Pemoline‐associated fulminant liver failure: Testing the evidence for causation

  title={Pemoline‐associated fulminant liver failure: Testing the evidence for causation},
  author={Matitiahu Berkovitch and Elena Pope and James Phillips and Gideon Koren},
  journal={Clinical Pharmacology \& Therapeutics},

Pemoline-Associated Hepatic Failure: A Critical Analysis of the Literature

A descriptive metaanalysis of the existing scientific literature and drug reporting databases appears to indicate that current assumptions of the risk of acute hepatic failure posed by pemoline usage alone are overestimates.

Pemoline hepatotoxicity in children.

Four cases of severe hepatotoxicity associated with pemoline: possible autoimmune pathogenesis.

Four cases of marked liver dysfunction in children on pemoline were encountered, two of these progressed to fulminant hepatic failure requiring liver transplantation and in those cases where autoantibodies were measured, there was evidence for autoimmune activation.

Pemoline Therapy Resulting in Liver Transplantation

With increasing evidence linking pemoline to liver failure, this agent should not be considered first-line therapy for ADHD and parents and patients should be educated on the signs and symptoms of liver toxicity.

Inappropriate pemoline therapy leading to acute liver failure and liver transplantation.

A Surveillance Method for the Early Identification of Idiosyncratic Adverse Drug Reactions

This method enables researchers, clinicians, drug companies and regulators to identify uncommon adverse drug reactions, caused mostly by new medications, earlier than they currently are in the course of marketing and thus quantify serious adverse events.

Safety assessment in pediatric studies.

In this chapter, several novel methods, both clinically based pharmacoepidemiological approaches and laboratory-based methods, are described to identify associations of a drug with a rare, serious adverse reaction.

New Agents and Second-line Therapies for Attention-Deficit / Hyperactivity Disorder

Alternative choices for the treatment of ADHD are covered, including a new medication, atomoxetine, and second-line therapies such as clonidine, antidepressants, and anxiolytics.

Treatment of cancer-related fatigue: an update

There is a lack of well-designed clinical trials to evaluate pharmacologic agents for the treatment of cancer-related fatigue, and an individualized treatment plan that includes several modalities may be developed.



Hepatotoxicity Due to Pemoline

Two patients who developed reversible liver abnormalities while receiving pemoline during the study and following rechallenge with the drug are described.

Hepatotoxicity due to pemoline (Cylert): a report of two cases.

A spectrum of hepatic disease due to pemoline is considered and the importance of obtaining aminotransferase values before, during initiation, and throughout treatment is stressed.

Emergency liver transplantation for fulminant liver failure in infants and children

Emergency liver transplantation appears to be an effective treatment for children with fulminant liver failure, Nevertheless, irreversible brain damage developed in 10 patients, and they died before or after surgery.

Predisposition to phenytoin hepatotoxicity assessed in vitro.

A heritable defect in response to arene oxides may predispose some patients to phenytoin hepatotoxicity, as exposed human lymphocytes to metabolites generated by a murine hepatic microsomal system.

A survey of medication treatment for hyperactive/inattentive students.

The results reveal a consistent doubling of the rate of medication treatment for hyperactive/inattentive students every four to seven years such that in 1987, 5.96% of all public elementary school students were receiving such treatment.

Trends in Medication Treatment of Hyperactive School Children

It was found that the rate of medication treatment of hyperactive students increased two- to threefold over the decade, and female, relative to male, students were treated with medication for hyperactivity less often than would be expected in teacher surveys of class room hyperactivity.

Pemoline (Cylert)-induced hepatotoxicity.

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  • Medicine
    Journal of pediatric gastroenterology and nutrition
  • 1990

Drug induced liver disease.

  • M. Black
  • Medicine
    Postgraduate medical journal
  • 1983