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Factors Influencing the Serum Levels of Carbamazepine and Carbamazepine-10, 11-Epoxide
Carbamazepine과 Carbamazepine-10, 11-epoxide의 혈청농도에 미치는 영향

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Authors
Hwang, Yong Seung; Lockman, Lawrence A.
Issue Date
1990-03
Publisher
Seoul National University College of Medicine
Citation
Seoul J Med, Vol.31 No.1, pp. 33-39
Keywords
CarbamazepineCarbamazepine-10, 11-epoxideAntiepileptic drugsTherapeutic drug monitoring
Abstract
Carbamazepine-1 0, 11-epoxide(CBZ-Epox). a metabolite of carbamazepins
(CBZ), IS known to have toxic effects as well as some antiepileptic property similar to
CBZ.
The serum levels of CBZ and CBZ-Epox at the steady state were measured by HPLC
assay for 141 children and young adults (1-29 years) who were on CBZ monotherapy or In
combination with other antiepileptic drugs. Eighty patients were on CBZ monotherapy. In
addition to CBZ, 20 patients were on ethosuximide, eight on valproate. eight on phenytoin,
five on phenobarbital or prrmidone and 20 on more than one additional antrepileptic
drug.
In patients on CBZ monotherapy, the mean CBZ level was 8.2 ug/ml ± 22 ( ± SE), the
CBZ-Epox level was 1.6 ug/ml ± 0.6 and the CBZ-Epox/CBZ ratio was 0.19±05 On
univariate analysis, factors that significantly' influenced the CBZ-Epox/CBZ ratio were
the age of the patient, the time Interval between the last dose and blood sampling, and
the dose/surface area. Multivarrate analysis demonstrated that the only factors that significantly'
influenced the CBZ-Epox/CBZ ratio were the time interval between the last doe
and blood sampling and the age of the patients
Patients on polytherapy had significantly' higher CBZ-Epox / CBZ ratios than patients
on monotherapy. The ratios were as follows: CBZ and ethosuximide, 0.23 ± 005; CBZ
and valproate, 0.33 ± 0.15; CBZ and phenytoin, 0.35 ± 011; CBZ and phenobarbital or
primidone, 0.29 ± 0.05; CBZ and more than one additional anticonvulsant, 0.44 ± 017
CBZ and CBZ-Epox levels are invarrably affected by the age of the patients. the CBZ
dose and co-medication with other annepileptrc durgs. Careful monitoring IS mandatory in
the latter group to avoid toxicity 'p < 001, unpaired t-test
ISSN
0582-6802
Language
English
URI
https://hdl.handle.net/10371/7302
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 31 No.1 (1990)
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