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Lukic V, Jankovic SM, Petrovic NZ, Vucinic S, Jovic Stosic J, Djordjevic S, Dragojevic-Simić V. Population toxicokinetics of carbamazepine and its metabolite carbamazepine-10,11-epoxide in adults. Expert Opin Drug Metab Toxicol 2024:1-9. [PMID: 39021252 DOI: 10.1080/17425255.2024.2381555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/15/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Carbamazepine is one of the most commonly used antiseizure medications. Although carbamazepine pharmacokinetics in epileptic patients is well described, much less is known about these processes in the patients who experienced self-poisoning episode by this drug. Therefore, the aim of our investigation was to perform population toxicokinetics of carbamazepine and its metabolite carbamazepine-10,11-epoxide in adults. RESEARCH DESIGN AND METHODS Software program NONMEM and the ADVAN2 TRANS2 subroutine were used for establishing a population toxicokinetic model for the estimation of clearance and volume of distribution based on of the sum values of carbamazepine and carbamazepine-10,11-epoxide concentrations. RESULTS Our results indicated that the adult patients' ability to eliminate carbamazepine and carbamazepine-10,11-epoxide following acute carbamazepine self-poisoning was strongly associated with the high levels of CRP and ASP, as well as by the treatment with sedation. CONCLUSIONS Our study should provide better understanding of the toxicokinetics of carbamazepine taken in overdose and better management of patient population admitted to hospital.
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Affiliation(s)
- Vladan Lukic
- National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Slobodan M Jankovic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Nemanja Z Petrovic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Slavica Vucinic
- National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Jasmina Jovic Stosic
- National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Snezana Djordjevic
- National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Viktorija Dragojevic-Simić
- Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia
- Centre for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia
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Al-Taani GM, Yehya A, Albals D, Alsous M. Assessment of adherence to carbamazepine using plasma and saliva samples, a study from Jordan. Heliyon 2024; 10:e26736. [PMID: 38455560 PMCID: PMC10918113 DOI: 10.1016/j.heliyon.2024.e26736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
Background The measurement of carbamazepine levels in a biological sample is required to guide dosing, and prevent toxicity, and can be useful to assess medication adherence. Aim The primary aim of the presented study is to analyze carbamazepine levels in saliva and plasma samples of outpatients and to assess adherence to carbamazepine using saliva and plasma levels. Methods Adults who used carbamazepine for at least one month were recruited from the outpatient clinic department of Princess Basma Hospital, a public hospital in Irbid. Saliva and blood samples (1 ml) were collected simultaneously from subjects, and using a microanalytical method with high-performance liquid chromatography coupled with an ultraviolet detector, the level of carbamazepine (in micrograms per milliliter) was ascertained. Analysis of adherence to carbamazepine was carried out using plasma and saliva levels. Results A total of 69 consecutive patients attending the neurology clinic were recruited, of whom 85.5% had epilepsy. Approximately one-third (34.8%) used carbamazepine as monotherapy, whereas the remainder used a combination of antiepileptic drugs to control seizures. Overall, about two-thirds (71.9%) of the studied samples were non-adherent in either plasma or saliva samples. By referring to the plasma sample carbamazepine concentration, 75.4% of the respondents were adherents, 15.9% had under-adherence, and 8.7% had over-adherence. A total of 85.9% of the responders were adherent using the carbamazepine level in saliva samples. Plasma and saliva carbamazepine levels were linearly correlated to one another. Polypharmacy was commonly utilized with the patients, as 42% of the patients used two medications, with a range of 1-7 drugs used concomitantly. The predictor associated with higher plasma and saliva carbamazepine levels, as determined by multiple linear regression analysis, was the occurrence of seizures less than once a month, as compared to seizures with higher frequencies. Conclusion Saliva carbamazepine levels show the potential to be used as an alternative matrix to assess medication adherence, with a considerable correlation with the plasma carbamazepine level. Healthcare professionals can address routine care non-adherence through such measures.
