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Drug-resistant epilepsy and topiramate: Plasma concentration and frequency of epileptic seizures.
Marques, Fabiana Angelo; Albuquerque, Nayara Cristina Perez de; Campos, Marília Silveira de Almeida; Freitas-Lima, Priscila; Baldoni, André Oliveira; Alexandre Júnior, Veriano; Sakamoto, Américo Ceiki; Oliveira, Anderson Rodrigo Moraes de; Pereira, Leonardo Régis Leira.
Afiliação
  • Marques FA; School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Albuquerque NCP; Department of Chemistry, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Campos MSA; School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Freitas-Lima P; Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Baldoni AO; Federal University of São João Del-Rei, Divinópolis, MG, Brazil.
  • Alexandre Júnior V; Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Sakamoto AC; Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Oliveira ARM; Department of Chemistry, School of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Pereira LRL; School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Clin Exp Pharmacol Physiol ; 45(7): 652-658, 2018 07.
Article em En | MEDLINE | ID: mdl-29424067
Topiramate (TPM) is a second-generation antiepileptic drug (AED), acting on drug-resistant epilepsy. The aim of the study was to evaluate the influence of the dose, use of other AEDs on TPM plasma concentration (Cp ), and frequency of epileptic seizures. A cross-sectional analytical study was developed with patients aged 18-60 years, for diagnosis of drug-resistant epilepsy, using TPM in monotherapy or associated with other AEDs. The following variables were analyzed: age, frequency of epileptic seizures, pharmacotherapeutic regimen with its respective doses, adherence to medication treatment, and adverse events score. Thirty-seven patients were included, 83.8% of the patients presented Cp below the therapeutic range. Multiple linear regression estimated that the increase of 1.0 mg/kg/d promoted an increase of 0.68 µg/mL in TPMCp , while the use of inducers predicted a reduction of 2.97 µg/mL (P < .001). Multiple Poisson regression predicts that an increase of 1.0 µg/mL in TPMCp decreased the patient's chance of presenting seizures, and patients using AED inducers were about ten times more likely to present seizures than those who do not use (P < .001). In addition, for patients using AED inducers with Cp below the therapeutic range, the mean number of seizures per month was greater than those with Cp within the therapeutic range. The prescribed dose and the use of AED inducers influence Cp of TPM, likewise the low Cp of first-line AEDs and of the adjuvant in the treatment, TPM, as well as low TPM dose seem to affect the control of epileptic seizures.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Convulsões / Resistência a Medicamentos / Topiramato / Anticonvulsivantes Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Clin Exp Pharmacol Physiol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Convulsões / Resistência a Medicamentos / Topiramato / Anticonvulsivantes Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Clin Exp Pharmacol Physiol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Austrália