Çocuk Sağlığı ve Hastalıkları Dergisi 2002 , Vol 45 , Num 3
Investigation of therapeutic dose and plasma concentration of gabapentin in children with partial epilepsy
Füsun Alehan1, John M. Pellock 2
Başkent Üniversitesi Tıp Fakültesi1 Pediatri Yardımcı Doçenti
Amerika Birleşik Devletleri "Medical College of Virginia" Hastanesi 2Nöroloji, Pediatri ve Farmakoloji Profesörü
There is inadequate data about the optimal dose, therapeutic plasma concentrations and renal clearance of gabapentin, a new antiepileptic drug, in routine pediatric practice. For this reason, this study was planned to determine the therapeutic dose and corresponding plasma-concentration range, as well as some pharmacokinetic properties of gabapentin in children with partial epilepsy. Patients maintained on gabapentin treatment at the Child Neurology Unit of the Medical College of Virginia, USA were included in the study. Plasma concentrations were obtained from 27 patients in whom more than 50% reduction in seizure frequency was achieved. The therapeutic dose ranged between 23.5 and 103.4 mg/kg/day, with a mean of 52.9 ± 18.8 mg/kg/day, and plasma concentration ranged from 2.1 to 17.2 mg/ml (mean 5.9 ± 3.0). A significant correlation was found between gabapentin dose and plasma concentration (r=0.826, p<0.001). Apparent gabapentin clearance ranged between 218 and 659 ml/kg/day and was independent of age. These results indicate that gabapentin has a wide range of therapeutic dose and plasma concentration. Since a positive correlation exists between doses and plasma concentrations, dose escalation should be attempted when no efficacy is obtained at lower doses. Anahtar Kelimeler : parsiyel epilepsi, gabapentin, plazma konsantrasyonu, çocuk, partial epilepsy, gabapentin, plasma concentration, children
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