Protein Binding of Antiepileptic Drugs During Pregnancy, Labor, and Puerperium
| Autor: | A H Bardy, P J Neuvonen, V K Hiilesmaa, K Teramo |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Phenytoin medicine.medical_specialty medicine.medical_treatment Fatty Acids Nonesterified 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Pregnancy Seizures Internal medicine Humans Medicine Pharmacology (medical) Serum Albumin Pharmacology Labor Obstetric business.industry Postpartum Period Albumin Orosomucoid Carbamazepine Fetal Blood medicine.disease 3. Good health Anticonvulsant Endocrinology Free fraction Gestation Anticonvulsants Female lipids (amino acids peptides and proteins) business 030217 neurology & neurosurgery Protein Binding Umbilical Cord Serum medicine.drug |
| Zdroj: | Therapeutic Drug Monitoring. 12:40-46 |
| ISSN: | 0163-4356 |
| DOI: | 10.1097/00007691-199001000-00008 |
| Popis: | Twenty-four epileptic women were followed-up during late pregnancy, labor, and early puerperium in order to detect possible alterations in serum protein binding of antiepileptic drugs (AEDs). The total and free concentrations of carbamazepine (CBZ), phenytoin (PHT), and valproate (VPA) in maternal serum were measured. In addition, the concentrations of albumin, alpha 1-acid glycoprotein (AGP), and free fatty acids (FFA) were also measured. Total AED concentrations during labor were influenced by changes in drug dosages; total PHT increased during the first puerperal weeks. During labor the free fraction of CBZ remained stable, whereas PHT and particularly VPA free fractions increased. This phenomenon was parallel to the increase in FFA concentration; FFA concentrations decreased again during the first days postpartum. Albumin and AGP concentrations were low during pregnancy and labor, and increased after delivery. The total umbilical CBZ and PHT concentrations were not significantly different from maternal concentrations. The total VPA concentration in umbilical serum was significantly higher than that in maternal serum. The free fraction of CBZ was higher and that of PHT and VPA lower in umbilical than in maternal serum at delivery. Umbilical cord serum had a higher albumin but a lower AGP and FFA concentration than maternal serum. The changes in PHT and particularly VPA free fraction associated with changes in FFA concentration should be considered when assessing the total concentration of these drugs in maternal and umbilical serum. |
| Databáze: | OpenAIRE |
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