THE ROLE OF THE THERAPEUTIC DRUG MONITORING WHEN USING ANTIEPILEPTIC DRUGS

Abstract

Objective. To define therapeutic drug monitoring (TDM) role when using drugs of valproic acid and a levetiraсetam as options of medication with a nonlinear and linear pharmakokinetics.

Materials and  methods. Analysed are the results of the therapeutic drug monitoring (TDM) among 80 patients who were using valproic acid during the monotherapy  and levetiracetam during monotherapy  or the combination  of any other antiepileptic drugs (AEDs). We determine  plasma concentration C min (before use next dose  AED).

Results.  Аmong  the  group consisting  of 57 patients and taking valproic acid with the individual daily dosages  in the range of 7.5 mg/kg  to 30.7 mg/kg,  C min of valproic acid equaled to the range of 44 to 111 mcg/ml  (therapeutic range is 50-100 mcg/ml).  The  research determined the presence  of significant individual pharmacokinetic features of valproic acid that play a role in achieving clinical effects and appearance of undesired results. 23 patients were taking the daily dosage of levetiracetam starting from 500 to 3000 mg  twice or thrice which equal from 7.5 mg/kg/day  to 36.9 mg/kg/day  individually. TDM confirmed  the linear pharmacokinetics  of levetiracetam, furthermore determining that the method  of determining the daily dosage by the body mass being more effective among the adults. 30 mg/kg can be considered the average effective daily dose of levetiracetam.

Conclusion. TDM proved to be a reasonable AEDs treatment not only for patients with the nonlinear pharmacokinetics  but also for those with the linear pharmacokinetics.