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Affiliation(s)
- Ghaith M. Al-Taani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid Jordan
| | - Alaa Yehya
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid Jordan
| | - Dima Albals
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Mervat Alsous
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid Jordan
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Saleh Faisal M, Jamil A, Ali N, Alshahrani AM, Almarshad F. Distribution pattern of UGT1A6 and UGT2B7 gene polymorphism and its impact on the pharmacokinetics of valproic acid and carbamazepine: Prospective genetic association study conducted in Pakistani patients with epilepsy. Gene 2024; 892:147886. [PMID: 37820941 DOI: 10.1016/j.gene.2023.147886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/14/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Ethnic variation is one of the important factors in clinical practice that may affect the pharmacokinetics of drugs. The present study aims to determine the distribution pattern of UGT1A6 and UGT2B7 gene polymorphism and its possible impact on the metabolism of valproic acid (VPA) and carbamazepine (CBZ) in patients with epilepsy from Khyber Pakhtunkhwa region of Pakistan. METHODS After the enrollment of targeted patients, blood was collected for genotype analysis through Sanger sequencing. Plasma concentrations of VPA and CBZ were determined by reversed-phase high-performance liquid chromatography (HPLC) at the follow-up visit of third month from the initiation of therapy. The drug plasma levels were correlated with different genotypes of UGT1A6 and UGT2B7 to determine the impact of genetic polymorphism on the drug metabolism. RESULTS Of the total 178 epileptic patients, 120 subjects were prescribed VPA monotherapy while 58 subjects were given CBZ monotherapy. The mean age of the subjects was recorded as 26.1 ± 13.5 years with a predominance of the male gender. Generalized tonic-clonic (GTC) was the most prevalent type of seizure (82%) followed by partial seizure. Genotype analysis revealed that the frequency of homozygous and heterozygous variants of the targeted UGT genes were exceptionally high in the Khyber Pakhtunkhwa population compared to the ethnic groups of other countries. In UGT1A6-A552C and UGT1A6-A541G, AC and AG were the most prevalent genotypes with respective frequencies of 43.2% and 41.1% whereas, in UGT2B7-T161C and UGT2B7-G211T, TC and GG were the most prevalent genotypes with respective frequencies of 42.7% and 99.4%. In the VPA-treated group, the homozygous and heterozygous variants of UGT1A6-A552C and UGT1A6-A541G were significantly associated with lower drug plasma concentrations (p < 0.05). However, none of the genotypes of UGT2B7-T161C revealed any significant association with VPA plasma concentration (p greater than 0.05). In the CBZ-treated group, UGT gene polymorphisms were not recognized to cause alteration in the drug plasma concentrations (p greater than 0.05). CONCLUSION The genetic polymorphisms of UGT1A6, but not UGT2B7 significantly affected the plasma levels of valproic acid. The chosen SNPs did not reveal a role in determining the plasma levels of carbamazepine.
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Affiliation(s)
- Muhammad Saleh Faisal
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan; Department of Pharmacology, Khyber Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan.
| | - Ayesha Jamil
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan; Department of Pharmacology, Khyber Girls Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan.
| | - Niaz Ali
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan; Department of Pharmacology, College of Medicine, Shaqra University, Shaqra, Saudi Arabia.
| | | | - Feras Almarshad
- Department of Medicine, College of Medicine, Shaqra University, Shaqra, Saudi Arabia.
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Chiș IA, Andrei V, Muntean A, Moldovan M, Mesaroș AȘ, Dudescu MC, Ilea A. Salivary Biomarkers of Anti-Epileptic Drugs: A Narrative Review. Diagnostics (Basel) 2023; 13:diagnostics13111962. [PMID: 37296814 DOI: 10.3390/diagnostics13111962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Saliva is a biofluid that reflects general health and that can be collected in order to evaluate and determine various pathologies and treatments. Biomarker analysis through saliva sampling is an emerging method of accurately screening and diagnosing diseases. Anti-epileptic drugs (AEDs) are prescribed generally in seizure treatment. The dose-response relationship of AEDs is influenced by numerous factors and varies from patient to patient, hence the need for the careful supervision of drug intake. The therapeutic drug monitoring (TDM) of AEDs was traditionally performed through repeated blood withdrawals. Saliva sampling in order to determine and monitor AEDs is a novel, fast, low-cost and non-invasive approach. This narrative review focuses on the characteristics of various AEDs and the possibility of determining active plasma concentrations from saliva samples. Additionally, this study aims to highlight the significant correlations between AED blood, urine and oral fluid levels and the applicability of saliva TDM for AEDs. The study also focuses on emphasizing the applicability of saliva sampling for epileptic patients.
