Blood Level Determin a t ions and Pharmacokinetic Stud ies of Anticonvulsants i n Ethiopian Epileptics

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Addis Ababa Universty


A gas chromatographic method was employed to monitor plasma levels of phenytoin and phenobarbital in 101 Ethiopian epileptic patients who were on chronic drug treatment and kinetics and plasma level-response relationship was studied. 40% of the patients were on single drug treatment while the remaining were taking both phenytoin and phenobarbital . A very low correlation between dose and plasma level was observed and there was high variation among individuals. Although 86% of the patients were receiving 300 mg of phenytoin per day , some patients showed plasma levels as low as 5|ig / ml others as high as 60 pg/ ml . and ! ! About 70% of patients were seizure-free at the range of 10-20 pg /ml phenytoin levels. However the best range for maximum seizure control in this study was 20-30 p g / ml. At lower levels, that is below 10 pg /ml , and at higher levels above 30 jug/ml , the seizures were poorly controlled. The therapeutic range of phenobarbital for optimum control of seizure was found to be comparable with that of phenytoin ( 20-30 pg /ml ). The kinetics of phepytoin is best described by Michaelis- Menten kinetics. The most important parameters K and V m max were estimated and found to be 6.5 mg /lt and 6.9 mg /kg / d respectively. The maximum metabolic capacity, vmax » for



Anticonvulsants in Ethiopian Epileptics