scholarly journals Optimal therapy of epilepsy by measuring serum concentration of antiepileptic drugs with least adverse effects

2003 ◽  
Vol 56 (9-10) ◽  
pp. 419-426 ◽  
Author(s):  
Mirjana Jovicevic ◽  
Vera Diklic-Jeremic ◽  
Ivana Divjak ◽  
Marija Zarkov ◽  
Aleksandar Jovanovic
Keyword(s):  
Valproic Acid ◽  
Adverse Effects ◽  
Serum Concentration ◽  
Antiepileptic Drugs ◽  
Drug Concentration ◽  
Drug Dosage ◽  
Optimal Therapy ◽  
Clinical Centre ◽  
Epileptic Patients ◽  
Novi Sad

The study comprised 150 epileptic patients treated at the Institute of Neurology of the Clinical Centre Novi Sad. The optimal therapy with least adverse effects and seizures was achieved in patients in whom measurement of serum concentration of antiepileptic drugs was performed. Patients were divided into five groups with respect to the therapy they received: I - carbamazepine; II - valproic acid; III - polytherapy with phenobarbitone and diphenylhydantoin; IV - phenobarbitone and valproic acid; and V - phenobarbitone, valproic acid and carbamazepine. No adverse effects were recorded in over 60% of patients on monotherapy, 35% of patients who received two anticonvulsants, and 30% of patients who received three anticonvulsants. Significant correlation between drug dosage and blood drug concentration (r>0.5) was found in polytherapy with phenobarbitone, carbamazepine and valproic acid (r=0,66); and phenobarbitone and diphenylhydantoin (r=0,53).

Plasma homocysteine and aminothiol levels in idiopathic epilepsy patients receiving antiepileptic drugs

2019 ◽  
Vol 44 (5) ◽  
pp. 661-666
Author(s):  
Dilber Çoban Ramazan ◽  
Ülker Anadol ◽  
A. Destina Yalçın ◽  
A. Süha Yalçın
Keyword(s):  
Valproic Acid ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Serum Vitamin ◽  
Idiopathic Epilepsy ◽  
Serum Folate ◽  
Significant Difference ◽  
Epileptic Patients

Abstract Objective Homocysteine is a sulfur containing amino acid that is formed during methionine metabolism. Patients under long-term antiepileptic drug treatment often have hyperhomocysteinemia. These patients have low levels of serum folate, vitamin B12 and vitamin B6, all of which are associated with homocysteine metabolism. We have investigated the effects of valproic acid and new generation antiepileptic drugs (lamotrigine and levetiracetam) on plasma levels of homocysteine and aminothiols as well as serum vitamin B12 and folic acid. Materials and methods Forty-seven idiopathic epileptic patients on antiepileptic drugs were compared with 38 age-matched healthy controls. Commercial immunoassay methods were used for vitamin B12 and folic acid analyses. Homocysteine, cysteine, cysteinylglycine and glutathione levels were determined by high performance liquid chromatography. Results There was no significant difference in patient and control values in terms of vitamin B12, folic acid and homocysteine. Valproic acid and lamotrigine seemed to effect aminothiol redox status. Glutathione levels of epileptic patients receiving valproic acid and lamotrigine were higher than controls. Conclusion Our results suggest that redox homeostasis may be impaired and glutathione synthesis increased in response to the oxidative stress caused by antiepileptic drug use.

scholarly journals Determining risk factors of developing adverse effects of antiepileptic drugs in epileptic patients

2019 ◽  
Vol 405 ◽  
pp. 141
Author(s):  
S. Mrabet ◽  
K. Moalla ◽  
A. Nasri ◽  
I. Kacem ◽  
M. Djebara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Effects ◽  
Antiepileptic Drugs ◽  
Epileptic Patients

Elevated Free Fractions of Valproic Acid in a Heart Transplant Patient with Hypoalbuminemia

2000 ◽  
Vol 34 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Jeffrey A Haroldson ◽  
Linda E Kramer ◽  
Denise L Wolff ◽  
Kathleen D Lake
Keyword(s):  
Valproic Acid ◽  
Adverse Effects ◽  
Serum Concentration ◽  
Transplant Patient ◽  
Total Serum ◽  
Heart Transplant Patient ◽  
Serum Concentrations ◽  
Case Summary ◽  
Related Adverse Effect ◽  
Drug Concentrations

