RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS
Abstract: this paper presents the results of therapeutic drug monitoring (TDM) of anticonvulsants – valproats and carbamazepins. Analysis include 800 patients with epilepsy in clinical practices, who received monotherapy and drug combinations. We determine plasma concentrations in two points: Cmin –...
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| Format: | Article |
| Language: | Russian |
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IRBIS LLC
2016-05-01
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| Series: | Эпилепсия и пароксизмальные состояния |
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| Online Access: | https://www.epilepsia.su/jour/article/view/70 |
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| author | M. V. Leonova Yu. B. Belousov I. F. Tischenkova L. L. Shteinberg A. V. Sokolov |
| author_facet | M. V. Leonova Yu. B. Belousov I. F. Tischenkova L. L. Shteinberg A. V. Sokolov |
| author_sort | M. V. Leonova |
| collection | DOAJ |
| description | Abstract: this paper presents the results of therapeutic drug monitoring (TDM) of anticonvulsants – valproats and carbamazepins. Analysis include 800 patients with epilepsy in clinical practices, who received monotherapy and drug combinations. We determine plasma concentrations in two points: Cmin – before use next dose and Cmax – after next dose; concentration range for valproats – 50-150 mg/l, for carbamazepin – 4-12 mg/l. Plasma concentrations of valproats was statistically low in combination with carbamazepins than in monotherapy: Cmin 44,1±1,4 versus 62.1±2.0 (р<0,001) и Cmax 57.6±1.9 versus 76.5±2.4, without differences in daily doses. The frequency of achievement the therapeutic concentrations of valproats on valproat/carbamazepin combination was 34% versus 67% in monotherapy as result of inducing metabolism valproate acid by carbamazepin. For carbamazepin there was tendency for high frequency of achievement the therapeutic concentrations on combination treatment than on monotherapy – 86% versus 75.9%, but the doses of carbamazepin were also higher in combination therapy. However, plasma concentrations of carbamazepin were statistically higher only in combinations with other anticonvulsants exclude valproats: Cmin 8.0±0.2 versus 6.1±0.16 и Cmax 9.4±0.2 versus 7.3±0.18 (р<0,001) in monotherapy. The frequency of achievement the therapeutic concentrations for valproats and carbamazepin simultaneously in combination therapy was only 28.5%. This demonstrate the level of drug interactions in combination therapy of epilepcy especially with valproats and carbamazepin. |
| first_indexed | 2024-04-10T02:49:25Z |
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| id | doaj.art-e7439743eb64426081826f047a9b3789 |
| institution | Directory Open Access Journal |
| issn | 2077-8333 2311-4088 |
| language | Russian |
| last_indexed | 2025-03-14T11:15:25Z |
| publishDate | 2016-05-01 |
| publisher | IRBIS LLC |
| record_format | Article |
| series | Эпилепсия и пароксизмальные состояния |
| spelling | doaj.art-e7439743eb64426081826f047a9b37892025-03-02T10:17:00ZrusIRBIS LLCЭпилепсия и пароксизмальные состояния2077-83332311-40882016-05-016461469RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICSM. V. Leonova0Yu. B. Belousov1I. F. Tischenkova2L. L. Shteinberg3A. V. Sokolov4Pirogov Russian National Research Medical University, MoscowPirogov Russian National Research Medical University, MoscowPirogov Russian National Research Medical University, MoscowPirogov Russian National Research Medical University, MoscowPirogov Russian National Research Medical University, MoscowAbstract: this paper presents the results of therapeutic drug monitoring (TDM) of anticonvulsants – valproats and carbamazepins. Analysis include 800 patients with epilepsy in clinical practices, who received monotherapy and drug combinations. We determine plasma concentrations in two points: Cmin – before use next dose and Cmax – after next dose; concentration range for valproats – 50-150 mg/l, for carbamazepin – 4-12 mg/l. Plasma concentrations of valproats was statistically low in combination with carbamazepins than in monotherapy: Cmin 44,1±1,4 versus 62.1±2.0 (р<0,001) и Cmax 57.6±1.9 versus 76.5±2.4, without differences in daily doses. The frequency of achievement the therapeutic concentrations of valproats on valproat/carbamazepin combination was 34% versus 67% in monotherapy as result of inducing metabolism valproate acid by carbamazepin. For carbamazepin there was tendency for high frequency of achievement the therapeutic concentrations on combination treatment than on monotherapy – 86% versus 75.9%, but the doses of carbamazepin were also higher in combination therapy. However, plasma concentrations of carbamazepin were statistically higher only in combinations with other anticonvulsants exclude valproats: Cmin 8.0±0.2 versus 6.1±0.16 и Cmax 9.4±0.2 versus 7.3±0.18 (р<0,001) in monotherapy. The frequency of achievement the therapeutic concentrations for valproats and carbamazepin simultaneously in combination therapy was only 28.5%. This demonstrate the level of drug interactions in combination therapy of epilepcy especially with valproats and carbamazepin.https://www.epilepsia.su/jour/article/view/70therapeutic drug monitoringanticonvulsantsvalproatscarbamazepinedrug interactionsepilepsy |
| spellingShingle | M. V. Leonova Yu. B. Belousov I. F. Tischenkova L. L. Shteinberg A. V. Sokolov RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS Эпилепсия и пароксизмальные состояния therapeutic drug monitoring anticonvulsants valproats carbamazepine drug interactions epilepsy |
| title | RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS |
| title_full | RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS |
| title_fullStr | RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS |
| title_full_unstemmed | RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS |
| title_short | RESULTS OF THERAPEUTIC DRUG MONITORING COMBINATION THERAPY OF ANTICONVULSANTS IN CLINICAL PRACTICS |
| title_sort | results of therapeutic drug monitoring combination therapy of anticonvulsants in clinical practics |
| topic | therapeutic drug monitoring anticonvulsants valproats carbamazepine drug interactions epilepsy |
| url | https://www.epilepsia.su/jour/article/view/70 |
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