Regulation of Anticonvulsant Therapeutic Schedule by Serum Concentrations

Abstract

In an attempt to improve the anticonvulsant therapy, the serum concentration of phenobarbital (PB), valproic acid (VPA) and phenytoin (PHT) was assessed in 62 pediatric patients who were treated with these drugs administered alone or concomitantly. The serum concentration of PB was higher when administered concomitantly with PHT or VPA as compared with that when administered alone. Conversely, the serum concentration of VPA tended to be lowered when administered in conjunction with PB. Good correlations were demonstrated between the determined concentration of PB or VPA and those predicted by the pharmacokinetic calculation.A case report was described referring to the therapeutic schedule of PB and PHT, their serum concentrations, occurrence of adverse effects and the symptoms. It was indicated that determination of serum concentration of administered anticonvulsants may prevent the possible adverse effects and be useful for improving the therapeutic schedule.