Therapeutic Drug Monitoring of Valproic Acid in Patients with Monotherapy at Steady State

  • سال انتشار: 1388
  • محل انتشار: مجله علوم پایه پزشکی ایران، دوره: 12، شماره: 3
  • کد COI اختصاصی: JR_IJBMS-12-3_004
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 346
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نویسندگان

Mohsen Forooghipour

Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Amir Hooshang Mohammadpour

Department of Pharmacodinamy & Toxicology, Pharmaceutical Research Center & School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

Naser Vahdati Mashhadian

Department of Pharmacodinamy & Toxicology, Pharmaceutical Research Center & School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

Mohammad Hassanzadeh Khayyat

Department of Medicinal Chemistry, Pharmaceutical Research Center & School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

Mahmood Reza Azarpajouh

Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Naghmeh Mokhber

Department of Psychiatry, Faculty of Medicine, Psychiatric Research Center, Ebn-sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Tamara Aghebati

Department of Pharmacodinamy & Toxicology, Pharmaceutical Research Center & School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

Jamal Shamsara

Department of Pharmacodinamy & Toxicology, Pharmaceutical Research Center & School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده

Objective(s) The role of therapeutic drug monitoring (TDM) in patient care has grown rapidly since its introduction three decades ago. The aim of present study was to evaluate the possible relationship between serum levels and the clinical response of valproic acid (VPA). Materials and Methods In the present study we evaluated a homogeneous group of adult patients receiving VPA monotherapy. A total of ۱۸ epileptic patients who fulfilled inclusion and exclusion criteria were entered this prospective study. Steady state trough plasma concentration was determined by fluorescence polarization immunoassay (FPIA). The correlation between therapeutic response and VPA serum concentration was evaluated. Results Mean VPA dose and mean total VPA plasma concentrations were ۸.۳۵±۱.۴۹ mg/kg/day and ۵۰.۴۰±۴.۱۸ pg/ml respectively. Mean VPA clearance was ۸.۸۴±۴.۴۳ (ml/kg/h). Plasma levels within the therapeutic range were found in ۳۳% of epileptic patients. Plasma levels were below the therapeutic range in ۶۷% of study population. Of patients ۷۵% and ۱۷% with sub-therapeutic levels achieved complete control and partial control respectively. Conclusion Poor correlation was found between the plasma concentration of VPA and its therapeutic effects. Therefore, this study showed that TDM of VPA will be useful only when individuals are non-responsive to treatment or vulnerable to adverse reactions with standard doses.

کلیدواژه ها

Therapeutic Drug Monitoring (TDM), Trough plasma concentration, Valproic acid

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