Phenobarbital drug monitoring

TEUTHROMYCIN BARBITURATES 1 levels of these drugs, with risk of therapeutic failure Induction of hepatic metabolism 1. Avoid co-administration of telithromycin for up to 2 weeks after stopping phenobarbital 2. With the other drugs, monitor for l clinical efficacy and T dose as required... 

Phenmetrazine chlorotheophyllinate, 882 Phenmetrazine hydrochloride, 882 Phenmetrazine theoclate, 882 Phenobarbital, 883 Phenobarbital sodium, 883 Phenobm bitone, 25, 883 (metabolite), 771,923 therapeutic drug monitoring, 109 Phenobarbitone sodium, 883 Phenobarbitone, soluble, 883 Phenoctide, 830 Phenododecinium bromide, 570 Phenol, 884 (metabolite), 380 Phenolphthalein, 885 Phenomorphan, xvii Phenomycilline, 887 Phenoperidine, 885 Phenoperidine hydrochloride, 886 Phenopromini sulphas, 349 Phenopropazine, 599 Phenothiazine, 886... 

The stereoselective metabolism of the drug was monitored using a p-CD CSP and mobile phase of water/acetonitrile (80 20) (see Fig, 7), The chronic treatment of 22 pediatric patients with phenytoin alone or in combination with phenobarbital was monitored using this method, and it was found that the S-(—) metabolite was favored over the R-(+) metabolite by a ratio of approximately 9 1. 

S226 Brettfeld, C., Gobrogge, R., Massoud, N., Munzenberger, P., Nigro, M. and Sarnaik, A. (1989). Evaluation of Ames Seralyzer for the therapeutic drug monitoring of phenobarbital and phenytoin. Ther. Drug Monit. 11, 612-615. 

BARBITURATES. The barbiturate phenobarbital (Luminal) is commonly used to treat convulsive disorders. When administering the barbiturates by the intravenous (IV) route, it is important not to exceed a rate of 60 mg/min and to administer the drug within 30 minutes of preparation. The nurse monitors the patient carefully during administration of a barbiturate. The blood pressure and respirations are taken frequently. Resuscitation equipment and artificial ventilation equipment are kept nearby. 

Primidone is an other second line barbiturate used orally to control tonic-clonic and partial seizures. It is a pro-drug as it is metabolized to phenobarbital and phenylethylmalonamide (PEMA), however both the parent compound as well as the metabolites have anti seizure activity. Its use is more difficult to monitor and adverse effects occur even more frequently than with phenobarbital. 

IMATINIB 1. ANTIBIOTICS-rifampicin 2. ANTICANCER AND IMMUNOMODULATING DRUGS - dexamethasone 3. ANTIDEPRESSANTS-St John s wort 4. ANTI EPILEPTICS - carbarn azepine, phenobarbital, phenytoin 1 imatinib levels Due to induction of CYP3A4-mediated metabolism of imatinib Monitor for clinical efficacy and adjust dose as required. Avoid co-administration of imatinib and rifampicin... 

VINCA ALKALOIDS - VINBLASTINE, VINCRISTINE 1. ANTIBIOTICS-rifampicin 2. ANTICANCER AND IMMUNOMODULATING DRUGS - dexamethasone 3. ANTIDEPRESSANTS-St John s wort 4. ANTI EPILEPTICS -carbamazepine, phenobarbital, phenytoin 1 of plasma concentrations of vinblastine and vincristine, with risk of inadequate therapeutic response. Reports of 1 AUC by 40% and elimination half life by 35%, and t clearance by 63%, in patients with brain tumours taking vincristine, which could lead to dangerously inadequate therapeutic responses Due to induction of CYP3A4-mediated metabolism Monitor for clinical efficacy, and t dose of vinblastine and vincristine as clinically indicated in the latter case, monitor clinically and radiologically for clinical efficacy in patients with brain tumours and t dose to obtain desired response... 

The major route of elimination is hepatic metabolism. The variability in the metabolism and pharmacokinetics in neonates, infants and children necessitates monitoring of drug concentrations in the plasma, particularly when it is co-administered with phenytoin, phenobarbital or rifampin. 

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