[Pharmacokinetics of anticonvulsants in the perinatal period].
We have examined the concentration of a range of anticonvulsant drugs in serum, amniotic fluid and breast milk in 23 pregnant patients. Drug determinations were made during the last 3 months of pregnancy, at birth and during the first week postpartum. In the cord serum the range of concentrations, expressed as a percentage of the maternal serum concentration was: primidone (67-131%), phenobarbitone (80-108%), carbamazepine (60-76%), phenytoin (95-162%), ethosuximide (104%), and valproic acid (125-147%). In the amniotic fluid the corresponding ranges were: primidone (62-230%), phenobarbitone (28-59%), carbamazepine (18-45%), phenytoin (18-60%), ethosuximide (111%) and valproic acid (5-11%). In breast milk the corresponding percentages were: primidone (44-228%), phenobarbitone (20-50%), carbamazepine (32-80%), phenytoin (46-53%), ethosuximide (92%) and valproic acid (2-8%). Anticonvulsant drugs can be given in relatively high doses during pregnancy. Pregnant patients and neonates are patients with therapeutic problems. For this group of patients is recommendable a therapeutic drug monitoring.
Meyer
F P
FP
Institut für Klinische Pharmakologie, Medizinischen Akademie Magdeburg.
Quednow
B
B
Potrafki
A
A
Walther
H
H
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects; D007744:Obstetric Labor Complications / Q000097:blood* / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000188:drug therapy; D011644:Puerperal Disorders / Q000097:blood* / Q000188:drug therapy
D000927:Anticonvulsants
Zur Pharmakokinetik von Antiepileptika in der Perinatalperiode.