also known as walking dandruff due to skin scales being carried by the mites. Cheyletiellosis is seen more commonly in areas where fleas are less prevalent, because of the decreased use of flea products that are also efficacious for the treatment of this mite.Cheyletiellosis is highly contagious. Transmission is by direct contact with an affected animal. Presentation
Symptoms in animals vary from no signs to intense itching, scales on the skin, and hair loss. The lesions are usually on the back of the animal. Symptoms in humans include multiple red, itchy bumps on the arms, trunk, and buttocks. Because humans are not a host for the mite, the symptoms usually go away in about three weeks. Though the medical community does not consider a human mite infestation a legitimate diagnosis, it will treat the symptoms if necessary. Diagnosis
Diagnosis is by finding the mites or eggs microscopically in a skin scraping, combing, or on acetate tape applied to the skin.