Abstract
The therapeutic drug monitoring (TDM) is an important strategy for the effectiveness and safety of long-term pharmacotherapy, such as the use of phenobarbital as an anticonvulsant drug in epilepsy. In this sense, HLPC has been presented as a technique for the measurement of phenobarbital in serum. However, the ideal conditions for carrying out the method must be established for each laboratory reality. An analytical method using HPLC was developed and validated in order to identify and quantify Phenobarbital in blood. The chromatographic conditions were C-18 column (Shimpack XR-ODS 50L x 3.0), acetonitrile-water mobile phase (30:70, v v-1), 0.2 mL min-1 flow and reading wavelength of 210 nm. Linearity was established in the range of 2.5 to 80 μg mL-1, the linear correlation coefficient was 0.9981. The average of the coefficient of variation of the precision was 5.30%. The relative standard error of the accuracy was -2.17% and of the recovery coefficient was 97.83%. In all eleven patients, phenobarbital concentrations were below the therapeutic range. The tested method was selective, linear, precise, accurate and showed good recovery.
Highlights
Phenobarbital is an anticonvulsant drug that amplifies the inhibitory neurotransmission of Gamma-AminoButyric Acid (GABA)
The vast majority (90%) came from the mesoregion of agreste Paraibano, especially from the municipality of Campina Grande, with patients still coming from municipalities in Borborema (8%) and Sertão da Paraíba (2%). This finding reflects the regional impact of the service provided by Hospital Universitario Alcides Carneiro (HUAC)
One can estimate the relevance of implementing a therapeutic monitoring service for anticonvulsants at HUAC as a strategy for optimization of individual pharmacotherapy
Summary
Phenobarbital is an anticonvulsant drug that amplifies the inhibitory neurotransmission of Gamma-AminoButyric Acid (GABA). Many experts and authors criticize the use of phenobarbital for its therapeutic limitations in some types of seizures and the high risk of serious adverse effects such as sedation, megaloblastic anemia, osteomalacia and light hypersensitivity, besides the risk of metabolic tolerance and drug dependence. There are frequent reports of cardiorespiratory depression and coma. Phenobarbital, even today, is still widely used to prevent seizures, especially for its low financial cost (Brasil, 2018; Macnamara, 2012). Conflicts of interest: The authors have no conflict of interest to declare.
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