Pharmacokinetics and Drug Interaction of Antiepileptic Drugs in Children and Adolescents

Paediatric Drugs
Giulia IapadreAlberto Verrotti

Abstract

Selecting the most appropriate antiepileptic drug (AED) or combination of drugs for each patient and identifying the most suitable therapeutic regimen for their needs is increasingly challenging, especially among pediatric populations. In fact, the pharmacokinetics of several drugs vary widely in children with epilepsy because of age-related factors, which can influence the absorption, distribution, metabolism, and elimination of the pharmacological agent. In addition, individual factors, such as seizure type, associated comorbidities, individual pharmacokinetics, and potential drug interactions, may contribute to large fluctuations in serum drug concentrations and, therefore, clinical response. Therapeutic drug concentration monitoring (TDM) is an essential tool to deal with this complexity, enabling the definition of individual therapeutic concentrations and adaptive control of dosing to minimize drug interactions and prevent loss of efficacy or toxicity. Moreover, pharmacokinetic/pharmacodynamic modelling integrated with dashboard systems have recently been tested in antiepileptic therapy, although more clinical trials are required to support their use in clinical practice. We review the mechanism of action, pharmacokinetics...Continue Reading

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Citations

Jan 29, 2019·Expert Opinion on Drug Metabolism & Toxicology·Alberto VerrottiMaria Laura Iezzi
May 18, 2019·Expert Opinion on Pharmacotherapy·Ganna BalaguraPasquale Striano
Feb 12, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Thierry P I J M CanisiusH J Marian Majoie
Feb 25, 2020·JAMA Neurology·Bshra Ali A AlsfoukZhibin Chen
Feb 13, 2020·Current Opinion in Neurology·Zhibin ChenPatrick Kwan
Jan 11, 2020·Frontiers in Pediatrics·Sara MatricardiAlberto Verrotti
Sep 3, 2020·CNS Drugs·Ganna BalaguraAlberto Verrotti
Feb 29, 2020·Lancet Neurology·Emilio PeruccaTorbjörn Tomson
Apr 27, 2021·Expert Opinion on Pharmacotherapy·Eleonora TulliAlberto Verrotti

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