Klinische Aspekte zur Bestimmung von Antikonvulsiva im Serum

Heipertz, R.; Pilz, H.; Eickhoff, K.; Seidel, David

doi:10.1007/bf00341618

Cited by 2 publications

(1 citation statement)

References 31 publications

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“…Primidon wird in Abhängigkeit von Dauer und Regelmäßigkeit der Einnahme zu Phenobarbital und durchschnittlich zur Hälfte zu dem nur selten bestimmten Phenyläthylmalonamid (PEMA) metabolisiert. Eine klinische Studie fand unter Primidon lediglich eine Korrelation der Dosis zum PEMA-Spiegel, während dies weder für Primidon noch Phenobarbital der Fall war (79). Bei unregelmäßiger Primidon-Einnahme nimmt die Metabolisierungsrate ab, weshalb die Bestimmung des Konzentrationsverhältnisses von Primidon gegenüber Phenobarbital bei bekannten, stabilen Ausgangswerten ein nützlicher Hinweis auf eine mangelnde Compliance sein kann (210).…”

Section: Antiepileptisch Wirksame Metaholiteunclassified

Stellenwert der Plasmaspiegelbestimmung von Antiepileptika

Krämer

1989

Fortschr Neurol Psychiatr

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Based on pharmacologic-pharmacokinetic data a critical synopsis of the role of anticonvulsant plasma level determinations in the treatment of epilepsy is given. The analytical methods themselves and the validity of the so called therapeutic range are evaluated in general as well as for the particular antiepileptic drugs. Whereas plasma levels of phenytoin play an important role in therapeutic management they are without major relevance in the therapy with clonazepam and other benzodiazepines. Determinations of anticonvulsant concentrations can be of help in certain circumstances of therapeutic decisions, but uncritical usage as a routine method has to be discouraged. So far, prospective studies were not able to proof a general advantage of this method in the management of epileptic patients.

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Section: Antiepileptisch Wirksame Metaholiteunclassified

Stellenwert der Plasmaspiegelbestimmung von Antiepileptika

Krämer

1989

Fortschr Neurol Psychiatr

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Primidone metabolism in renal insufficiency and acute intoxication

1979

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Primidone (PRIM) is metabolized into phenobarbital (PB) and phenylethylmalonamide (PEMA). During anticonvulsant therapy with PRIM under normal conditions PB represents by fat the largest portion of the total concentration of all three components (PRIM + PB + PEMA). In combined therapy with diphenylhydantoin (DPH), and during chronic PRIM overdosage, the relative concentration of PB is even higher. A case of renal insufficiency while on PRIM therapy and a case of acute PRIM intoxication are presented. In both cases PRIM and PEMA are elevated while PB is relatively low. The mechanisms involved in this phenomenon are discussed. Excluding young children with chronic PRIM overdosage, and the endogenous and exogenous intoxication described here, a relative PB concentration below 40% indicates a lack of patient compliance if a steady treatment schedule has been maintained for at least 3 weeks.

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Klinische Aspekte zur Bestimmung von Antikonvulsiva im Serum

Cited by 2 publications

References 31 publications

Stellenwert der Plasmaspiegelbestimmung von Antiepileptika

Stellenwert der Plasmaspiegelbestimmung von Antiepileptika

Primidone metabolism in renal insufficiency and acute intoxication

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