P34 – 2727: Optimization of approaches in treatment of patients with epilepsy

Abstract

Objective Optimization of adequate plasma concentrations of antiepileptic drugs (AED)s to achieve a prolonged and sustained remission of epilepsy. Methods The study is based on the results of a survey of 40 patients with epilepsy, varying in age debut, duration and etiology of the disease, clinical phenomenology of seizures, but all of them taking carbamazepine as AED. Conducted therapeutic drug monitoring (TDM), MRI, EEG. Results The majority of patients were between the ages of 1 to 5 years of life 52.5%. Selection criteria were the children taking AEDs for at least 3 months. Therapeutic range of carbamazepine concentration is 4–12 mkg/ml, toxicity develops at the level of circulating carbamazepine above 15 mkg/ml TDM allowed to establish causes of no adequate treatment strategy, such as, prescribing AEDs in unreasonable low doses, the appointment of two and more AEDs from different groups without regard to their pharmacokinetic interactions, that caused subtherapeutic drug levels in the blood serum in 33 (82.5%) cases. Level of drugs was at the recommended therapeutic range in 6 (15%) cases, which directly reflects the high individual variability between the received dose and drug levels in the blood. Feedback was analyzed assignable dose of drugs in mg per patient's weight with its concentration in blood plasma. In patients with low drug concentration in blood plasma confirmed adequate calculation of the drug per body weight. Its once again confirm individual tolerability of each patient and the presence of unknown causes which impact on the drug perception, such as helminthes, enzymes deficiency, lack of the liver functional activity and not identified blood minerals. Conclusion Treatment correction on the basis of TDM in patients with various forms of epilepsy lead to the decreasing of the attacks frequency. Clinical positive trend was confirmed by EEG data.