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Affiliation(s)
- Ioana-Andreea Chiș
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania
| | - Vlad Andrei
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania
| | - Alexandrina Muntean
- Department of Paediatric Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania
| | - Marioara Moldovan
- Department of Polymer Composites, Institute of Chemistry "Raluca Ripan", University Babes-Bolyai, 400294 Cluj-Napoca, Romania
| | - Anca Ștefania Mesaroș
- Department of Dental Propaedeutics and Aesthetics, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania
| | - Mircea Cristian Dudescu
- Department of Mechanical Engineering, Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, 400641 Cluj-Napoca, Romania
| | - Aranka Ilea
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania
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Parvin Shahdousti, Aghamohammadi M, Fallahi E, Kalhor H. Simultaneous Determination of Lamotrigine and Carbamazepine in Plasma Using Ultrasound-Assisted Emulsification Microextraction-High Performance Liquid Chromatography. JOURNAL OF ANALYTICAL CHEMISTRY 2020. [DOI: 10.1134/s1061934820050160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Capacity of Two Ornamental Species (Iris sibirica and Zantedeschia aethiopica) to Take up, Translocate, and Accumulate Carbamazepine under Hydroponic Conditions. WATER 2020. [DOI: 10.3390/w12051272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Iris sibirica and Zantedeschia aethiopica are ornamental species that have previously been used in pilot-scale treatment wetlands (TWs) focused on the removal of carbamazepine (CBZ), in which good results were obtained; however, the plant influence was not completely determined. In addition, plant uptake has been reported to play a crucial role in CBZ removal in comparison to other mechanisms. Therefore, the aim of this study was to evaluate the capacity of I. sibirica and Z. aethiopica to take up, translocate, and accumulate CBZ in hydroponic conditions using a nutrient solution spiked with the drug. The maximum CBZ tolerance threshold for the two species was found to be 10 mg/L, which was used to carry out the uptake experiments. The results showed a better performance of I. sibirica compared to Z. aethiopica reaching 31.1% and 20.9% of removal efficiency, respectively. The parent compound accumulated mainly on the leaves of both species. Furthermore, a high proportion of the CBZ taken up by the plants (up to 70%) was metabolized by both species. The performance of the two species suggests the importance of plant harvesting in TWs in order to promote CBZ removal and indicates the need for future works.
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Dziurkowska E, Wesolowski M. Deproteinization as a Rapid Method of Saliva Purification for the Determination of Carbamazepine and Carbamazepine-10,11 Epoxide. J Clin Med 2020; 9:jcm9040915. [PMID: 32230768 PMCID: PMC7230990 DOI: 10.3390/jcm9040915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
Saliva is a valuable diagnostic material that, in some cases, may replace blood. However, because of its different composition, its use requires the development of new, or the modification of existing, extraction procedures. Therefore, the aim of the study was to develop a method of saliva purification that would enable the determination of carbamazepine and its metabolite, carbamazepine-10,11 epoxide. When comparing two methods of sample purification (Solid Phase Extration (SPE) and deproteinization), it was found that the second method yielded more favorable results. A 1% formic acid solution in acetonitrile was used for extraction. The samples were shaken and centrifuged, and the supernatant obtained was evaporated and dissolved in a mobile phase, then chromatographically analyzed. The developed method was validated by determining its linearity in the range of 10-5000 ng/mL for both analytes. Intra- and inter-day precision did not exceed 14%. In order to check the usefulness of the method, both analytes were determined in the saliva samples from 20 patients treated with carbamazepine. The content of both analytes was detected and determined in all of the tested samples of saliva. It was found that the method developed is rapid, sensitive, reliable, and can be used to monitor the concentration of carbamazepine and metabolite in patients' saliva.
