ABSTRACT
Monitoring the blood levels of antiepileptic drugs (AED) has shown that maintaining steady individual-specific effective drug levels improves seizure control. Absorption of orally ingested AED is generally adequate. Food has little if any effect on the completeness of absorption but may affect the profile of the AUC. Therefore it is recommended that the temporal sequence between ingestion of food and AED be kept constant. Reduction of binding usually occurs with kidney and liver disease.8 In uremic state binding sites are competed for by uremic products and some structural change of binding proteins is also thought to occur through carbamylation. Among the environmental factors influencing the rate of AED biotransformation are environmental chemicals, medicinal drugs, and some foodstuffs via induction or inhibition of drug metabolism. Increased dose requirement for phenytoin, phenobarbital, ethosuximide, and carbamazepine to maintain effective target concentrations in the plasma reflects increased clearance for these drugs in pregnancy.
