Newer Second-Generation Agents

Felbamate (FelbatolFelbamate is indicated for treatment of partial seizures in adults and children as well as generalized absence seizures (Lennox-Gastaut syndrome) in children. Felbamate appears to bind 

Lamotrigine (Lamictal ). Lamotrigine is used primarily as an adjunct to other medications in adults with partial seizures, although it has also been used 

Generic Name Felbamate Trade Name Felbatol Primary lndication(s) Used alone or as an adjunct in partial seizures in adults treatment adjunct in partial and generalized seizures associated with Lennox-Gastaut syndrome in children 

Gabapentin Neurontin Treatment adjunct in partial seizures in adults and children over age 3 

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In the past, tricyclic drugs such as amitriptyline and nortriptyline were the most commonly used antidepressants and were the standard against which other antidepressants were measured.30 The use of tricyclic drugs as the initial treatment of depression has diminished somewhat in favor of some of the newer second-generation drugs, which may have more favorable side-effect profiles. Tricyclic agents, nonetheless, remain an important component in the management of depressive disorders, especially in more severe forms of depression that fail to respond to other antidepressants.6,53... 

The newer second generation compounds, glyburide and glypizide, have a greatly increased potency and sometime efficacy (i.e., they may produce clinical responses in patients who have failed to exhibit one with earlier agents). 

Over 10000 quinolone antibacterial agents have now been synthesized. Nalidixic acid is regarded as the progenitor of the new quinolones. It has been used for several years as a clinically important drug in the treatment of urinary tract infections. Since its clinical introduction, other 4-quinolone antibacterials have been synthesized, some of which show considerably greater antibacterial potency. Furthermore, this means that many types of bacteria not susceptible to nahdixic acid therapy m be sensihve to the newer derivahves. The most important development was the introduction of a fluorine substituent at C-6, which led to a considerable increase in potency and spectrum of activity compared with nalidixic add. These second-generation quinolones are known as fluoroquinolones, examples of which are ciprofloxacin and norfloxacin (Fig. 5.19). 

Second-generation" or newer agents consisting of vigabatrin (8), gabapentin (9),... 

Du Busks LM Second-generation antihistamines the risk of ventricular amhythmlas. Clin Ther 1999 21 281-295. [PMID 10211532] (The newer agents loratadine, cetlrizlne, azelastine, and fexofenadine are not associated with torsade de pointes or other ventricular arrhythmias.) HIgh-dose loratadine exposure In a six-year-old child. Vet Hum Tox/co/2001 43(3) 163-164. [PMID 11383659] (A 300-mg overdose caused only minor elevation of blood pressure and heart rate.)... 

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