Serum concentration/dose ratio of topiramate during pregnancy
Autor: | Andreas Austgulen Westin, Arne Reimers, Kari Mette Lillestølen, Karl O. Nakken, Eylert Brodtkorb, Svein I. Johannessen |
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Rok vydání: | 2009 |
Předmět: |
Topiramate
Metabolic Clearance Rate Pregnancy Trimester Third medicine.medical_treatment Physiology Renal function Epilepsies Myoclonic Fructose Pharmacokinetics Pregnancy medicine Humans Epilepsy Dose-Response Relationship Drug medicine.diagnostic_test business.industry Infant Newborn Pregnancy Outcome Abnormalities Drug-Induced medicine.disease Pregnancy Complications Pregnancy Trimester First Treatment Outcome Anticonvulsant Epilepsy Absence Neurology Therapeutic drug monitoring Pregnancy Trimester Second Anesthesia Concomitant Gestation Anticonvulsants Drug Therapy Combination Female Epilepsies Partial Epilepsy Tonic-Clonic Neurology (clinical) business medicine.drug |
Zdroj: | Epilepsia. 50:480-485 |
ISSN: | 1528-1167 0013-9580 |
Popis: | SUMMARY Purpose: To study the impact of pregnancy on the serum concentration/dose ratio (C/D-ratio) of topiramate (TPM). Methods: Twelve women with epilepsy using TPM during pregnancy, and 15 pregnancies were studied. The main target variable was the C/D-ratio at baseline and during pregnancy. Additional variables were changes in TPM dose, concomitant use of other antiepileptic drugs, seizure frequency, and pregnancy outcome. Clinical and pharmacological data were obtained from the women’s medical records. Results: The average C/D-ratios in the second and third trimester were 30% (p ¼ 0.002, n ¼ 11) and 34% (p ¼ 0.001, n ¼ 8) lower than the baseline values, respectively. The interindividual variability was pronounced. Increased seizure frequency was common in pregnant women using TPM, but a correlation to the decline in TPM C/D-ratio could not be established from our data. Discussion: Dose-corrected serum concentrations of TPM appear to decline gradually throughout pregnancy. The underlying mechanisms are not known. Increased glomerular filtration may play a major role. During pregnancy, therapeutic drug monitoring of TPM may be useful. |
Databáze: | OpenAIRE |
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