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Evaluation of therapeutic drug monitoring (TDM) on older antiepileptic medications | Abstract
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Abstract

Evaluation of therapeutic drug monitoring (TDM) on older antiepileptic medications

Author(s): Dayana Nicholas, Azmi Bin Sarriff, Tharmalingam Palanivelu, Kenneth Nelson and Samson P. George

The Prospective study was conducted to evaluate the measure of Therapeutic Drug Monitoring (TDM) services on conventional antiepileptic drugs (AEDs) in 160 epileptic patients’ data of children and adults with both genders was on AEDs. The study results have shown 66 patients (50.38%), under subtherapeutic range on single AEDs with phenytoin and Na.valproate. In 160 patients, 13 of 98 (13.54%) adult patients received co-medication and 3 of 62 (6.25%) children with co-medications. Overall average (Vd) for carbamazepine in adult and children patients was found to be 78.25L which was higher than Vd for phenytoin (35.12L) and Na.Valproate (11.73L). The overall mean of clearance (Cl) for phenytoin (35.59L/hr) was found to be the highest, followed by Carbamazepine (3.81L/hr) and Na.Valproate (0.40L/hr). Na.Valproate had shown the higher value of Css(ave), which 71.90mcg/ml, than phenytoin (6.39mcg/ml) and Carbamazepine (4.73mcg/ml, where all these three drugs shown highly significant P<0.000. we recpmmend to bring the 100% of appropriateness of TDM utilization and optimization of the drug dosage by validating the data using screening checklist by TDM pharmacist in the TDM laboratory and the better clinical outcome can be evaluated only by monitoring the pharmacokinetic parameters for the variations appearing on individual patients.