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The Older Antiepileptic Drugs

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Book cover Antiepileptic Drugs and Pregnancy

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Abstract

This chapter outlines the pharmacokinetics and clinical pharmacology of the longer established antiepileptic drugs that continue to be reasonably often used in pregnancy, to provide a background to considering the alterations pregnancy and its aftermath produce in these parameters. The four drugs considered, viz. phenobarbitone, phenytoin, carbamazepine and valproate, are cleared from the body mainly by virtue of metabolism, and the clearance values of all increase progressively during pregnancy, though the change for carbamazepine is relatively small unless it is co-administered with another antiepileptic drug that induces the activity of drug-metabolising enzymes. The literature contains information regarding the individual metabolic pathways for phenytoin and carbamazepine biotransformation during pregnancy, indicating that the increased clearances of these drugs are due mainly to the development of increased capacities of already existing metabolic pathways rather than the appearance of new metabolic pathways. Relatively little information has been published concerning the dispositions of these drugs in the neonate, though there are data on their concentration ratios between maternal plasma and breast milk.

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Authors and Affiliations

  1. Clinical Neurology and Neuropharmacology, University of Queensland, and Honorary Consultant Neurologist, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    MJ Eadie (Emeritus Professor)

  2. Department of Medicine and Neurology Director of the Australian Epilepsy and Pregnancy Register, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia

    FJE Vajda

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  1. MJ Eadie
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  2. FJE Vajda
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Eadie, M., Vajda, F. (2016). The Older Antiepileptic Drugs. In: Antiepileptic Drugs and Pregnancy. Adis, Cham. https://doi.org/10.1007/978-3-319-21434-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-21434-4_4

  • Publisher Name: Adis, Cham

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