By Philip N Patsalos
This up-to-date 3rd version of a profitable publication is an outline of either pharmacokinetic and pharmacodynamic antiepileptic drug (AED) interactions, together with info of the value and mechanism of interactions, and likewise of drug combos that aren't linked to interactions and for that reason might be coprescribed with no undue quandary. provided in alphabetical order and by means of drug category, drug interactions that happen among AEDs and in addition among AEDs and non-AEDs are defined in 3 sections: Drug interactions among AEDs; Drug interactions among AEDs and non-AED medications: Interactions affecting AEDs; Drug interactions among AEDs and non-AED medications: Interactions tormented by AEDs.
Antiepileptic Drug Interactions: A medical consultant, third Edition with its transparent, concise and unambiguous content material will
allow physicians and allied wellbeing and fitness execs to make extra rational offerings while AED polytherapy regimens are indicated. there's consistently a decision and warding off hugely interacting medicinal drugs and selecting drug combos which are minimally interacting or don't have interaction might be the objective in treating sufferers with epilepsy. This ebook presents all of the valuable info in order to let this target to be accomplished and, if priceless, to assist powerful administration of AED interactions.
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Additional info for Antiepileptic Drug Interactions: A Clinical Guide
Patsalos PN, Bourgeois BFD. The epilepsy prescriber’s guide to antiepileptic drugs. Cambridge: Cambridge University Press; 2nd Ed, 2014. 10. Reutens DC, Duncan JS, Patsalos PN. Disabling tremor after lamotrigine with sodium valproate. Lancet. 1993;342:185–6. 11. Rowan AJ, Meijer JW, de Beer-Pawlikowski N, van der Geest P, Meinardi H. Valproateethosuximide combination therapy for refractory seizures. Arch Neurol. 1983;40:797–802. 12. Pisani F, Oteri G, Russo MF, Di Perri R, Perucca E, Richens A.
Secondly, it is known that drugs that inhibit CYP2C19 (without inhibiting CYP2C9), including carbamazepine, omeprazole, ticlopidine, felbamate, and topiramate, produce inconsistent elevations in phenytoin plasma levels. Thirdly, there is pharmacogenetic variability in CYP expression and a significant proportion of Caucasians and Asians exhibit the “poor metabolizer phenotype” of CYP2C19. In such subjects, inhibition of CYP2C19 is not manifested. Lastly, in the case of the interaction with carbamazepine, carbamazepine may increase the clearance of phenytoin through induction of CYP2C9 and/or CYP2C19.
By following a few simple rules, potential adverse consequences of AED interactions can be minimized or even avoided: Rule 1 Utilize multiple drug therapy only when it is clearly indicated. Most patients with epilepsy can be best managed with a carefully individualized dosage of a single AED. Rule 2 If a patient suffers from comorbidities requiring multiple medications, it is preferable to treat the seizure disorder with an AED having a low interaction potential. Brivaracetam, eslicarbazepine acetate, ethosuximide, lamotrigine, topiramate, lacosamide, levetiracetam, perampanel, retigabine, tiagabine, gabapentin, and pregabalin have little or no ability to cause enzyme induction or inhibition.
Antiepileptic Drug Interactions: A Clinical Guide by Philip N Patsalos