Evaluation of carbamazepine and carbamazepine-epoxide protein binding in patients undergoing epilepsy surgery

Epilepsia
B E GidalM E Pitterle

Abstract

Carbamazepine (CBZ) serum concentrations increase after epilepsy surgery. A possible mechanism may be acute changes in protein binding, specifically those involving the acute phase reactant alpha(1)-acid glycoprotein (AAG). We prospectively evaluated 16 adults (11 receiving CBZ) with epilepsy (mean age 30 +/- 9.9 years, 8 women and 8 men) undergoing temporal lobe resections and characterized AAG, albumin, CBZ, and CBZ-epoxide (CBZ-E) free fractions over time. AAG, ALB, CBZ, and CBZ-E free fractions were determined before surgery (baseline) and on postoperative days 1-5, 14, and 30. AAG was measured with a radial immunodiffusion assay method, CBZ and CBZ-E serum concentrations were determined by high-performance liquid chromatography (HPLC). Free fractions of CBZ and CBZ-E were calculated as the ratio of unbound (determined after ultracentrifugation) to total serum drug concentrations. Statistical analysis included analysis of variance (ANOVA) and Student's t test for paired data when appropriate, with significance assigned at p<0.05. All data are mean +/- SD. AAG concentrations increased significantly from baseline 61.9 +/- 21.3 mg/dl), peaking at postoperative day 3 (116.8 +/- 20.6 mg/gl) and decreasing to baseline levels betw...Continue Reading

References

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Citations

Jun 1, 2000·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·R S McLachlan, J Maher
Dec 29, 2006·Pharmaceutical Research·Theresa V NguyenDavid Fleisher
May 7, 2005·Seizure : the Journal of the British Epilepsy Association·Girish K HiremathDavid Nelson
Apr 17, 2007·Seizure : the Journal of the British Epilepsy Association·Friedemann PaulHeinz-Joachim Meencke

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