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Therapeutic Drug Monitoring on Gabapentin: A Review
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| Author:
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, PRATHYUSHA RANI.T, AKILADEVI D
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| Abstract:
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Therapeutic Drug Monitoring (TDM) of antiepileptic drugs (AEDs) isn't regularly performed for all epilepsy patients, although this can guide for an individualized dosage regimen to achieve greater efficacy and safety. Gabapentin was initially affirmed in 1994 in the United States for the treatment of epilepsy with a proper pharmacokinetic (PK) profile. Regardless, recent research difficulties this assertion and consequently we meant to investigate factors that adjust gabapentin Pharmacokinetics. Gabapentin is endorsed as an adjunctive treatment in focal epilepsies in patients aged>6 years and as monotherapy in patients aged>12 years The concentration of the dose increases significantly with age, nearly 30% larger doses would be required in younger children <5 years to accomplish the equivalent in older children. It is also used for the treatment of peripheral neuropathy in adult epileptic patients. Gabapentin is secreted into saliva, its Salivary concentrations of gabapentin are just 5–10% those in plasma, restricting the utility of salivary gabapentin concentrations for TDM .In any case, concentrations are much lower than observed in plasma, with a significant correlation between plasma and saliva concentrations. Cimetidine causes a reduction in renal clearance of gabapentin and antacids containing aluminum or magnesium can reduce gabapentin absorption 20%. Gabapentin TDM is as of now not basic in the clinical setting due
to the wide therapeutic range and the low predominance of results. Dose adjustment is obligatory in patients with creatinine clearance>60 ml/min and in the elderly because of decreased renal capacity. Nevertheless, current data to support regular gabapentinTDM are deficient . Prospective research is needed to investigate the significance of gabapentin TDM in chose patient groups such as neonates, elderly and pregnant women.
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| Keyword:
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Therapeutic Drug Monitoring (TDM) of antiepileptic drugs (AEDs) isn't regularly performed for all epilepsy patients, although this can guide for an individualized dosage regimen to achieve greater efficacy and safety. Gabapentin was initially affirmed in 1994 in the United States for the treatment of epilepsy with a proper pharmacokinetic (PK) profile. Regardless, recent research difficulties this assertion and consequently we meant to investigate factors that adjust gabapentin Pharmacokinetics. Gabapentin is endorsed as an adjunctive treatment in focal epilepsies in patients aged>6 years and as monotherapy in patients aged>12 years The concentration of the dose increases significantly with age, nearly 30% larger doses would be required in younger children <5 years to accomplish the equivalent in older children. It is also used for the treatment of peripheral neuropathy in adult epileptic patients. Gabapentin is secreted into saliva, its Salivary concentrations of gabapentin are just 5–10% those in plasma, restricting the utility of salivary gabapentin concentrations for TDM .In any case, concentrations are much lower than observed in plasma, with a significant correlation between plasma and saliva concentrations. Cimetidine causes a reduction in renal clearance of gabapentin and antacids containing aluminum or magnesium can reduce gabapentin absorption 20%. Gabapentin TDM is as of now not basic in the clinical setting due to the wide therapeutic range and the low predominance of results. Dose adjustment is obligatory in patients with creatinine clearance>60 ml/min and in the elderly because of decreased renal capacity. Nevertheless, current data to support regular gabapentinTDM are deficient . Prospective research is needed to investigate the significance of gabapentin TDM in chose patient groups such as neonates, elderly and pregnant women.
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.03.169
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| Download:
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