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Gasca-Pérez E, Galar-Martínez M, García-Medina S, Pérez-Coyotl IA, Ruiz-Lara K, Cano-Viveros S, Pérez-Pastén Borja R, Gómez-Oliván LM. Short-term exposure to carbamazepine causes oxidative stress on common carp (Cyprinus carpio). ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2019; 66:96-103. [PMID: 30639901 DOI: 10.1016/j.etap.2018.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/04/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
The aim of this research was to determine the bioconcentration factor and if subacute exposure to carbamazepine (2 mg L-1) modifies the oxidative state of liver, gills and brain of Cyprinus carpio. This was measured through the following biomarkers: hydroperoxide and protein carbonyl content, lipid peroxidation degree, as well as superoxide dismutase, catalase and glutathione peroxidase activity. Carbamazepine concentration in carp's tissue was also determined by liquid chromatography with a diode arrangement detector. An increase in lipid peroxidation degree, hydroperoxide and protein carbonyl content, and a decrease in the activity of the antioxidant enzymes (P < 0.05) with respect to control was observed. Also, there is an increase in the concentration of carbamazepina present in the organs with respect to the water in the system, which denotes bioconcentration of the drug. In conclusion, carbamazepine is bioconcentrated and produces oxidative stress on the common carp (C. carpio).
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Affiliation(s)
- Eloy Gasca-Pérez
- Cátedra CONACYT, Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico; Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico.
| | - Marcela Galar-Martínez
- Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico.
| | - Sandra García-Medina
- Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico
| | - Isabel A Pérez-Coyotl
- Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico
| | - Karina Ruiz-Lara
- Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico
| | - Selene Cano-Viveros
- Laboratory of Aquatic Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico
| | - Ricardo Pérez-Pastén Borja
- Laboratory of Molecular and Cellular Toxicology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, AV. Wilfrido Massieu s/n y cerrada Manuel Stampa, Col. Industrial Vallejo., Ciudad de México, CP, 07700, Mexico
| | - Leobardo M Gómez-Oliván
- Laboratory of Environmental Toxicology, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n. Col. Residencial Colón, 50120, Toluca, Estado de México, Mexico
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Nazish HR, Ali N, Ullah S. The possible effect of SCN1A and SCN2A genetic variants on carbamazepine response among Khyber Pakhtunkhwa epileptic patients, Pakistan. Ther Clin Risk Manag 2018; 14:2305-2313. [PMID: 30538486 PMCID: PMC6254658 DOI: 10.2147/tcrm.s180827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE SCN1A (3184 A>G) and SCN2A (56G>A) gene encodes α subunit of the neuronal voltage-gated sodium channel, which is a target for carbamazepine (CBZ). Recent studies have demonstrated that polymorphism of SCN1A (3184 A>G) and SCN2A (56G>A) was associated with use of CBZ. However, it has not been determined whether the polymorphism affects CBZ or other antiepileptic drug responsiveness. The aim of the study was to establish whether the SCN1A (3184 A>G) and SCN2A (56G>A) polymorphisms of the SCN1A and SCN2A genes affect responsiveness to CBZ. METHODS SCN1A (3184 A>G) and SCN2A (56G>A) gene polymorphisms were genotyped in 93 Khyber Pakhtunkhwa epileptic patients treated with CBZ. The association between CBZ responsiveness and the polymorphism was estimated by adjusting for clinical factors affecting the outcome of therapy. The number of seizure episodes was documented at baseline, and the therapy of each of the 93 patients was followed up. The plasma level of CBZ was determined using reverse-phase high-performance liquid chromatography. SCN1A and SCN2A genes were genotyped using RFLP. Data were analyzed using Graph Pad Prism 6. RESULTS Mean age of the patients was 18.6±9.3 at the 3rd month and 18.7±9.5 at the 6th month. The baseline dose of CBZ was 468±19.8 mg/d and titrated at the rate of 48±1.4 and 4.0±0.2 mg/d. The difference in plasma level of CBZ was significant (P=0.004) between 3rd and 6th month among different genotypes of SCN1A gene in nonresponder and responder patients. At the 3rd month of the therapy, the poor responders were more likely (P=0.003 and P=0.01) to have variants (3184AG and 3184GG) of SCN1A gene. Similarly, poor responsders were more likely (P=0.0007 and P=0.001) to have variant genotypes (56GA, 56AA) of SCN2A gene at the 3rd month of the therapy. CONCLUSION This study demonstrated a significant association between the SCN1A (3184 AG and GG) and SCN2A (56GA and AA) genotype with CBZ-nonresponsive epilepsy.
