مقايسه سطوح بزاقي و سرمي كار با مازپين در بيماران مبتلا بهصرع مقاوم و غير مقاوم به درمان دارويي مراجعه كننده به بيمارستان هاي امام خمينين (ره ) و رازي تبريز در سال 1378

Comparison of salivang and serum level of carbamazepine in patients with and without refractory epilepsy attending Tabriz Imam Khomeini and Razi hospital

Measurement of anticonvulsant drug concentrations, particularly in free form, may serve as an efficient tool in the management of epileptic patients. However, in the most our hospitals, the drug treatment protocol is prepared based on the recommended dose of drugs and clinical assessment of patients. The aim of this study is to investigate carbamazepine serum total and saliva concentrations in epileptic patients with and without refractory epilepsy. The subjects were 30 epileptic patients without refractory epilepsy and 24 patients with refractory epilepsy undergoing treatment in Imam Khomeine and Razi hospitals of Tabriz in 1999. The serum and saliva samples were collected in the morning before taking the morning dose and the levels of carbamazepine were measured using HPLC. Although the average dose received by patients with refractory epilepsy was grater than that of patients without refractory epilepsy (p<0.05), no significant difference was found in the serum or saliva levels in these two groups (p>0.05). Furthermore, these values were in the almost lowest end of therapeutic range of carbamazepine. Therefore, it is necessary to adjust the treatment protocol of patients with refractory epilepsy through measurement of the carbamazepine concentration in the serum or preferentially saliva. There was also some evidence indicating that some pharmacokenetics properties of carbamazepine might be different in patients with refractory epilepsy compared with patients without refractory epilepsy.