Abstract
In epilepsy, therapeutic drug monitoring (TDM) could aid in individualizing dosage regimen and ascertaining compliance on anti-epileptic drugs (AEDs). The aim of this study was to survey the requests for TDM of AEDs to determine drugs involved, observed concentrations, reasons for requests and action undertaken. TDM requests for AEDs were surveyed at a university hospital in Oman from January 2006 to December 2009. A total of 151 patients with 354 TDM requests were collected. These requests were for valproic acid (46.9%), phenytoin (26.8%), carbamazepine (25.4%) and phenobarbital (0.8%). 50, 37 and 13% of all reported concentrations were below, within and above therapeutic range, respectively. For majority of the subjects (70%), there were no clear reasons for plasma concentrations to lie outside the therapeutic range. No change in the drug therapy/dosing was required subsequent to the TDM reports in 42.7% of the cases. Emergency department was the main unit requesting TDM (63.8%) and TDM was mostly indicated for an increase in the seizures frequency on the same day (62.7%). This study provides an overview of the specific requests for TDM of AEDs in routine clinical practice which might help in auditing and improving this service for optimal utilization. Key words: Antiepileptic drugs, therapeutic drug monitoring, epilepsy, plasma.
Highlights
Dermatitis caused by plants is commonly encountered in practice of dermatology
Eleven fractions were collected from methanol extract of powdered seeds by liquid column chromatography
It was concluded that A. aspera contained skin irritant compounds
Summary
Dermatitis caused by plants is commonly encountered in practice of dermatology (wood, 1962). The old Indian barbers made use of the irritant properties of certain plants for cauterization of skin diseases. It must be realized that certain plants cause irritation at one time and sensitization and photosensitization at another time, depending on the amount and concentration of the irritant and other environmental factors (Behl, 2004). Achyranthes aspera known as prickly chaff flower and devil's horsewhip, belongs to family Amaranthaceae. It is used as laxative and antiemetic. The whole plant decoction along with root is given to treat menorrhagia, diarrhoea, and stomach pain (Aggarawal and Tamarkar, 2002). Seeds paste is given to treat Rabies (Ravendra and Martin, 2006). This plant is reported to possess antidiabetic and antirheumatic properties. It was published that A. aspera is used as antispasmodic, diuretic, purgative, antifungal, cardiac stimulant, anticoagulant, hypertensive, abortifacient and antileprotic (Aggarawal et al, 2002)
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