Cagnotti Giulia, Odore Rosangela, Gardini Giulia, Amedeo Stefano, Bertone Iride, Guerriero Giulia, Lentini Laura, Dappiano Elena, D'Angelo Antonio
Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy.
BMC Vet Res. 2018 Jun 18;14(1):189. doi: 10.1186/s12917-018-1522-0.
Levetiracetam can be used for seizure control alone or in combination with other antiepileptic medications. A previous study achieved the minimum targeted serum drug concentration after rectal administration of levetiracetam in healthy dogs. The purpose of the present study was to determine the pharmacokinetics of rectal LEV in dogs presented for cluster seizures or status epilepticus and potentially in treatment with other anti-epileptic drugs. Furthermore, preliminary information on response to this treatment as add-on to the standard treatment protocol is reported.
Eight client-owned dogs were enrolled. Plasma levetiracetam concentrations (measured at 0, 30, 60, 90, 120, 180, 240, 360, 720, and 1440 min after drug administration) reached the minimum target concentration (5 μg/ml) at 30 min in all but one patient. At T1 (30 min) the mean concentration was 28.2 ± 15.5 μg/ml. Plasma concentrations remained above the targeted minimum concentration in all patients until 240 min and in 7/8 until 360 min. Six out of eight patients experienced no seizures in the 24-h period after hospitalization and were classified as "responders".
Minimum plasma levetiracetam concentration can be reached after rectal administration of 40 mg/kg in dogs affected by cluster seizures and status epilepticus and concurrently receiving other antiepileptic drugs. These preliminary results may encourage the evaluation of rectal levetiracetam as an additional treatment option for cluster seizures and status epilepticus in a larger number of dogs.
左乙拉西坦可单独用于控制癫痫发作，也可与其他抗癫痫药物联合使用。先前的一项研究在健康犬直肠给予左乙拉西坦后达到了最低目标血清药物浓度。本研究的目的是确定直肠给予左乙拉西坦在患有丛集性癫痫发作或癫痫持续状态且可能正在接受其他抗癫痫药物治疗的犬中的药代动力学。此外，还报告了作为标准治疗方案附加治疗对此治疗反应的初步信息。
纳入了8只客户拥有的犬。血浆左乙拉西坦浓度（在给药后0、30、60、90、120、180、240、360、720和1440分钟测量）除1只犬外，在所有犬中均在30分钟时达到最低目标浓度（5μg/ml）。在T1（30分钟）时，平均浓度为28.2±15.5μg/ml。所有犬的血浆浓度在240分钟前均保持高于目标最低浓度，7/8的犬在360分钟前保持高于目标最低浓度。8只犬中有6只在住院后24小时内未发生癫痫发作，被归类为“反应者”。
在患有丛集性癫痫发作和癫痫持续状态且同时接受其他抗癫痫药物治疗的犬中，直肠给予40mg/kg左乙拉西坦后可达到最低血浆浓度。这些初步结果可能会促使对直肠左乙拉西坦作为更多犬丛集性癫痫发作和癫痫持续状态的附加治疗选择进行评估。
