Difference between revisions of "Postmortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study"

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(Created page with "''Tomson T, Sköld AC, Holmgen P, Nilsson L, and Danielsson B (1998) Postmortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study. Ther Dru...")
 
 
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''Tomson T, Sköld AC, Holmgen P, Nilsson L, and Danielsson B (1998) Postmortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study. Ther Drug Monit 20:3 309–12.''
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{{Reference
  
'''[http://ovidsp.tx.ovid.com/sp-3.27.1a/ovidweb.cgi?QS2=434f4e1a73d37e8c332e69fd91e192ae44669fcff9e9b4823cb27e98987c453db557e3539840db94eb8ae3815e13bdccbc5457d0c18c0adde74aaf5fe5df9fca1093aa2789dd6aba2d061e0b7254f313a0fb009a95f959af6b6794ea9ffe2e4364aa1b1083923c7eb9677aa8c30b2eb954bfae1cec243a93766ca4f64639cb3156d63eb6273887a11596186362d5d08cd868fd50dae3345df53a5a371fbce18adcc7578c6db3e9a9ea92d629cb2ae08f7ff8ecd18f6c0d2e0f44821a9748cded5ae862a18f5006e75d0c78683b74279ef5719f2f4d787d3bc0d4a9ad0af3cab83b53d5ce58cc44d0fe49db3d107a84c2 Link to Article]'''
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'''Abstract:''' Observations of low postmortem blood concentrations of antiepileptic drugs in cases of sudden unexpected death in epilepsy (SUDEP) have led to the assumption that noncompliance may play a role in SUDEP. However, the reliability of postmortem drug levels has been questioned. The purpose of this study was to analyze possible postmortem changes in blood concentrations of carbamazepine (CBZ) and phenytoin (PHT). New Zealand white rabbits were fed with PHT or CBZ until assumed steady state. A blood sample was then drawn for determination of serum and whole blood concentrations of CBZ and PHT, after which the rabbits were killed and stored at 6 degrees C. A further blood sample for drug analysis was obtained 72 hours after death. Antemortem serum concentrations of CBZ were not significantly different from whole blood concentration 72 hours after death. In contrast, antemortem whole blood concentrations of PHT were only 65% of the corresponding serum concentrations, and postmortem PHT blood levels were even lower, being 35% of antemortem serum concentrations. In conclusion, blood concentrations of CBZ seem to be stable during 72 hours after death under these experimental conditions. However, postmortem PHT concentrations should be interpreted with caution and low postmortem concentrations do not necessarily imply a poor compliance.
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Tomson T, Sköld AC, Holmgen P, Nilsson L, and Danielsson B (1998) Postmortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study. Ther Drug Monit 20:3 309–12.
  
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*Animal study in rabbit to compare antemortem and post-mortem levels in either whole blood or serum of two AEDs, CBZ and PHT.  
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http://ovidsp.tx.ovid.com/sp-3.27.1a/ovidweb.cgi?QS2=434f4e1a73d37e8c332e69fd91e192ae44669fcff9e9b4823cb27e98987c453db557e3539840db94eb8ae3815e13bdccbc5457d0c18c0adde74aaf5fe5df9fca1093aa2789dd6aba2d061e0b7254f313a0fb009a95f959af6b6794ea9ffe2e4364aa1b1083923c7eb9677aa8c30b2eb954bfae1cec243a93766ca4f64639cb3156d63eb6273887a11596186362d5d08cd868fd50dae3345df53a5a371fbce18adcc7578c6db3e9a9ea92d629cb2ae08f7ff8ecd18f6c0d2e0f44821a9748cded5ae862a18f5006e75d0c78683b74279ef5719f2f4d787d3bc0d4a9ad0af3cab83b53d5ce58cc44d0fe49db3d107a84c2
  
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Observations of low postmortem blood concentrations of antiepileptic drugs in cases of sudden unexpected death in epilepsy (SUDEP) have led to the assumption that noncompliance may play a role in SUDEP. However, the reliability of postmortem drug levels has been questioned. The purpose of this study was to analyze possible postmortem changes in blood concentrations of carbamazepine (CBZ) and phenytoin (PHT). New Zealand white rabbits were fed with PHT or CBZ until assumed steady state. A blood sample was then drawn for determination of serum and whole blood concentrations of CBZ and PHT, after which the rabbits were killed and stored at 6 degrees C. A further blood sample for drug analysis was obtained 72 hours after death. Antemortem serum concentrations of CBZ were not significantly different from whole blood concentration 72 hours after death. In contrast, antemortem whole blood concentrations of PHT were only 65% of the corresponding serum concentrations, and postmortem PHT blood levels were even lower, being 35% of antemortem serum concentrations. In conclusion, blood concentrations of CBZ seem to be stable during 72 hours after death under these experimental conditions. However, postmortem PHT concentrations should be interpreted with caution and low postmortem concentrations do not necessarily imply a poor compliance.
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*Animal study in rabbit to compare antemortem and post-mortem levels in either whole blood or serum of two AEDs, CBZ and PHT.
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Latest revision as of 13:50, 17 June 2019


Tomson T, Sköld AC, Holmgen P, Nilsson L, and Danielsson B (1998) Postmortem changes in blood concentrations of phenytoin and carbamazepine: An experimental study. Ther Drug Monit 20:3 309–12.

Link to Article

Abstract: Observations of low postmortem blood concentrations of antiepileptic drugs in cases of sudden unexpected death in epilepsy (SUDEP) have led to the assumption that noncompliance may play a role in SUDEP. However, the reliability of postmortem drug levels has been questioned. The purpose of this study was to analyze possible postmortem changes in blood concentrations of carbamazepine (CBZ) and phenytoin (PHT). New Zealand white rabbits were fed with PHT or CBZ until assumed steady state. A blood sample was then drawn for determination of serum and whole blood concentrations of CBZ and PHT, after which the rabbits were killed and stored at 6 degrees C. A further blood sample for drug analysis was obtained 72 hours after death. Antemortem serum concentrations of CBZ were not significantly different from whole blood concentration 72 hours after death. In contrast, antemortem whole blood concentrations of PHT were only 65% of the corresponding serum concentrations, and postmortem PHT blood levels were even lower, being 35% of antemortem serum concentrations. In conclusion, blood concentrations of CBZ seem to be stable during 72 hours after death under these experimental conditions. However, postmortem PHT concentrations should be interpreted with caution and low postmortem concentrations do not necessarily imply a poor compliance.

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  • Animal study in rabbit to compare antemortem and post-mortem levels in either whole blood or serum of two AEDs, CBZ and PHT.

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