Smith Casey, Barnes Heller Heidi L, Reif Nicole, Van Hesteren Matthew, Reinhart Jennifer M
Department of Medical Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
Veterinary Hospital Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin.
J Vet Intern Med. 2019 Mar;33(2):827-830. doi: 10.1111/jvim.15412. Epub 2019 Jan 21.
Repeated oral administration of antiepileptic drugs can be challenging for cat owners, resulting in reduced compliance, poor seizure control, and reduced quality of life for cats. Levetiracetam (LEV) has several properties that make it an appealing drug for transdermal application.
The aims were to (1) determine if transdermal LEV, in a lipophilic, liposomic cream vehicle, resulted in serum concentrations above 5 μg/mL; (2) identify clinical adverse effects; and (3) evaluate the concentration of LEV in a lipophilic liposomic cream at set intervals.
Six healthy, client-owned cats weighing ≤5 kg.
Prospective clinical trial. Transdermal LEV was applied to the inner pinna at a dosage of 60 mg/kg (400 mg/mL concentration) at home for 6 days. Day 7, cats were hospitalized for blood sample collection for LEV concentration at times 0 (before dose administration), 0.5, 1, 2, 3, and 4 hours after administration.
Median (range) timed serum concentrations were 16.6 (8.6-39.6) μg/mL, 16.1 (6.8-34.4) μg/mL, 15.4 (10.1-36.7) μg/mL, 17.4 (9.2-32.7) μg/mL, 15.1 (8.3-25.9) μg/mL, and 14.8 (11.9-28.4) μg/mL, respectively. Adverse events were limited to sedation (1/6 cats) and pinna crusting (1/6 cats). The LEV, in the proposed vehicle, retained concentration above 95% at 400 mg/mL up to 5 weeks.
Thrice daily transdermal LEV resulted in median serum concentrations ≥5 μg/mL throughout the sampling period and clinical adverse events were minimal. Transdermal LEV can provide an alternative for cats resistant to administration of other forms of anticonvulsant medication.
对于猫主人来说，反复口服抗癫痫药物可能具有挑战性，这会导致依从性降低、癫痫控制不佳以及猫的生活质量下降。左乙拉西坦（LEV）具有多种特性，使其成为经皮给药的理想药物。
旨在（1）确定在亲脂性脂质体乳膏载体中的经皮LEV是否能使血清浓度高于5μg/mL；（2）识别临床不良反应；（3）按设定间隔评估亲脂性脂质体乳膏中LEV的浓度。
6只体重≤5kg的健康、客户拥有的猫。
前瞻性临床试验。在家中以60mg/kg（浓度400mg/mL）的剂量将经皮LEV应用于内耳廓，持续6天。第7天，猫住院，在给药前（0小时）、给药后0.5、1、2、3和4小时采集血样以检测LEV浓度。
定时血清浓度中位数（范围）分别为16.6（8.6 - 39.6）μg/mL、16.1（6.8 - 34.4）μg/mL、15.4（10.1 - 36.7）μg/mL、17.4（9.2 - 32.7）μg/mL、15.1（8.3 - 25.9）μg/mL和14.8（11.9 - 28.4）μg/mL。不良事件仅限于镇静（1/6只猫）和耳廓结痂（1/6只猫）。在所提议的载体中，400mg/mL的LEV在长达5周的时间内浓度保持在95%以上。
每日三次经皮给予LEV在整个采样期间导致血清浓度中位数≥5μg/mL，且临床不良事件极少。经皮LEV可为对其他形式抗惊厥药物给药有抵抗的猫提供一种替代方法。
