Karande S C, Joshi M V, Kshirsagar N A, Shah P U
Dept of Pharmacology, Seth GS Medical College, Parel, Bombay.
J Assoc Physicians India. 1992 Jul;40(7):445-7.
Fifty-four consecutively referred patients with uncontrolled epilepsy were subjected to Therapeutic Drug Monitoring on an out patient basis. Regular 2 weekly follow up for a minimum period of 2 months was done, after altering the drug dosage and bringing plasma level(s) within therapeutic range. Plasma levels of Phenobarbitone, Phenytoin and Carbamezepine were done by High Pressure Liquid Chromatography. Eventually, 24 patients were controlled and 30 remained uncontrolled. Significant differences between these 2 groups were found, as regards, duration of epilepsy (p < 0.01), associated mental retardation (p < 0.02), initial carbamazepine dosage and plasma levels in patients on carbamazepine montherapy (p < 0.02 and P < 0.01, respectively) and final phenytoin plasma levels in patients on combined therapy with phenobarbitone and phenytoin (p < 0.05). This study emphasizes the importance of early diagnosis and treatment of epilepsy with the help of plasma level monitoring of anti-epileptic drugs.
54例连续转诊的癫痫控制不佳患者在门诊接受了治疗药物监测。在调整药物剂量并使血浆水平处于治疗范围内后,进行了至少2个月的每2周一次的定期随访。苯巴比妥、苯妥英和卡马西平的血浆水平通过高压液相色谱法测定。最终,24例患者的癫痫得到控制,30例仍未得到控制。在癫痫持续时间(p < 0.01)、相关智力发育迟缓(p < 0.02)、卡马西平单药治疗患者的初始卡马西平剂量和血浆水平(分别为p < 0.02和P < 0.01)以及苯巴比妥和苯妥英联合治疗患者的最终苯妥英血浆水平(p < 0.05)方面,发现这两组之间存在显著差异。本研究强调了借助抗癫痫药物血浆水平监测进行癫痫早期诊断和治疗的重要性。