Comparative Study on Concentrations of Antiepileptic Drugs in Epileptogenic Focus and Adjacent Tissue in Patients with Intractable Epilepsy
SHEN Jiang-hua，JIANG De-chun，WANG Yu-qin*
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Pharmacey Department of Xuanwu Hospital of Capital Medical University， Beijing 100053， China
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History+
Received
Revised
Published
2011-11-11
2011-11-11
2012-01-01
Issue Date
2011-05-15
Abstract
OBJECTIVE To clarify the mechanism of drug resistance by comparing the antiepileptic drug concentration in epileptic foci and lesion adjacent tissue. METHODS Patients diagnosed with intractable epilepsy and underwent excision operation of epileptic foci in functional neurosurgery of Xuanwu Hospital of Capital Medical University were collected from April 2007 to March 2009. The drug concentration in the intractable epileptic patients was determined by high performance liquid chromatography. All patients provided informed consent before surgery. RESULTS Twenty-three cases who took phenobarbital(PB，phenytoin(PHT，carbamazepine(CBZ or lamotrigine(LTG before surgery， were collected. All epileptic foci and lesion adjacent tissues were distinguished by nerve electrophysiological method， and used for drug concentration determination. Three cases were excluded. The remaining cases included 4 cases of PB and 16 cases of CBZ. There were 20 patients in this study. The average drug concentration in epileptic foci was （1.83±0.39μg·mL-1. The average drug concentration in lesion adjacent tissue was （2.11±0.45μg·mL-1， SPSS statistical analysis result was statistically significant. The drug concentrations in epileptic foci tissue were lower than that in the lesion. The same results were shown in groups of PB and CBZ. CONCLUSION Previous study has showed that P-gp expression in epileptic foci is significantly higher than that in lesion adjacent tissue. All the drugs included in this study （PB，CBZ，PHT and LTGare substrates of P-gp. We conclude that the higher expression of P-gp in epileptic foci results in lower drug concentration than that in lesion adjacent tissue.
SHEN Jing-hu;JING De-chun;WNG Yu-qin.
Comparative Study on Concentrations of Antiepileptic Drugs in Epileptogenic Focus and Adjacent Tissue in Patients with Intractable Epilepsy[J]. Chinese Pharmaceutical Journal, 2011, 46(10): 774-777
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References
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