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Affiliation(s)
- Haleema Rehana Nazish
- Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan,
| | - Niaz Ali
- Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan,
| | - Shakir Ullah
- Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan,
- Center for Neuroscience, Shantou University Medical College, Shantou, Guangdong 515041, People's Republic of China,
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Ullah S, Ali N, Khan A, Ali S, Nazish HR, Uddin Z. Epilepsy control with carbamazepine monotherapy from a genetic perspective. BMC Pharmacol Toxicol 2018; 19:73. [PMID: 30442198 PMCID: PMC6238399 DOI: 10.1186/s40360-018-0261-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 10/23/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ethnicity variation is one of the main factors that may affect drug response in clinical practice. As MTHFR gene affects different transcriptome and proteome which affect the clinical response of drugs. Purpose of the current study was to observe possible variations in plasma levels of carbamazepine monotherapy and seizures' control in Pakhtun population of Khyber Pakhtunkhwa (KP) in the context of MTHFR (C677T and A1298C) gene polymorphisms. METHODS Blood was collected from the epileptic patients treated with carbamazepine monotherapy for the first time following respective oral doses on its steady state concentration after 3 h of morning dose at 3rd and 6th month of the therapy. Plasma carbamazepine levels were determined using reverse phase high performance liquid chromatography after method validation. MTHFR (C677T, AA298C) gene was genotyped. Patients were followed on 3rd and 6th month of the therapy for monitoring of response to carbamazepine therapy. RESULTS Following for 3rd and 6th month of duration of carbamazepine therapy, poor seizure controlled patients were more likely noticed in heterozygous variants (677CT and 1298 AC) of MTHFR gene (P < 0.05). There was no significant (P > 0.05) difference in the dose and plasma level of carbamazepine among different genotypes of MTHFR (C677T and A1298C) gene. Similarly, the difference in dose and plasma level of carbamazepine was not significant (P > 0.05) in the responder and non-responder people with epilepsy. CONCLUSION Our study suggests that heterozygous variants of MTHFR (C677T and A1298C) gene are associated with poor seizure control in Pakhtun population of KP despite the fact that plasma level of carbamazepine were found within the therapeutic range.
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Affiliation(s)
- Shakir Ullah
- Department of Pharmacology Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Niaz Ali
- Department of Pharmacology Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Adnan Khan
- Department of Neurology, Govt. Lady Reading Hospital Peshawar, Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Saad Ali
- Department of Neurology, Govt. Lady Reading Hospital Peshawar, Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Haleema Rehna Nazish
- Department of Pharmacology Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Zia Uddin
- Department of Pharmacology Institute of Basic Medical Science, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa Pakistan
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Carvalho J, Rosado T, Barroso M, Gallardo E. Determination of Antiepileptic Drugs Using Dried Saliva Spots. J Anal Toxicol 2018; 43:61-71. [DOI: 10.1093/jat/bky064] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Indexed: 01/24/2023] Open
Affiliation(s)
- Joana Carvalho
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal
| | - Tiago Rosado
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, EM506, Covilhã, Portugal
| | - Mário Barroso
- Instituto Nacional de Medicina Legal e Ciências Forenses – Delegação do Sul, Rua Manuel Bento de Sousa, 3, Lisboa, Portugal
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, EM506, Covilhã, Portugal
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Interindividual and Intraindividual Variation of Methylphenidate Concentrations in Serum and Saliva of Patients With Attention-Deficit/Hyperactivity Disorder. Ther Drug Monit 2018; 40:435-442. [DOI: 10.1097/ftd.0000000000000520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hutchinson L, Sinclair M, Reid B, Burnett K, Callan B. A descriptive systematic review of salivary therapeutic drug monitoring in neonates and infants. Br J Clin Pharmacol 2018; 84:1089-1108. [PMID: 29442362 PMCID: PMC5980545 DOI: 10.1111/bcp.13553] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 01/24/2023] Open
Abstract
AIMS Saliva, as a matrix, offers many benefits over blood in therapeutic drug monitoring (TDM), in particular for infantile TDM. However, the accuracy of salivary TDM in infants remains an area of debate. This review explored the accuracy, applicability and advantages of using saliva TDM in infants and neonates. METHODS Databases were searched up to and including September 2016. Studies were included based on PICO as follows: P: infants and neonates being treated with any medication, I: salivary TDM vs. C: traditional methods and O: accuracy, advantages/disadvantages and applicability to practice. Compounds were assessed by their physicochemical and pharmacokinetic properties, as well as published quantitative saliva monitoring data. RESULTS Twenty-four studies and their respective 13 compounds were investigated. Four neutral and two acidic compounds, oxcarbazepine, primidone, fluconazole, busulfan, theophylline and phenytoin displayed excellent/very good correlation between blood plasma and saliva. Lamotrigine was the only basic compound to show excellent correlation with morphine exhibiting no correlation between saliva and blood plasma. Any compound with an acid dissociation constant (pKa) within physiological range (pH 6-8) gave a more varied response. CONCLUSION There is significant potential for infantile saliva testing and in particular for neutral and weakly acidic compounds. Of the properties investigated, pKa was the most influential with both logP and protein binding having little effect on this correlation. To conclude, any compound with a pKa within physiological range (pH 6-8) should be considered with extra care, with the extraction and analysis method examined and optimized on a case-by-case basis.
