Articulo epilepsia farmacos

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ARTICLE IN PRESS

Farm Hosp. 2011;xxx(xx):xxx--xxx
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www.elsevier.es/farmhosp

REVIEW

Pharmacokinetic Monitoring of Antiepileptic Drugs
A. Aldaz,a R. Ferriols,b,∗ D. Aumente,c M.V. Calvo,d M.R. Farre,e B. García,f
R. Marqués,g P. Mas,h B. Porta,i M. Outeda,j D. Soyk , Grupo PK-gen de la Sociedad
Espa˜ola de Farmacia Hospitalaria
n
a

Servicio de Farmacia, ClínicaUniversitaria, Pamplona, Spain
Servicio de Farmacia, Hospital General de Castellón, Castellón, Spain
c
Servicio de Farmacia, Hospital Universitario Reina Sofía, Córdoba, Spain
d
Servicio de Farmacia, Hospital Universitario de Salamanca, Spain
e
Servicio de Farmacia, Hospital San Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
f
Servicio de Farmacia, Hospital Severo Ochoa, Leganés,Madrid, Spain
g
Servicio de Farmacia, Hospital Universitario La Fe, Valencia, Spain
h
Servicio de Farmacia, Hospital General de Alicante, Spain
i
Servicio de Farmacia, Hospital Universitario Dr. Peset, Valencia, Spain
j
Servicio de Farmacia, Hospital Universitario Juan Canalejo, La Coru˜a, Spain
n
k
Servicio de Farmacia, Hospital Clínico, Barcelona, Spain
b

Received 13 July 2010; accepted25 October 2010

KEYWORDS
Antiepileptic drugs;
Monitoring;
Pharmacokinetics

PALABRAS CLAVE
Antiepilépticos;
Monitorización;
Farmacocinética

∗

Abstract Monitoring plasma levels of antiepileptic drugs for the treatment and prophylaxis of
epilepsy is one of the strategies enabling clinical results to improve by reducing adverse affects
and increasing effectiveness.
The objectiveof this article is to review the basic aspects in the monitoring of antiepileptic
drugs using a consensus document prepared and endorsed by the pharmacokinetics and pharmacogenetics working group (PK.gen) of the Sociedad Espa˜ola de Farmacia Hospitalaria (Spanish
n
Society of Hospital Pharmacists).
© 2010 SEFH. Published by Elsevier España, S.L. All rights reserved.

Monitorizaciónfarmacocinética de antiepilépticos
Resumen La determinación de las concentraciones plasmáticas de antiepilépticos para el
tratamiento y profilaxis de la epilepsia es una de las estrategias que permiten mejorar los
resultados clínicos, reduciendo los efectos adversos y aumentando la efectividad.
El objetivo de este artículo es revisar los aspectos básicos en la determinación de los
antiepilépticosmediante un documento de consenso realizado y avalado por el grupo de

Please cite this article as: Aldaz A, et al. Monitorización farmacocinética de antiepilépticos. Farm Hosp. 2011;35:326--39.
Corresponding author.
E-mail address: ferriols raf@gva.es (R. Ferriols).

2173-5085/$ – see front matter © 2010 SEFH. Published by Elsevier España, S.L. All rights reserved.

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A. Aldaz et al.
trabajo de farmacocinética y farmacogenética de la Sociedad Espa˜ola de Farmacia Hospitalaria
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(PK.gen).
© 2010 SEFH. Publicado por Elsevier España, S.L. Todos los derechos reservados.

Introduction
The main objective of pharmacokinetic monitoring of
antiepileptic drugs is to optimise treatment by studying drug
levels in biologicalmatrices. Adapting individual doses is no
easy task, due to the presence of factors including: a) the
considerable inter-individual pharmacokinetic variability of
antiepileptic drugs; b) the use of these drugs as prophylactics for long-term epileptic seizure control, and c) having no
defined correlation between efficacy and a biological marker
that could help with decision-making.1
It isobvious that epilepsy treatment has benefited
from the determination of serum concentrations during
treatments. High inter- and intra-individual variability,
serum concentration-effect relationships, drug interactions, and so on, are all aspects that make personalising
antiepileptic treatments through pharmacokinetic determination recommendable.2
However, the fact that these techniques have...