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Purpose: To investigate the physiological mechanisms behind the pronounced decline of lamotrigine (LTG) serum concentrations during pregnancy. Methods: Serum and urine concentrations of LTG and its main metabolite, LTG-N2-glucuronide (LTG-GLUC), were measured monthly in 21 pregnancies of 19 women using LTG. Simultaneously, a panel of biochemical variables was monitored to evaluate liver and kidney
Bakgrunn.I 2007 kom det anbefalinger om at serumkonsentrasjonen av digitoksin bør ligge i området 8 – 15 nmol/l, noe som er ca. halvparten av det som tidligere var ansett som optimalt, og forslag til nye doseringsrutiner.Materiale og metode.Utviklingen for angitt dosering og serumkonsentrasjoner av digitoksin er undersøkt med utgangspunkt i 13 054 prøver sendt til Avdeling for klinisk farmakologi
Purpose: To investigate long-term trends and changes in the pattern of use of lamotrigine (LTG). Methods: Retrospective survey of a large, routine therapeutic drug monitoring database. Results: Twelve thousand one hundred and seven samples from 4123 subjects were analysed from October 1999 to May 2007. Within this period, the mean daily dose rose from 183 to 253 mg, whereas the median dose remaine
The placenta contains a large variety of metabolizing enzymes, among them UDP-glucuronosyltransferase (UGT). Several UGT2B isozymes have so far been detected in human placenta, but little is known on placental expression of UGT1A isozymes. The antiepileptic drug lamotrigine (LTG) is a UGT1A4-substrate, and its serum concentration falls by over 50% during pregnancy, leading to impaired seizure cont
Bakgrunn.I Norge blir det hvert år analysert hundretusener av urinprøver for å påvise inntak av rusmidler og legemidler med ruspotensial. Ved Avdeling for klinisk farmakologi ved St. Olavs hospital analyseres årlig rundt 60 000 urinprøver for rusmidler og legemidler med ruspotensial. Vi ønsket å finne ut om vårt standard analysepanel avdekker de fleste.Materiale og metode.Alle urinprøver mottatt i
We present a systematic study on the interaction potential of lamotrigine, with focus on psychoactive drugs. A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 1733 serum samples from 829 patients (530 women, 299 men) suitable for statistical analysis. Main results for the whole study population were (median; interquartile range in pa
Purpose: To study the interaction between lamotrigine (LTG) and hormonal contraception. Methods: LTG serum concentrations of female patients using either no hormonal contraception (n = 18), an ethinyl estradiol (EE)-containing (n = 11), or a progestogen (PG)-only-containing compound (n = 16) were analyzed. Patients were recruited prospectively, and blood samples were drawn during drug fasting and
Objective: To investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents. Methods: A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2-19 years) suitable for statistical analysis. The primary o
Efficient prevention of adverse drug reactions (ADRs) requires knowledge about their severity and pharmacological mechanisms and is dependent on reliable data on their frequencies and possible risk factors. The study was conducted to investigate the prescribers' experience and understanding of the ADRs of psychotropic drugs, and their attitude towards reporting these. In a questionnaire, physician
OBJECTIVES: To measure the serum concentrations of lamotrigine throughout a complete menstrual cycle. METHODS: Serum concentrations of lamotrigine, estradiol, and progestogen throughout a menstrual cycle were measured in 2 young women not using hormonal contraception. RESULTS AND CONCLUSIONS: The physiological hormonal fluctuations during an ovulatory cycle were not associated with clinically rele
Purpose: To investigate changes in levetiracetam (LEV) serum concentration/dose ratio (C/D-ratio) in relation to pregnancy. Methods: Altogether 21 consecutive pregnancies in 20 women with epilepsy receiving LEV during gestation were studied retrospectively. The main target variable was the C/D-ratio before and during pregnancy, and in the post partum period. Secondary target variables were changes
Background. In some situations, and particularly when intoxications are suspected, it would be advantageous if medicines and drugs of abuse could be swiftly detected in serum or urine. Material and methods. The Department of Clinical Pharmacology at St. Olav University Hospital has since 2004 been developing a comprehensive toxicology service (at all hours 7-days/week) for immediate quantitative a
The main concerns associated with epilepsy during pregnancy consist of maternal and fetal risks from uncontrolled seizures, and harmful effects of the treatment on the development of the offspring. Although seizure control is maintained in the majority, worsening occurs in a fraction of childbearing women with epilepsy. As multiple factors associated with pregnancy may have a negative impact on ep
Purpose: To study the impact of pregnancy on the serum concentration/dose ratio (C/D-ratio) of topiramate (TPM). Methods: Twelve women with epilepsy using TPM during pregnancy, and 15 pregnancies were studied. The main target variable was the C/D-ratio at baseline and during pregnancy. Additional variables were changes in TPM dose, concomitant use of other antiepileptic drugs, seizure frequency, a
