Individualizing Antiepileptic Therapy for Patients

Бондарева, И. Б.

doi:10.1016/b978-0-12-803348-7.00019-8

Cited by 2 publications

(2 citation statements)

References 89 publications

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“…Using population pharmacokinetic modelling, to develop the initial dosage regime and followed by TDM measurement, a useful initial dosage regimen can be computed to best achieve the desired target goal for a particular patient. 163 A significant advantage of the individualized patient model is that it allows dosage adjustments without having to achieve steady-state before measuring plasma concentrations. This is especially important when individual patient's clearance varies significantly from mean half-life values.…”

Section: Future Perspectives Population Pharmacokinetic Modellingmentioning

confidence: 99%

Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

Patsalos

Spencer

Berry

2018

Therapeutic Drug Monitoring

341

315

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TDM provides a pragmatic approach to epilepsy care, in that bespoke dose adjustments are undertaken based on drug concentrations so as to optimize clinical outcome. For the older first-generation AEDs (carbamazepine, ethosuximide, phenobarbital, phenytoin, primidone, and valproic acid), much data have accumulated in this regard. However, this is occurring increasingly for the new AEDs (brivaracetam, eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, piracetam, pregabalin, rufinamide, stiripentol, sulthiame, tiagabine, topiramate, vigabatrin, and zonisamide).

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Section: Future Perspectives Population Pharmacokinetic Modellingmentioning

confidence: 99%

Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

Patsalos

Spencer

Berry

2018

Therapeutic Drug Monitoring

341

315

View full text Add to dashboard Cite

show abstract

“…It can be done for indications such as evaluating drug efficacy, compliance with medications, checking drug interactions, avoiding toxicity due to overdose, and monitoring drug levels following initiation or when planning to stop the therapy. 2 An essential element of TDM is the provision of accurate and clinically relevant reference intervals. Individuals have different pharmacokinetics and drug responses, particularly in the case of combined therapies, which raises the challenge of universal TDM targets.…”

Section: Introductionmentioning

confidence: 99%

An audit of prescribing pattern of anti-epileptic drugs with its effect on therapeutic drug levels and seizure control at a tertiary care public hospital

Munshi,

Pilliwar,

Maurya

2023

gmj

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Objective: The study objective was to evaluate the prescription pattern and use of anti-seizure medications (ASMs) in patients with a seizure disorder and to evaluate if a change in the ASM dose had a beneficial effect on seizure control, observed through Therapeutic Drug Monitoring [TDM] level of ASMs.Methods: Details of anti-seizure medications with their therapeutic levels in the blood of patients with seizure disorder were analysed.Design: Hospital-based retrospective analysis of patient case recordsSettings: Therapeutic Drug Monitoring OPD of a tertiary care public teaching hospitalParticipants: Case records of 918 patients with seizure disorder from 2016-2021Results: Data of men (53%) and women (47%) aged between 18-75 years was assessed About 62% (566/918) of patients were on levetiracetam, the most frequently prescribed anti-seizure medication. Whenever the ASMs dose was increased or decreased based on TDM levels, it was associated with a significant increase in the frequency of breakthrough seizures [OR- 5 (95% CI: 1.28-19.46)]. However, significant seizure control was observed when the patients were on the same maintenance dose of the anti-seizure medication [OR- 0.2 (95% CI: 0.06-0.63)]. Whenever an additional new anti-epileptic drug was prescribed or removed from the pre-existing anti-epileptic medications, it did not significantly impact seizure control.Conclusion: Individualising drug therapy and therapeutic drug monitoring for each patient, along with patient factors such as medication compliance, concomitant drug and disease history, and pharmacogenetic assessment, should be the ideal practice in patients with seizures for better seizure control.

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Individualizing Antiepileptic Therapy for Patients

Cited by 2 publications

References 89 publications

Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update

An audit of prescribing pattern of anti-epileptic drugs with its effect on therapeutic drug levels and seizure control at a tertiary care public hospital

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