OBJECTIVE: To report a case demonstrating the importance of monitoring unbound valproic acid (VPA) serum concentrations in a patient with hypoalbuminemia. CASE SUMMARY: A 53-year-old white woman status–post heart transplantation was admitted to the hospital for declining cardiac function, possible rejection, and increased lethargy requiring intubation. An extensive workup of the patient's profound lethargy was initiated, including an evaluation of her VPA regimen. Initially, VPA dosages were adjusted based on the total serum concentration of VPA. Hypoalbuminemia compounded with increased lethargy prompted the measurement of unbound serum concentrations of VPA. The VPA dosage was then adjusted based on the unbound rather than the total VPA serum concentration; the patient eventually improved and was discharged from the hospital. DISCUSSION: Lethargy is a concentration-related adverse effect of VPA. The nonlinear pharmacokinetic and protein saturation characteristics of VPA may result in nonproportional elevations in unbound drug, and subsequent increases in adverse effects, when dosage adjustments are based solely on measurement of total VPA serum concentrations in patients with hypoalbuminemia. CONCLUSIONS: This case report suggests that appropriate monitoring of unbound drug concentrations of VPA may prevent unrecognized concentration-related adverse effects. Awareness of the pharmacokinetic relationship and adverse effects of VPA will aid clinicians in identifying the etiology of symptoms.

scholarly journals Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients

Seizure ◽  
2011 ◽  
Vol 20 (4) ◽  
pp. 343-346 ◽  
Author(s):  
Soodeh Razeghi Jahromi ◽  
Mansoureh Togha ◽  
Sohrab Hashemi Fesharaki ◽  
Masoumeh Najafi ◽  
Nahid Beladi Moghadam ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Antiepileptic Drugs ◽  
Epileptic Patients

scholarly journals PR0GRESS OF SAMARA REGIONAL ANTIEpILEpTIC CENTER

2019 ◽  
Vol 19 (1-2) ◽  
pp. 107-114
Author(s):  
A. V Yakunina ◽  
V. A Kalinin ◽  
I. E Poverennova
Keyword(s):  
Valproic Acid ◽  
Pregnant Women ◽  
Antiepileptic Drugs ◽  
Focal Epilepsy ◽  
Age Groups ◽  
Number Of Patients ◽  
Epileptic Patients

Aim. Evaluation of the results that adult antiepileptic service of Samara region achieved during the period 2002-2018. Methods. 5246 patient cards of people treated in Samara Regional Antiepileptic Center were analyzed, 688 of them were pregnant women. Results. 70.5% of all the patients were 40 years old or younger. Focal epilepsy prevailed in all age groups and occurred in 82.7% cases. Valproic acid, Levetiracetam and Carbamasepinе were the most used antiepileptic drugs among epileptic patients in 2018. The number of patients with remission increased from 2011 to 2018. Practical evidence of dealing with pregnant patients showed that reasonable treatment is positively correlated with pregnancy success.

Population pharmacokinetic of antiepileptic drugs in different populations

Open Medicine ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. 383-391
Author(s):  
Jasmina Milovanovic ◽  
Slobodan Jankovic
Keyword(s):  
Population Pharmacokinetics ◽  
Antiepileptic Drugs ◽  
Drug Dosage ◽  
Heterogeneous Population ◽  
Population Pharmacokinetic ◽  
Pharmacokinetic Models ◽  
The Past ◽  
Epileptic Patients ◽  
Rational Therapy ◽  
Different Populations

AbstractThis article reviews a population pharmacokinetics studies conducted during the past few years in Serbia. Studies have included three the most frequently used antiepileptic drugs (valproate, carbamazepine and lamotrigine) and different populations of epileptic patients: children, adults and heterogeneous population composed of both children and adults. The review compares obtained values of population pharmacokinetic models of clearance of these drugs, and factors that are significantly determined, making brief comments on the results of other authors on the same topic. Individualization of drug dosage is the basis of rational therapy, and factors of variability will always be subject of scientific research.

