Irshaid Y M, Hamdi A A, Al Homrany M
Department of Clinical Pharmacology, College of Medicine and Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Int J Clin Pharmacol Ther. 2003 Mar;41(3):126-31.
Results of the therapeutic drug monitoring (TDM) of the concentration of antiepileptic drugs (AEDs), performed at Aseer Central Hospital over a 1-year period were evaluated. Most of the requests were for phenytoin (PHT) determination followed by carbamazepine (CBZ), valproic acid (VPA) and phenobarbital (PB). Serum concentrations of PB, CBZ, VPA and PHT within the presumed therapeutic range constituted 87%, 73%, 45% and 33%, respectively. Valproic acid exhibited age differences in the proportion of concentrations below the presumed therapeutic range, such that subtherapeutic concentrations increased while therapeutic concentrations decreased with age. When the requests were related to particular patients, 71% of patients were on monotherapy with PHT as the most commonly used single drug and PB the least. Patients using 2 AEDs were found to constitute 23.5% of all patients with "PHT + CBZ" and "CBZ + VPA" being the most commonly prescribed 2 drugs combination. The frequency of concentrations within the therapeutic ranges decreased when 1 or 2 more drugs were used with either PHT or VPA. In addition, combination with PHT was associated with a reduction in mean CBZ concentration, while combination with CBZ was associated with a reduction in mean VPA concentration.
对阿西尔中心医院在1年期间进行的抗癫痫药物（AEDs）浓度治疗药物监测（TDM）结果进行了评估。大多数检测申请是针对苯妥英（PHT）测定，其次是卡马西平（CBZ）、丙戊酸（VPA）和苯巴比妥（PB）。PB、CBZ、VPA和PHT血清浓度处于假定治疗范围内的比例分别为87%、73%、45%和33%。丙戊酸在低于假定治疗范围的浓度比例上存在年龄差异，即随着年龄增长，亚治疗浓度增加而治疗浓度降低。当检测申请与特定患者相关时，71%的患者接受单药治疗，其中PHT是最常用的单一药物，PB是最不常用的。发现使用两种AEDs的患者占所有患者的23.5%，其中“PHT + CBZ”和“CBZ + VPA”是最常用的两种药物组合。当与PHT或VPA联合使用1种或2种以上药物时，治疗范围内浓度的频率降低。此外，与PHT联合使用会使CBZ平均浓度降低，而与CBZ联合使用会使VPA平均浓度降低。
