EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS
This paper summarises scientific literature on pharmacotherapy of epilepsy in pregnant women from the perspective of clinical pharmacology. It analyses general principles of antiepileptic therapy in pregnant women. It was demonstrated that the optimal conditions for treating epilepsy during pregnanc...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)
2018-06-01
|
| Series: | Регуляторные исследования и экспертиза лекарственных средств |
| Subjects: | |
| Online Access: | https://www.vedomostincesmp.ru/jour/article/view/175 |
| _version_ | 1826566744268865536 |
|---|---|
| author | E. A. Sоkоvа V. V. Arkhipov R. A. Chilova O. A. Demidova G. F. Proklova T. V. Pikuza |
| author_facet | E. A. Sоkоvа V. V. Arkhipov R. A. Chilova O. A. Demidova G. F. Proklova T. V. Pikuza |
| author_sort | E. A. Sоkоvа |
| collection | DOAJ |
| description | This paper summarises scientific literature on pharmacotherapy of epilepsy in pregnant women from the perspective of clinical pharmacology. It analyses general principles of antiepileptic therapy in pregnant women. It was demonstrated that the optimal conditions for treating epilepsy during pregnancy involve the use of the minimum dose of an anticonvulsant. The article describes specific pharmacokinetic parameters of antiepileptic drugs (valproic acid, carbamazepine, lamotrigine, phenytoin, phenobarbital) that require adjustment of the dose regimen based on therapeutic drug monitoring. It was demonstrated that carriership of «slow» allelic variants of CYP2C9 is associated with a slowdown in hepatic biotransformation of valproic acid, carbamazepine, topiramate, phenytoin, oxcarbazepine, diazepam, phenobarbital, and primidone, and, consequently, with increased drug concentrations in blood plasma and an increased risk of adverse reactions. Taking into account polymorphism of genes encoding metabolic isoenzymes of traditional antiepileptic drugs, it is recommended for pregnant women and women planning a pregnancy to undergo genotyping. It was demonstrated that polymorphism of the ABCB1 gene and genes of other transport proteins can modify the effect of antiepileptic drugs on the foetus, thus increasing the teratogenic risk. |
| first_indexed | 2024-03-07T19:17:42Z |
| format | Article |
| id | doaj.art-0b04dafd464241aaba16f50c10816233 |
| institution | Directory Open Access Journal |
| issn | 3034-3062 3034-3453 |
| language | Russian |
| last_indexed | 2025-03-14T10:56:31Z |
| publishDate | 2018-06-01 |
| publisher | Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’) |
| record_format | Article |
| series | Регуляторные исследования и экспертиза лекарственных средств |
| spelling | doaj.art-0b04dafd464241aaba16f50c108162332025-03-02T10:46:40ZrusFederal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)Регуляторные исследования и экспертиза лекарственных средств3034-30623034-34532018-06-0182727610.30895/1991-2919-2018-8-2-72-76157EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTSE. A. Sоkоvа0V. V. Arkhipov1R. A. Chilova2O. A. Demidova3G. F. Proklova4T. V. Pikuza5Scientific Centre for Expert Evaluation of Medicinal ProductsScientific Centre for Expert Evaluation of Medicinal ProductsI. M. Sechenov First Moscow State Medical UniversityScientific Centre for Expert Evaluation of Medicinal ProductsI. M. Sechenov First Moscow State Medical UniversityI. M. Sechenov First Moscow State Medical UniversityThis paper summarises scientific literature on pharmacotherapy of epilepsy in pregnant women from the perspective of clinical pharmacology. It analyses general principles of antiepileptic therapy in pregnant women. It was demonstrated that the optimal conditions for treating epilepsy during pregnancy involve the use of the minimum dose of an anticonvulsant. The article describes specific pharmacokinetic parameters of antiepileptic drugs (valproic acid, carbamazepine, lamotrigine, phenytoin, phenobarbital) that require adjustment of the dose regimen based on therapeutic drug monitoring. It was demonstrated that carriership of «slow» allelic variants of CYP2C9 is associated with a slowdown in hepatic biotransformation of valproic acid, carbamazepine, topiramate, phenytoin, oxcarbazepine, diazepam, phenobarbital, and primidone, and, consequently, with increased drug concentrations in blood plasma and an increased risk of adverse reactions. Taking into account polymorphism of genes encoding metabolic isoenzymes of traditional antiepileptic drugs, it is recommended for pregnant women and women planning a pregnancy to undergo genotyping. It was demonstrated that polymorphism of the ABCB1 gene and genes of other transport proteins can modify the effect of antiepileptic drugs on the foetus, thus increasing the teratogenic risk.https://www.vedomostincesmp.ru/jour/article/view/175pregnancyantiepileptic drugspharmacokineticspharmacogeneticssafetyefficacydrug transporterstherapeutic drug monitoring |
| spellingShingle | E. A. Sоkоvа V. V. Arkhipov R. A. Chilova O. A. Demidova G. F. Proklova T. V. Pikuza EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS Регуляторные исследования и экспертиза лекарственных средств pregnancy antiepileptic drugs pharmacokinetics pharmacogenetics safety efficacy drug transporters therapeutic drug monitoring |
| title | EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS |
| title_full | EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS |
| title_fullStr | EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS |
| title_full_unstemmed | EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS |
| title_short | EFFICACY AND SAFETY OF ANTIEPILEPTIC DRUGS DURING PREGNANCY: PHARMACOGENETIC ASPECTS |
| title_sort | efficacy and safety of antiepileptic drugs during pregnancy pharmacogenetic aspects |
| topic | pregnancy antiepileptic drugs pharmacokinetics pharmacogenetics safety efficacy drug transporters therapeutic drug monitoring |
| url | https://www.vedomostincesmp.ru/jour/article/view/175 |
| work_keys_str_mv | AT easokova efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects AT vvarkhipov efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects AT rachilova efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects AT oademidova efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects AT gfproklova efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects AT tvpikuza efficacyandsafetyofantiepilepticdrugsduringpregnancypharmacogeneticaspects |