Blood Level Determin A T Ions And Pharmacokinetic Stud Ies Of Anticonvulsants I N Ethiopian Epileptics

A gas chromatographic method was employed to monitorrnplasma levels of phenytoin and phenobarbital in 101 Ethiopianrnepileptic patients who were on chronic drug treatment andrnkinetics and plasma level-response relationship was studied.rn40% of the patients were on single drug treatment while thernremaining were taking both phenytoin and phenobarbital . Arnvery low correlation between dose and plasma level was observedrnand there was high variation among individuals. Although 86%rnof the patients were receiving 300 mg of phenytoin per day ,rnsome patients showed plasma levels as low as 5|ig / mlrnothers as high as 60 pg/ ml .rnandrn!rn!rnAbout 70% of patients were seizure-free at the rangernof 10-20 pg /ml phenytoin levels. However the best range forrnmaximum seizure control in this study was 20-30 p g / ml. Atrnlower levels, that is below 10 pg /ml , and at higher levelsrnabove 30 jug/ml , the seizures were poorly controlled. Therntherapeutic range of phenobarbital for optimum control ofrnseizure was found to be comparable with that of phenytoinrn( 20-30 pg /ml ).rnThe kinetics of phepytoin is best described by Michaelis-rnMenten kinetics. The most important parameters K and V m maxrnwere estimated and found to be 6.5 mg /lt and 6.9 mg /kg / drnrespectively. The maximum metabolic capacity, vmax » for

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