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Affiliation(s)
- Laura Hutchinson
- Institute of Nursing and Health ResearchUlster UniversityNewtownabbeyCo AntrimUK
| | - Marlene Sinclair
- Institute of Nursing and Health ResearchUlster UniversityNewtownabbeyCo AntrimUK
| | - Bernadette Reid
- Institute of Nursing and Health ResearchUlster UniversityNewtownabbeyCo AntrimUK
| | - Kathryn Burnett
- Biomedical Sciences Research InstituteUlster UniversityNewtownabbeyCo AntrimUK
| | - Bridgeen Callan
- Biomedical Sciences Research InstituteUlster UniversityNewtownabbeyCo AntrimUK
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Serum and Saliva Concentrations of Venlafaxine, O-Desmethylvenlafaxine, Quetiapine, and Citalopram in Psychiatric Patients. Ther Drug Monit 2018; 40:351-355. [DOI: 10.1097/ftd.0000000000000508] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Belal F, Ibrahim F, Sheribah Z, Alaa H. Micellar HPLC method for the simultaneous determination of three anticonvulsant drugs in dosage forms and biological fluids. Application to dissolution-rate testing. ANNALES PHARMACEUTIQUES FRANÇAISES 2018; 76:172-186. [DOI: 10.1016/j.pharma.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/25/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
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16
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Application of cation-modified sulfur nanoparticles as an efficient sorbent for separation and preconcentration of carbamazepine in biological and pharmaceutical samples prior to its determination by high-performance liquid chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1063:245-252. [DOI: 10.1016/j.jchromb.2017.07.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/10/2017] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
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Andonie D, Gáll Z, Bosa P, Dogaru MT, Vancea S. Simultaneous Determination of Carbamazepine and Carbamazepine-10,11-epoxide in Different Biological Matrices by LC-MS/MS. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
An uncomplicated, sensitive liquid chromatography linked to mass spectrometry (LC/MS) for evaluation of carbamazepine and carbamazepine-10,11-epoxide (its metabolite) in human plasma, human saliva, rat plasma, and rabbit plasma was developed. Analyses were conducted on a Zorbax SB-C18, 100 mm × 3 mm ID, 3.5 μm column, at a column temperature of 40 ºC. The mobile phase was comprised of 0.1% formic acid in water and methanol in a 35 : 65 (v/v) ratio, with a flow rate of 0.4 mL/min. Lacosamide was utilized as internal standard. Under these chromatographic conditions, the retention times of lacosamide, carbamazepine-10,11-epoxide, and carbamazepine were 1.4 min, 1.6 min, and 2.2 min, respectively. The quantification of the analytes was performed using multiple reaction monitoring, with the use of a triple quadrupole mass spectrometer with electrospray positive ionization. The monitored ions were m/z 194 derived from m/z 237 for carbamazepine, m/z 180 derived from m/z 253 for carbamazepine-10,11-epoxide, and m/z 108 derived from m/z 251 for lacosamide. The samples were prepared by protein precipitation from 0.2 mL of plasma/saliva using 0.6 mL of internal standard solution in methanol. Calibration curves were constructed over the ranges 1.1–17.6 µg/mL and 0.23–5.47 µg/mL for carbamazepine and carbamazepine-epoxide, respectively. The coefficients of determination obtained by using a weighted (1/x) linear regression were greater than 0.994. The reported LC-MS/MS method was applied to preclinical pharmacokinetic studies and therapeutic drug monitoring.
