Effectiveness of valporic acid and carbamazepine therapeutic drug monitoring on adult patient / Nurul Khaleyda Kamarudin

The aim of this study is to analyze the effectiveness of therapeutic drug monitoring in hospitalized adult patients who were treated with carbamazepine and valproic acid. The population in this study is 129 adult patients including 56 of male patients and 73 of female patients. The population pharmacokinetic is assumed using one­ compartment pharmacokinetic model. The demographic parameter, renal profiles were analyzed based on gender and race to check their influence on effectiveness on drug therapies. Pharmacokinetic parameters like clearance (Cl), drug serum level and dose/kg in both monotherapy and polytherapy is identified to check their potential influence on carbamazepine and valproic acid pharmacokinetics. From carbamazepine monotherapy, data analysis of mean and standard variation of Cl(49.23±10.9), dose/kg(I0±5.3) ,drug serum level (7.1±4.0) whereas m carbamazepine polytherapy with valproic acid, the mean and standard variation of Cl(I0.23±4.9), dose/kg(l 1±4.7) and drug serum level(7.3±4.0). On the other hand, in valproic acid monotherapy data analysis, the mean and standard variation of Cl( I 0.23±4.9) , dose/kg( 14.3±5.8) ,drug serum level (52.95± I 0.36) whereas valproic acid polytherapy with carbamazepine, the mean and standard variation of Cl(l5.29±5.6), dose/kg(l 1±4.7 ) and drug serum level(39.48±9.85 ). This study indicates there are high inter and intra-individuality of patients between these two therapy since COV value for CBZ's Cl = 62%, CBZ's dose/kg and CBZ's serum level are 61 %. COV value in VPA's Cl is 58%, VPA's dose/kg=37% and VPA's serum = 171 %.