A comparison of plasma and saliva levels of carbamazepine and phenytoin as monotherapy

Callaghan, N.; Goggin, T.

doi:10.1007/bf02939820

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…When monotherapy was used, saliva and plasma concentrations of both PTN and CBZ showed marked interindividual variability and a respective mean S/P ratio of 0.26 and 0.13, and both drugs showed good saliva-to-plasma correlations. 44 Another study 45 found mean ratios of 0.09 for PTN, 0.33 for CBZ, and also 0.31 for phenobarbital. Both studies 44,45 found ratios similar to those reported previously.…”

Section: Ethanol and Drugs Of Abusementioning

confidence: 99%

“…44 Another study 45 found mean ratios of 0.09 for PTN, 0.33 for CBZ, and also 0.31 for phenobarbital. Both studies 44,45 found ratios similar to those reported previously. [46][47][48][49] The unbound to total serum concentration ratios were 0.08, 0.23, and 0.47, respectively.…”

Section: Ethanol and Drugs Of Abusementioning

confidence: 99%

“…Some researchers 43 found that CBZ and PTN saliva concentrations were related to toxicity, but not to efficacy. When monotherapy was used, saliva and plasma concentrations of both PTN and CBZ showed marked interindividual variability and a respective mean S/P ratio of 0.26 and 0.13, and both drugs showed good saliva‐to‐plasma correlations 44 . Another study 45 found mean ratios of 0.09 for PTN, 0.33 for CBZ, and also 0.31 for phenobarbital.…”

Section: Saliva Therapeutic Drug Management Applied To Drug Classesmentioning

confidence: 99%

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The Use of Oral Fluid for Therapeutic Drug Management

Langman

2007

Annals of the New York Academy of Sciences

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One of the underlying tenets of clinical pharmacology is that only free drugs are pharmacologically active. It is thought that only free drugs can cross biological membranes to interact with a given receptor to alter its function, and that drug responses, both efficacious and toxic, are a function of unbound concentrations. The rationale for measuring drugs in oral fluid is that the free fraction of a drug in plasma reaches equilibrium with the drug in saliva. Although reports concerning the appearance of organic solutes in saliva have been in the literature for over 70 years, it has only been in the past 30 years that there has been emphasis on the appearance of drugs. Although many assumptions for drug level monitoring in saliva are made, the primary requisite for salivary monitoring to be useful is a constant or predictable relationship between the drug concentration in saliva and the drug concentration in plasma. Measurement of oral fluid drug levels for the purpose of managing patients and making dosage adjustments may be useful for select drugs or drug classes. However, it does not appear to be useful for the majority of drugs therapeutically monitored. Some work with antipsychotic medications has indicated that although the measurement of drug concentrations themselves may not be useful for dosage adjustment, the ratio of parent drug to metabolite may reflect altered metabolic status due to either pharmacogenetic variation or other clinical conditions. Furthermore, analysis of saliva may provide a cost-effective approach for the screening of large populations.

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Section: Ethanol and Drugs Of Abusementioning

confidence: 99%

Section: Ethanol and Drugs Of Abusementioning

confidence: 99%

Section: Saliva Therapeutic Drug Management Applied To Drug Classesmentioning

confidence: 99%

See 1 more Smart Citation

The Use of Oral Fluid for Therapeutic Drug Management

Langman

2007

Annals of the New York Academy of Sciences

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“…In the absence of a correlation, saliva may provide a convenient matrix for abuse control, e.g., abuse of psychoactive agents. One of the drugs for which the correlation between differences in the blood and saliva concentration has been confirmed is carbamazepine (Figure 1a) [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 93%

“…Saliva sampling for the analysis of the carbamazepine content is most often taken following stimulating its secretion by chewing Parafilm [3,9,14] or eating citric acid [15][16][17][18]. Saliva samples can also be collected in a tube without prior stimulation [8][9][10][11][12][13][14][15][16][17][18][19][20] or on cotton swabs specially designed for this purpose, which are placed in the mouth to soak up the saliva [21][22][23]. After removing the swab from the mouth, it is placed in a tube and is centrifuged.…”

Section: Introductionmentioning

confidence: 99%

Deproteinization as a Rapid Method of Saliva Purification for the Determination of Carbamazepine and Carbamazepine-10,11 Epoxide

Dziurkowska

Wesołowski

2020

JCM

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Saliva is a valuable diagnostic material that, in some cases, may replace blood. However, because of its different composition, its use requires the development of new, or the modification of existing, extraction procedures. Therefore, the aim of the study was to develop a method of saliva purification that would enable the determination of carbamazepine and its metabolite, carbamazepine-10,11 epoxide. When comparing two methods of sample purification (Solid Phase Extration (SPE) and deproteinization), it was found that the second method yielded more favorable results. A 1% formic acid solution in acetonitrile was used for extraction. The samples were shaken and centrifuged, and the supernatant obtained was evaporated and dissolved in a mobile phase, then chromatographically analyzed. The developed method was validated by determining its linearity in the range of 10–5000 ng/mL for both analytes. Intra- and inter-day precision did not exceed 14%. In order to check the usefulness of the method, both analytes were determined in the saliva samples from 20 patients treated with carbamazepine. The content of both analytes was detected and determined in all of the tested samples of saliva. It was found that the method developed is rapid, sensitive, reliable, and can be used to monitor the concentration of carbamazepine and metabolite in patients’ saliva.

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Comparison of plasma and saliva concentrations of the active monohydroxy metabolite of oxcarbazepine in patients at steady state

Cardot¹,

Degen

Flesch

et al. 1995

Biopharm & Drug Disp

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A study was performed in ten patients, stabilized with oxcarbazepine monotherapy (450-750 mg bid) for two weeks minimum, to investigate the possibility of using saliva to monitor the oxcarbazepine therapy. Thirteen paired blood and saliva samples were taken over 24 h. The saliva samples were obtained after stimulation. The analysis performed on the data suggests a dose dependence for the relationship between plasma and saliva concentrations of the main active metabolite, 10, 11-dihydro-10-hydroxycarbamazepine (MHD), and the importance of the type of stimulation for the saliva's production. Therefore it would be preferable to use plasma concentrations to monitor oxcarbazepine therapy, if necessary.

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A comparison of plasma and saliva levels of carbamazepine and phenytoin as monotherapy

Cited by 5 publications

References 14 publications

The Use of Oral Fluid for Therapeutic Drug Management

The Use of Oral Fluid for Therapeutic Drug Management

Deproteinization as a Rapid Method of Saliva Purification for the Determination of Carbamazepine and Carbamazepine-10,11 Epoxide

Comparison of plasma and saliva concentrations of the active monohydroxy metabolite of oxcarbazepine in patients at steady state

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