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Affiliation(s)
- Dan Andonie
- Faculty of Pharmacy , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Zsolt Gáll
- Faculty of Pharmacy , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Paul Bosa
- Faculty of Pharmacy , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Maria Titica Dogaru
- Faculty of Pharmacy , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Szende Vancea
- Faculty of Pharmacy , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
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Asgari S, Bagheri H, Es-haghi A, AminiTabrizi R. An imprinted interpenetrating polymer network for microextraction in packed syringe of carbamazepine. J Chromatogr A 2017; 1491:1-8. [DOI: 10.1016/j.chroma.2017.02.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 10/20/2022]
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Raju KSR, Taneja I, Singh SP, Wahajuddin. Utility of noninvasive biomatrices in pharmacokinetic studies. Biomed Chromatogr 2013; 27:1354-66. [PMID: 23939915 DOI: 10.1002/bmc.2996] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 12/31/2022]
Abstract
Blood and plasma are the biomatrices traditionally used for drug monitoring and their pharmacokinetic profiling. Blood is the circulating fluid in contact with all organs and tissues of body and thus is the most representative fluid for measuring systemic drug levels. However, venipuncture suffers from the caveat of being an invasive technique which often makes people reluctant to participate in clinical studies. Thus, there is a need for noninvasive bio-fluids that are ethically appropriate, cost-efficient and toxicologically relevant. These alternate bio-fluids may prove clinically useful as alternatives to plasma/serum in therapeutic drug monitoring, pharmacokinetic and toxicokinetic studies, doping control in sports medicine and to monitor local adverse effects. These may be of particular interest in the case of special population groups such as neonates, children, the elderly, terminally ill patients and pregnant or lactating women, and offer the advantage of circumvention of the demand for specialized personnel for sample collection. This review describes such noninvasive bio-fluids (saliva, sweat, tears and milk) that have been considered for pharmacokinetic drug analysis, emphasizing their sample preparation, its associated difficulties and their correlation with plasma.
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Affiliation(s)
- Kanumuri Siva Rama Raju
- Pharmacokinetics and Metabolism Division, CSIR-Central Drug Research Institute, Lucknow-226021, India
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Dong WC, Zhang ZQ, Jiang XH, Sun YG, Jiang Y. Effect of volume ratio of ultrafiltrate to sample solution on the analysis of free drug and measurement of free carbamazepine in clinical drug monitoring. Eur J Pharm Sci 2012. [PMID: 23201310 DOI: 10.1016/j.ejps.2012.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Traditional ultrafiltration (UF) usually has a large volume ratio of ultrafiltrate to sample solution, and this ratio cannot be well controlled. It can break the balance of protein-binding equilibrium and exert an influence on the analysis of free drug. In the present study, we evaluated the influence of volume ratio of ultrafiltrate to sample solution on the analysis of free drug in human plasma. We used carbamazepine as a model drug and studied the effect of different centrifugation times on ultrafitrate volume and the related effects on unbound carbamazepine measurement. Moreover, we compared the hollow fiber centrifugal ultrafiltration (HFCF-UF) with traditional UF. Our results showed that the ultrafiltrate volume was changed from 40 to 400 μL with the increase of centrifugation time for the traditional UF, and the related changes in unbound concentration were significant. The rate of protein binding (BP) was changed from 40% to 70%. In contrast, a tiny and invariant ultrafiltrate yield (40 μL) was obtained using the HFCF-UF method, and the BP rate was around 72%. In addition, with the HFCF-UF method, the volume ratio of ultrafiltrate to sample solution could be also well controlled by the inner diameters of both the glass tube and hollow fiber. The HFCF-UF method was a more accurate plasma pretreatment procedure, by which the in vivo balance of protein-binding equilibrium was hardly broken. Therefore, this method was successfully employed to quantify the free fraction of carbamazepine in clinical samples.
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Affiliation(s)
- Wei-Chong Dong
- Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, Hebei Province 050017, China
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Analysis of carbamazepine and its five metabolites in serum by large-volume sample stacking–sweeping capillary electrophoresis. Anal Bioanal Chem 2012; 405:259-66. [DOI: 10.1007/s00216-012-6481-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 09/13/2012] [Accepted: 10/04/2012] [Indexed: 11/26/2022]
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Enhanced electrochemical response of carbamazepine at a nano-structured sensing film of fullerene-C60 and its analytical applications. Electrochim Acta 2011. [DOI: 10.1016/j.electacta.2010.08.071] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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