Document Detail


Possible roles for frequent salivary antiepileptic drug monitoring in the management of epilepsy.
MedLine Citation:
PMID:  2117529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Salivary levels of phenytoin, phenobarbitone, carbamazepine and carbamazepine-epoxide correlate with the simultaneous plasma water levels of these substances, after correcting for the effects of pH differences between saliva and plasma in the case of phenobarbitone. Saliva is easy and painless to collect, and salivary levels of the drugs are conveniently measured. Frequent (often daily) monitoring of pre-dose morning anticonvulsant drug concentrations in saliva over periods of weeks or months in 3 groups of epileptic subjects showed that (i) in some but not all poorly controlled epileptic patients seizures tended to occur on days when salivary anticonvulsant levels were lower than on non-seizure days, (ii) in such subjects it was possible to estimate an anticipated optimal drug concentration and dose to minimize seizure activity from the plot of seizure frequency against drug concentrations, (iii) in women with 'catamenial' epilepsy, salivary anticonvulsant levels were lower on perimenstrual days than at mid-cycle in half of the subjects studied, and (iv) in pregnant epileptic women the time course of the change in drug levels relative to dose could be followed more closely throughout pregnancy and the post-natal period than was practicable when using blood level measurements. Frequent measurement of salivary anticonvulsant concentrations appears a promising and inexpensive adjunct to the investigation and management of certain problem areas in epilepsy.
Authors:
G K Herkes; M J Eadie
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsy research     Volume:  6     ISSN:  0920-1211     ISO Abbreviation:  Epilepsy Res.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-09-25     Completed Date:  1990-09-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703089     Medline TA:  Epilepsy Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  146-54     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Queensland, Royal Brisbane Hospital, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / analysis*
Carbamazepine / analysis
Epilepsies, Partial / drug therapy,  metabolism
Epilepsy / drug therapy*,  metabolism
Female
Humans
Male
Menstruation / physiology
Monitoring, Physiologic
Phenobarbital / analysis
Phenytoin / analysis
Pregnancy
Saliva / analysis*
Chemical
Reg. No./Substance:
0/Anticonvulsants; 298-46-4/Carbamazepine; 50-06-6/Phenobarbital; 57-41-0/Phenytoin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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