New Methods Used in Pharmacokinetics and Therapeutic Monitoring of the First and Newer Generations of Antiepileptic Drugs (AEDs)

Molecules. 2020 Nov 2;25(21):5083. doi: 10.3390/molecules25215083.

Abstract

The review presents data from the last few years on bioanalytical methods used in therapeutic drug monitoring (TDM) of the 1st-3rd generation and the newest antiepileptic drug (AEDs) cenobamate in patients with various forms of seizures. Chemical classification, structure, mechanism of action, pharmacokinetic data and therapeutic ranges for total and free fractions and interactions were collected. The primary data on bioanalytical methods for AEDs determination included biological matrices, sample preparation, dried blood spot (DBS) analysis, column resolution, detection method, validation parameters, and clinical utility. In conclusion, the most frequently described method used in AED analysis is the LC-based technique (HPLC, UHPLC, USLC) combined with highly sensitive mass detection or fluorescence detection. However, less sensitive UV is also used. Capillary electrophoresis and gas chromatography have been rarely applied. Besides the precipitation of proteins or LLE, an automatic SPE is often a sample preparation method. Derivatization was also indicated to improve sensitivity and automate the analysis. The usefulness of the methods for TDM was also highlighted.

Keywords: antiepileptic drugs; bioanalysis; capillary electrophoresis; clinical samples; dried blood spots; high-performance liquid chromatography; pharmacokinetics; therapeutic drug monitoring.

Publication types

  • Review

MeSH terms

  • Anticonvulsants* / pharmacokinetics
  • Anticonvulsants* / therapeutic use
  • Carbamates* / chemistry
  • Carbamates* / pharmacokinetics
  • Chlorophenols* / chemistry
  • Chlorophenols* / pharmacokinetics
  • Drug Monitoring*
  • Humans
  • Seizures* / drug therapy
  • Seizures* / metabolism
  • Tetrazoles* / chemistry
  • Tetrazoles* / pharmacokinetics

Substances

  • Anticonvulsants
  • Carbamates
  • Chlorophenols
  • Tetrazoles
  • Cenobamate