Research Article| Volume 16, ISSUE 1, P23-26, January 1994

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Role of therapeutic drug monitoring (TDM) in pediatric anti-convulsant drug dosing

  • Philip D. Walson
    Correspondence address: Dr. P.D. Walson, Division of Clinical Pharmacology/Toxicology, Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Fax: (1) (614) 722-4565.
    Department of Pediatrics, Pharmacology and Pharmacy, The Ohio State University, Columbus, OH ,USA

    Division of Clinical Pharmacology/Toxicology, Children's Hospital, Columbus, OH ,USA

    Division of Neurology, Children's Hospital, Columbus, OH ,USA
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      The role of therapeutic drug monitoring (TDM) in patient care has grown rapidly since its introduction three decades ago. The role of a TDM service in establishing proper pediatric anti-epileptic drug (AED) use is described. A number of studies are reviewed which identified proper pediatric dosage regimens for phenobarbital, carbamazepine, valproic acid, phenytoin and clonazepam. Finally, the potential role of TDM in the use of new AEDs is mentioned. These studies are given as examples of how professionals knowledgeable in clinical epilepsy management, clinical pharmacology and pharmacokinetics, can use TDM to design individualized dosage regimens, as well as assess compliance, toxicity and drug interactions.


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        • Cox S
        • Walson P.D.
        Providing effective therapeutic drug monitoring services.
        Ther Drug Monit. 1989; 11: 310-322
        • Walson P.D.
        • Edwards R
        • Cox S
        Neonatal therapeutic drug monitoring — its clinical relevance.
        Ther Drug Monit. 1989; 11: 425-430
        • Walson P.D.
        • Mimaki T
        • Curless R
        • Mayersohn M
        • Perrier D
        Once daily doses of phenobarbital in children.
        J Pediatr. 1980; 97: 303-305
        • Suzuki Y
        • Cox S
        • Hayes J
        • Walson P.D.
        Phenobarbital doses necessary to achieve ‘therapeutic’ concentrations in children.
        Dev Pharmacol Ther. 1991; 17: 79-87
        • O'Dougherty M
        • Wright F
        • Cox S
        • Walson P.D.
        Carbamazepine plasma concentration: relationship to cognitive impairment.
        Arch Neurol. 1987; 44: 863-867
        • Suzuki Y
        • Cox S
        • Hayes J
        • Walson P.D.
        Carbamazepine age-dose-ratio relationship in children.
        Ther Drug Monit. 1991; 13: 201-208
        • Suzuki Y
        • Cox S
        • Hayes J
        • Walson P.D.
        Valproic acid dosages necessary tomaintain therapeutic concentrations in children.
        Ther Drug Monit. 1991; 13: 314-317
        • Curless R.G.
        • Walson P.D.
        • Carter D.E.
        Phenytoin kinetics in children.
        Neurology. 1976; 26: 715-720
        • Jung D
        • Powell J.R.
        • Walson P.D.
        • Perrier D
        Effect of dose on phenytoin absorption.
        Clin Pharmacol Ther. 1980; 28: 479-485
        • Banner Jr, W
        • Johnson D.G.
        • Walson P.D.
        • Jung D
        Effects of single large doses of phenytoin on glucose homeostasis — a preliminary report.
        J Clin Pharmacol. 1982; 22: 79-81
        • Edge J.H.
        • Walson P.D.
        • Rane A
        Clonazepam and 7-aminoclonazepam in human plasma.
        Ther Drug Monit. 1991; 13: 363-368