Antiepileptic drugs blood concentration

In a retrospective study of cases from the Jefferson County Coroner/Medical Examiners Office, Alabama, USA between January 1982 and December 2000 there were 101 deaths in patients in whom methadone was detected in the blood (35). Methadone was the sole intoxicant in 15 cases, with a mean concentration of 0.27 pg/ml. A benzodiazepine was the most frequently detected co-intoxicant in 60 of the 101 cases and the only co-intoxicant in another 30 cases. In 26 cases methadone had been taken with a range of non-benzodiazepine substances, including antidepressants, antipsychotic drugs, antiepileptic drugs, and cocaine. The high... 

In one case, isoniazid increased blood concentrations of the antiepileptic drug ethosuximide and caused hiccups, anorexia, nausea, vomiting, insomnia, and an acute psychosis (SEDA-9, 267) (56). This may have been due to inhibition of ethosuximide metabolism by isoniazid. 

Epilepsy Antiepileptic drugs, surgery Medication serum concentrations, sedation, cognitive abilities, liver function tests, blood dyscrasias, bleeding abnormalities, CNS toxicities, rashes, seizure counts, other drug-specific adverse effects... 

Poly(N-vinyl-pyrrolidone), or PNVP, is a biocompatible, water-soluble (JJ ) polymer that has previously been used as a synthetic blood plasma extender, as a component of soft contact lenses, and in a complex with iodine as the commercially available topical antiseptic Betadine ( ). It also forms a remarkable variety of chemically specific complexes with drugs and hormones such as the tetracyclines, phenothiazine antipsychotics, the antiepileptic drug phenytoin, procaine local anesthetics, and methyldopa antiparkinsonian drugs ( ). In its insoluble, chemically cross-linked form, PNVP has also been used as a concentrating agent for a variety of phenols and catechol compounds (22). 

Immunoaffinity measurement of drug concentration. At therapeutic levels in blood, 90% of the antiepileptic drug phenytoin is bound to the protein serum albumin. The unbound 10% is thought to be the active form of the drug. Free phenytoin can be measured with a thin-layer (0.94 mm tall X 2.1 mm diameter) affinity column at 37°C containing antiphenytoin antibodies covalently bound to silica. 

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