scholarly journals Pharmacovigilance in epileptic patients using antiepileptic drugs

2006 ◽  
Vol 64 (2a) ◽  
pp. 198-201 ◽  
Author(s):  
Paulo Afonso Mei ◽  
Maria Augusta Montenegro ◽  
Marilisa M. Guerreiro ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Adverse Event ◽  
Adverse Effects ◽  
Adverse Events ◽  
Antiepileptic Drugs ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Depression Score ◽  
Structure Questionnaire ◽  
Epileptic Patients ◽  
Probable Depression

OBJECTIVE: To investigate the occurrence of adverse effects of antiepileptic drugs (AED) in chronic epileptic patients in mono or polytherapy. METHOD: We evaluated consecutive patients that met the following inclusion criteria: age of 18 years or older, diagnosis of epilepsy for at least one year, stable dose of AED for at least three months. Patients were asked if they had any adverse event related to the AED. After that, they were interviewed according to a detailed semi-structure questionnaire. We also assessed specifically the adverse events in the last four weeks. The data were analyzed regarding the use of monotherapy x polytherapy, and the presence of probable depression (score >15) according to the Center for Epidemiologic Studies Depression Scale. RESULTS: Sixty-five patients were evaluated, 35 women, mean age 38.3 years; 35 patients were in use of monotherapy and 35 in polytherapy. Only 45 (69.2%) patients spontaneously reported adverse effects. After the formal questionnaire, 63 (97%) patients referred experiencing an adverse event (p<0.001). Seventeen men had adverse events, as opposed to 28 women (p=0.042). When the last four weeks were evaluated, patients with probable depression presented adverse events more frequently (p<0.0001). CONCLUSION: Our data suggest that adverse events are highly prevalent when a detailed questionnaire is applied and that depression may aggravate the number and intensity of side effects in patients using AEDs.

Comparison of conducted antiepileptic therapy with indicators of hormones level in blood serum of girls with epilepsy

2016 ◽  
Vol 7 (1) ◽  
pp. 32-42
Author(s):  
Valentina I Guzeva ◽  
Victoria V Guzeva ◽  
Oksana V Guzeva
Keyword(s):  
Valproic Acid ◽  
Antiepileptic Drugs ◽  
Adolescent Girls ◽  
Drug Dosage ◽  
Thyroid Stimulating Hormone ◽  
Hormonal Status ◽  
Average Content ◽  
Hormone Levels ◽  
Significant Difference ◽  
Stimulating Hormone

Introduction. Multiple changes in the organism, which are observed in prepubertal and pubertal age, creates the need of clear diagnosis and treatment of the disease based on drugs interactions and their influence on hormonal status. In girls with epilepsy, such studies were not conducted. The aim of the study was to investigate the influence of modern antiepileptic drugs on hormonal status in adolescent girls with epilepsy. Materials and methods. In blood of 50 girls aged 8 to 17 years with epilepsy studied levels of thyroid-stimulating hormone (TSH), thyrogiobulin antibodies (a/b TG), triiodothyronine (T3), thyroxine (T4), parathyroid hormone (P) and cortisol (C). Treatment in most cases included valproic acid, carbamazepine, and topiramate. The main results of the study. In treatment with use of various drugs detected 2 (9.52 %) significant differences in hormone levels and 7 (33.33 %), significant differences in the width of distribution of hormones values. The highest content of thyroid-stimulating hormone found in girls 8-17 years treated by valproic acid, antibodies to thyroglobulin - treatment without AED, triiodothyronine - use of phenobarbital or benzobarbital, thyroxine - treatment on topiramate, PTH - in girls treated by valproic acid, cortisol in girls 8-13 years - on phenobarbital or benzobarbital, girls 14-17 years old - on oxcarbazepine. In 19 girls with epilepsy within 2-12 months after the first study hormone levels of TSH, a/b TG, T3, T4, C were re-determined. Indicators of hormones in different drug treatment changed according to the initial average content of hormones in all girls in 64.86 % of cases same way as in the first study. Conclusions. Significant difference of all hormones, in the content or width of distributions of their values, was found in girls with epilepsy taking different antiepileptic drugs. Choice of drug, dosage and its correction should be made taking into account its impact on children's hormonal status.

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