Therapeutic drug monitoring epilepsy

HPLC is an indispensable tool in the laboratory Therapeutic drug monitoring Monitoring of asthma treatment Management of epilepsy treatment A qualitative analysis tool J Testing incoming raw materials... 

Therapeutic drug monitoring is as essential as clinical and biochemical monitoring in the drug treatment of epilepsy. 

Epilepsy Phenytoin is effective against partial and tonic-clonic but not absence seizures. Phenytoin preparations differ significantly in bioavailabdity and rate of absorption. In general, patients should consistently be treated with the same drug from a single manufacturer. However, if it becomes necessary to temporarily switch between products, care should be taken to select a therapeutically equivalent product and patients should be monitored for loss of seizure control or onset of new toxicides. 

The effect of phenytoin on theophylline is established and of clinical importance. Patients given both drugs should be monitored to confirm that theophylline remains effective. Ideally the serum levels should be measured to confirm that they remain within the therapeutic range. Theophylline dosage increases of up to 50% or more may be required. Conversely, patients should be monitored for signs of toxicity and theophylline levels should be checked in patients who stop phenytoin. The effect of theophylline on phenytoin is not established and the documentation is limited. It may be prudent to monitor phenytoin levels as well. Separating the doses appears to minimise any interaction. Note that theophylline itself can cause seizures, although mostly in overdose, and should be used with caution in patients with epilepsy. 

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