Therapeutic drug monitoring of old and newer anti-epileptic drugs
| Autor: | Simon Scharpé, George M Hatfield, Ann C Sierens, Kristine Naelaerts, Willy E. Lambert, Hugo Neels |
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| Rok vydání: | 2004 |
| Předmět: |
Drug
Topiramate media_common.quotation_subject medicine.medical_treatment Clinical Biochemistry Pharmacology Lamotrigine Models Biological Felbamate Cytochrome P-450 Enzyme System Seizures medicine Humans Oxcarbazepine media_common Epilepsy medicine.diagnostic_test business.industry Pharmacology. Therapy Biochemistry (medical) General Medicine Anticonvulsant Models Chemical Pharmaceutical Preparations Therapeutic drug monitoring Phenytoin Anticonvulsants Drug Monitoring business Primidone Chromatography Liquid medicine.drug |
| Zdroj: | Clinical chemistry and laboratory medicine |
| ISSN: | 1437-4331 1434-6621 |
| DOI: | 10.1515/cclm.2004.245 |
| Popis: | The aim of the present paper is to provide information concerning the setting up and interpretation of therapeutic drug monitoring (TDM) for anti-epileptic drugs. The potential value of TDM for these drugs (including carbamazepine, clobazam, clonazepam, ethosuximide, felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pheneturide, phenobarbital, phenytoin, primidone, tiagabine, topiramate, valproic acid, vigabatrin and zonisamide) is discussed in relation to their mode of action, drug interactions and their pharmacokinetic properties. The review is based upon available literature data and on observations from our clinical practice. Up until approximately 15 years ago anti-epileptic therapeutics were restricted to a very few drugs that were developed in the first half of the 20th century. Unfortunately, many patients were refractory to these drugs and a new generation of drugs has been developed, mostly as add-on therapy. Although the efficacy of the newer drugs is no better, there is an apparent improvement in drug tolerance, combined with a diminished potential for adverse drug interactions. All new anticonvulsant drugs have undergone extensive clinical studies, but information on the relationship between plasma concentrations and effects is scarce for many of these drugs. Wide ranges in concentrations have been published for seizure control and toxicity. Few studies have been undertaken to establish the concentration-effect relationship. This review shows that TDM may be helpful for a number of these newer drugs. |
| Databáze: | OpenAIRE |
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