Use of total and free anticonvulsant serum levels in clinical practice.
Total and free (unbound) anticonvulsant drug levels in serum (361 analyses) were measured in a series of 117 patients who attended for routine management of epilepsy. Comparison of predetermined therapeutic ranges for the two types of level demonstrated disagreement in as many as 30% of assessments. The clinical significance of this finding is discussed and wider acceptance of the use of free drug levels in the management of epilepsy is advocated.
D000927:Anticonvulsants / Q000097:blood* / Q000627:therapeutic use; D002220:Carbamazepine / Q000097:blood / Q000627:therapeutic use; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007124:Immunoenzyme Techniques; D010634:Phenobarbital / Q000097:blood / Q000627:therapeutic use; D010672:Phenytoin / Q000097:blood / Q000627:therapeutic use; D014635:Valproic Acid / Q000097:blood / Q000627:therapeutic use
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin; D010634:Phenobarbital