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Use of saliva in monitoring carbamazepine medication in epileptic children

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Abstract

In 17 children on carbamazepine medication alone and 15 children on combined drug regimens, carbamazepine levels were determined in paired samples of serum and mixed saliva by enzyme immunoassay. Carbamazepine levels in serum and saliva were highly correlated in within-patient and between-patient series (r=0.87–0.94). Salivary levels were altered to a minor and clinically insignificant degree by stimulation of saliva flow. Mean saliva/serum ratios, calculated from drug concentrations in saliva specimens collected without and with stimulation were 0.44–0.45 and 0.41–0.43, respectively. The saliva/serum ratio was independent of the serum carbamazepine level and was not affected by concomitant drug medication. The data indicate that measuring salivary levels by enzyme immunoassay is suitable for predicting serum carbamazepine levels. Thus, measurement of carbamazepine levels in mixed saliva samples obtained by a noninvasive technique is recommended for routine monitoring of carbamazepine medication in epileptic children.

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References

  • Cook, C. E., Amerson, E., Poole, W. K., Lesser, P., O'Tuama, L.: Phenytoin and phenobarbital concentrations in saliva and plasma measured by radioimmunoassay. Clin. Pharmacol. Ther. 18, 742–747 (1975)

    Google Scholar 

  • Di Salle, E., Pacifici, G. M., Morselli, P. L.: Studies in plasma protein binding of carbamazepine. Pharmacol. Res. Commun. 6, 193–202 (1974)

    Google Scholar 

  • Dvorchik, B. H., Vesell, E. S.: Pharmacokinetic interpretation of data gathered during therapeutic drug monitoring. Clin. Chem. 22, 868–878 (1976)

    Google Scholar 

  • Hooper, W. D., Dubetz, D. K., Bochner, F., Cotter, L. M., Smith, G. A., Eadie, M. J., Tyrer, J. H.: Plasma protein binding of carbamazepine. Clin. Pharmacol. Ther. 17, 433–440 (1975)

    Google Scholar 

  • Horning, M. G., Brown, L., Nowlin, J., Lertratanangkoon, K., Kellaway, P., Zion, T. E.: Use of saliva in therapeutic drug monitoring. Clin. Chem. 23, 157–164 (1977)

    Google Scholar 

  • Johannessen, S. I., Standjord, R. E.: The concentration of carbamazepine (Tegretol®) in serum and cerebrospinal fluid in patients with epilepsy. Acta Neurol. Scand. 48, Suppl. 51, 445–446 (1972)

    Google Scholar 

  • Morselli, P. L., Gerna, M., De Maio, D., Zanda, G., Viani, F., Garattini, S.: Pharmacokinetic studies on carbamazepine in volunteers and in epileptic patients. In: Clinical pharmacology of anti-epileptic drugs (eds. H. Schneider, D. Janz, C. Gardner-Thorpe, H. Meinardi, A. L. Sherwin), pp. 166–180. Berlin-Heidelberg-New York: Springer 1975

    Google Scholar 

  • Paxton, J. W., Whiting, B., Rowell, F. J., Ratcliffe, J. G., Stephen, K. W.: Salivary concentrations of antiepileptic drugs. Lancet 1976 II, 639–640

    Google Scholar 

  • Rane, A., Höjer, B., Wilson, J. T.: Kinetics of carbamazepine and its 10, 11-epoxide metabolite in children. Clin. Pharmacol. Ther. 19, 276–283 (1976)

    Google Scholar 

  • Rawlins, M. D., Collste, P., Bertilsson, L., Palmér, L.: Distribution and elimination kinetics of carbamazepine in man. Eur. J. Clin. Pharmacol. 8, 91–96 (1975)

    Google Scholar 

  • Reynolds, F., Jones, N. F., Ziroyanis, P. N., Smith, S. E.: Salivary phenytoin concentrations in epilepsy and in chronic renal failure. Lancet 1976 II, 384–386

    Google Scholar 

  • Schmidt, D.: Salivary concentrations of antiepileptic drugs. Lancet 1976 II, 639

    Google Scholar 

  • Schmidt, D., Kupferberg, H. J.: Diphenylhydantoin, phenobarbital, and primidone in saliva, plasma, and cerebrospinal fluid. Epilepsia 16, 735–741 (1975)

    Google Scholar 

  • Schmidt, D., Kupferberg, H. J.: Antiepileptic drugs in saliva: Clinical applications. In: Epileptology (ed. D. Janz), pp. 419–425. Stuttgart: Thieme 1976

    Google Scholar 

  • Troupin, A. S., Friel, P.: Anticonvulsant level in saliva, serum and cerebrospinal fluid. Epilepsia 16, 223–227 (1975)

    Google Scholar 

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Supported by Deutsche Forschungsgemeinschaft (Ba 246/11)

The data comprise part of the doctoral thesis of Elke Günther, University of Kiel

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Bartels, H., Oldigs, H.D. & Günther, E. Use of saliva in monitoring carbamazepine medication in epileptic children. Eur J Pediatr 126, 37–44 (1977). https://doi.org/10.1007/BF00443121

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