Therapeutic Drug Monitoring of Antiepileptic Drugs in a Tertiary Care Hospital in India

2015 ◽  
Vol 38 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Natarajan Harivenkatesh ◽  
Natarajan Haribalaji ◽  
Darling Chellathai David ◽  
C. M. Prabu Kumar
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Antiepileptic Drugs ◽  
Drug Monitoring ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Therapeutic Drug ◽  
Care Hospital

scholarly journals Readdressing the role of therapeutic drug monitoring for antiepileptic drugs – A tertiary care hospital experience

2016 ◽  
Vol 4 (1) ◽  
pp. 75-82
Author(s):  
Dr Radhika Soanker ◽  
◽  
Dr Shobha JC Udutha ◽  
Dr Ramesh Kumar Rao T ◽  
◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Antiepileptic Drugs ◽  
Drug Monitoring ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Therapeutic Drug ◽  
Care Hospital ◽  
Hospital Experience

An Audit of Therapeutic Drug Monitoring Services of Anticonvulsants at a Tertiary Care Hospital in India

2013 ◽  
Vol 35 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Santosh R. Taur ◽  
Namrata B. Kulkarni ◽  
Nithya J. Gogtay ◽  
Urmila M. Thatte
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Therapeutic Drug ◽  
Care Hospital

scholarly journals Therapeutic drug monitoring of phenytoin using high performance liquid chromatography in a tertiary care hospital of Kashmir, India

2019 ◽  
Vol 8 (5) ◽  
pp. 995
Author(s):  
Mohd Adil ◽  
Sameena Farhat ◽  
Mohd Younis Rather
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
High Performance ◽  
Tertiary Care ◽  
Therapeutic Drug ◽  
Care Hospital ◽  
Chi Square ◽  
Active Involvement ◽  
Chi Square Test ◽  
Set Up

Background: Phenytoin is the most commonly used anti-epileptic drug (AED) in this set up due to cost effectiveness and easy availability. Significant fluctuations in serum phenytoin levels leading to toxicities or treatment failures make it an ideal candidate for therapeutic drug monitoring (TDM).Methods: Patients of age ≥18 years who were put on phenytoin were enrolled in this study. Estimation of serum phenytoin levels was done using HPLC. Data was analysed using SPSS version 20.0. Chi square test, Kruskal Wallis test were used to analyse the data.Results: A total of 105 patients enrolled in the study, twenty patients (19%) had normal or therapeutic serum phenytoin levels. Thirty-nine patients (37.2%) had sub therapeutic serum phenytoin levels, while forty-six patients (43.8%) had toxic serum phenytoin levels.Conclusions: The TDM of phenytoin should adopt a multi-disciplinary approach with active involvement of neuro-physicians, pharmacologists, pharmacists and other technical staff for improving the overall management of epilepsy. TDM data will provide the clinicians with greater insight into the factors determining the patient’s response to drug therapy.

scholarly journals Therapeutic Drug Monitoring of Second- and Third-Generation Antiepileptic Drugs: Insights From a College of American Pathologists Proficiency Testing Survey

2021 ◽  
Author(s):  
Matthew D. Krasowski ◽  
Thomas A. Long ◽  
Christine L. H. Snozek ◽  
Annabel Dizon ◽  
Barbarajean Magnani ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Antiepileptic Drugs ◽  
Proficiency Testing ◽  
Drug Monitoring ◽  
First Generation ◽  
Therapeutic Drug ◽  
Third Generation ◽  
Enzyme Immunoassays ◽  
Steady Growth ◽  
Survey Results

Context.— Therapeutic drug monitoring has traditionally been widely used for first-generation antiepileptic drugs (AEDs) such as carbamazepine and phenytoin. The last 2 decades have seen the introduction of second- and third-generation AEDs (eg, lamotrigine, levetiracetam, and topiramate) into clinical practice. Objective.— To use data from the College of American Pathologists Therapeutic Drug Monitoring, Extended proficiency testing survey to determine the performance of assays used for therapeutic drug monitoring of newer AEDs, including comparison of enzyme immunoassay and chromatographic techniques. Design.— Six years of proficiency testing surveys were reviewed (2013–2018). Results.— Steady growth was seen in participant volumes for newer AEDs. The analytical performance of automated enzyme immunoassays for lamotrigine, levetiracetam, and topiramate was similar to that of chromatographic methods, consistent with published literature using patient samples for comparisons. The majority of participating laboratories now use enzyme immunoassays to measure levetiracetam. Conclusions.— Survey results reflect steadily growing interest in therapeutic drug monitoring of newer AEDs. The increasing availability of robust immunoassays for new AEDs should facilitate their clinical utility, especially for clinical laboratories that do not perform chromatographic assays for therapeutic drug monitoring.

scholarly journals Therapeutic Drug Monitoring of Newer Antiepileptic Drugs: A Randomized Trial for Dosage Adjustment

2019 ◽  
Vol 87 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Irene Aícua‐Rapún ◽  
Pascal André ◽  
Andrea O. Rossetti ◽  
Philippe Ryvlin ◽  
Andreas F. Hottinger ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Randomized Trial ◽  
Antiepileptic Drugs ◽  
Drug Monitoring ◽  
Dosage Adjustment ◽  
Therapeutic Drug

Pharmacokinetic Properties of New Antiepileptic Drugs

2005 ◽  
Vol 18 (6) ◽  
pp. 444-460 ◽  
Author(s):  
Michele Y. Splinter
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Interactions ◽  
Antiepileptic Drugs ◽  
Drug Monitoring ◽  
The United States ◽  
Therapeutic Drug ◽  
Kinetic Properties ◽  
New Antiepileptic Drugs ◽  
Drug Concentrations ◽  
Pharmacokinetic Properties

Eight new antiepileptic drugs (AEDs) have been approved for use within the United States within the past decade. They are felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, and zonisamide. These afford clinicians with more options to increase efficacy and tolerability in the treatment of patients with epilepsy. Pharmacokinetic properties and drug interactions with other AEDs and other medications taken for comorbidities are individually discussed for each of these new agents. Drug concentrations are not routinely monitored for these newer agents, and there have been few studies designed to investigate their concentration-effect relationships. For most of these medications, the concentrations observed in responders and nonresponders overlap considerably and levels associated with efficacy are often associated with adverse events, complicating the definition of target ranges. Also, epilepsy manifests itself sporadically causing difficulty in clinically monitoring efficacy of medications. Therapeutic drug monitoring provides for the individualization of treatment for these agents, which is important because they demonstrate significant variability in inter- and intraindividual pharmaco-kinetic properties. Therapeutic drug monitoring also allows for identification of noncompliance, drug interactions, and toxicity. Current knowledge of the relationships between efficacy, toxicity, and drug concentrations is discussed.

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