Applied Clinical Pharmacokinetics, 2e
|Part IV. Anticonvulsants >|
Use of Carbamazepine Serum Concentrations to Alter Doses
Sections: Use of Carbamazepine
Serum Concentrations to Alter Doses, Pseudolinear
Pharmacokinetics Method, Example 1, Example 2.
Topics Discussed: carbamazepine; central nervous system agents; epilepsy; linear and nonlinear pharmacokinetics; therapeutic drug concentrations and their interpretation; therapeutic drug monitoring.
Excerpt:"Because of the large amount of pharmacokinetic variability among
patients, it is likely that doses computed using patient population
characteristics will not always produce carbamazepine serum concentrations
that are expected or desirable. Because of pharmacokinetic variability,
the autoinduction pharmacokinetics followed by the drug, the narrow
therapeutic index of carbamazepine and the desire to avoid adverse
side effects of carbamazepine, measurement of carbamazepine serum
concentrations is conducted for almost all patients to ensure that
therapeutic, nontoxic levels are present. In addition to carbamazepine
serum concentrations, important patient parameters (seizure frequency, potential
carbamazepine side effects, etc.) should be followed to confirm
that the patient is responding to treatment and not developing adverse
drug reactions. When carbamazepine serum concentrations are measured
in patients and a dosage change is necessary, clinicians should
seek to use the simplest, most straightforward method available
to determine a dose that will provide safe and effective treatment.A simple, easy way to approximate new total serum concentrations
after a dosage adjustment with..."