Skip to main content

Measurement of Anticonvulsants and Their Metabolites in Biological Fluids

  • Chapter
Antiepileptic Drugs

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 138))

Abstract

There seems to be a greater volume of literature dealing with the assay of antiepileptic drugs and their metabolites than with the assay of almost any other class of drugs. Many factors have contributed to this situation, including (1) the older antiepileptic drugs have been studied over a long period, (2) several antiepileptic drugs have unusual and interesting disposition characteristics, which have warranted extensive study, (3) antiepileptic drugs are probably the drug class to which therapeutic drug monitoring (TDM) is most commonly applied, and (4) there are a large number of antiepileptic drugs in clinical use or under development. There is a great diversity of analytical methods, and to a large extent the choice of method is governed by the application to which the method will be put. It is often the case that a method which is suitable for therapeutic drug monitoring will not meet the requirements of clinical pharmacokinetic or metabolic studies, while methods which meet these latter requirements may be inappropriate in terms of cost, speed or convenience in the therapeutic drug monitoring laboratory. While it is not possible in the space available to give a comprehensive survey of all methods for all drugs, we have attempted to provide a contemporary outline of the most commonly used methods, to indicate their attributes, limitations and areas of applicability, and to provide references in which further information may be located.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Albani F, Riva R, Baruzzi A (1992) Therapeutic drug monitoring of antiepileptic drugs II. Analytical Techniques. Il Farmaco 47 [Suppl 5]:671–680

    PubMed  CAS  Google Scholar 

  • Bernus I, Hooper WD, Dickinson RG, Eadie MJ (1995) Metabolism of carbamazepine and co-administered anticonvulsants during pregnancy. Epilepsy Res 21:65–75

    Article  PubMed  CAS  Google Scholar 

  • Brettfeld C, Gobrogge R, Massoud N, Munzenberger P, Nigro M, Sarnaik A (1989) Evaluation of the Ames Seralyser for the therapeutic drug monitoring of phenobarbetal and phenytoin. Ther Drug Monit 11:612–615

    Article  PubMed  CAS  Google Scholar 

  • Chan DW (1995) Clinical Instrumentation (Immunoassay Analysers). Anal Chem 67:519R–524R

    Article  PubMed  CAS  Google Scholar 

  • Chankvetadzee B (1997) Capillary electrophoresis in chiral analysis. Wiley, London

    Google Scholar 

  • Chee KY, Lee D, Byron D, Naidoo D, Bye A (1993) A simple collection method for saliva in children: potential for home monitoring of carbamazepine therapy. Br J Clin Pharmacol 35:311–313

    PubMed  CAS  Google Scholar 

  • Dasgupta A, Blackwell W, Bard D (1996) Stability of therapeutic drug measurement in specimens collected in VACUTAINER plastic blood — collection tubes. Ther Drug Monit 18:306–309

    Article  PubMed  CAS  Google Scholar 

  • Dickinson RG, Hooper WD, King AR, Eadie MJ (1985) Fallacious results from measuring salivary carbamazepine concentrations. Ther Drug Monit 7:41–45

    Article  PubMed  CAS  Google Scholar 

  • Drobitch RK, Svensson CK (1992) Therapeutic drug monitoring in saliva — an update. Clin Pharmacokinet 23:365–379

    Article  PubMed  CAS  Google Scholar 

  • Evenson MA, Wiktorowicz JE (1992) Automated capillary electrophoresis applied to therapeutic drug monitoring. Clin Chem 38:1847–1852

    PubMed  CAS  Google Scholar 

  • Fleming CS, Waller SJ, Craig AR, Chu VP, Reiner JA (1995) A phenobarbital method on the Dimension clinical chemistry system. Ther Drug Monit 17:391

    Article  Google Scholar 

  • Freeman RR (ed) (1981) High resolution gas chromatography, 2nd edn. Hewlett-Packard Company, California

    Google Scholar 

  • Garcia LL, Shihabi ZK, Oles K (1995) Determination of gabapentin in serum by capillary electrophoresis. J Chromatogr B Biomed Appl 669:157–162

    Article  PubMed  CAS  Google Scholar 

  • Goldsmith RF, Ouvrier RA (1981) Salivary anticonvulsant levels in children: a comparison of methods. Ther Drug Monit 3:151–157

    Article  PubMed  CAS  Google Scholar 

  • Gorog S, Gazdag M (1994) Enantiomeric derivatisation for biomedical chromatography. J Chromatogr B Biomed Appl 659:51–84

    Article  PubMed  CAS  Google Scholar 

  • Grant DW (1995) Capillary gas chromatography. Wiley, New York

    Google Scholar 

  • Gurley BJ, Marx M, Olsen K (1995) Phenytoin free fraction determination: comparison of an improved direct serum injection HPLC method to ultrafiltration coupled with FPIA. J Chromatogr B Biomed Appl 670:358–364

    Article  PubMed  CAS  Google Scholar 

  • Haegele KD, Schecter P (1986) Kinetics of the enantiomers of vigabatrin after an oral dose of the racemate or the active S enantiomer. Clin Pharmacol Ther 40:581–586

    Article  PubMed  CAS  Google Scholar 

  • Jennings W, Mittlefehldt E, Stremple P (1997) Analytical gas chromatography, 2nd edn. Academic Press, New York

    Google Scholar 

  • Johansen K, Krogh M, Andersen AT, Christophersen AS, Lehne G, Rasmussen KE (1995) Automated analysis of free and total concentrations of three antiepileptic drugs in plasma with on-line dialysis and hplc. J Chromatogr B Biomed Appl 669:281–288

    Article  PubMed  CAS  Google Scholar 

  • Johnson EL, Stevenson R (1978) Basic liquid chromatography. Varian Associates, Palo Alto, California

    Google Scholar 

  • Kapetanovic IM (1990) Analysis of antiepileptic drugs. J Chromatogr 531:421–457

    Article  PubMed  CAS  Google Scholar 

  • Kassahun K, Burton R, Abbott FS (1989) Negative ion chemical ionization gas chromatography/mass spectrometry of valproic acid metabolites. Biomed Environ Mass Spectrom 18:918–926

    Article  PubMed  CAS  Google Scholar 

  • Kintz P, Marescaux C, Mangin P (1995) Testing human hair for carbamazepine in epileptic patients: is hair investigation suitable for drug monitoring? Hum Exp Toxicol 14:812–815

    Article  PubMed  CAS  Google Scholar 

  • Kitson FG, Larsen BS, McEwen CN (1996) Gas chromatography and mass spectrometry: a practical guide. Academic Press, New York

    Google Scholar 

  • Klein G, Lehman P, Coty W (1995) Multicentre evaluation of the CEDIA immunoassay for carbamazepine, phenytoin, phenobarbital and valproic acid on Hitachi 704, 717 and 911 analysers. Ther Drug Monit 17:409

    Article  Google Scholar 

  • Knott C, Reynolds F (1984) The place of saliva in antiepileptic drug monitoring. Ther Drug Monitor 6:35–41

    Article  CAS  Google Scholar 

  • Knott C, Reynolds F (1987) Citrate and salivary drug measurement. Lancet 97

    Google Scholar 

  • Knott C, Reynolds F (1989) Saliva monitoring of anticonvulsants Report on the workshop conference “Application of saliva in laboratory medicine”. J Clin Chem Clin Biochem 27:226–228

    PubMed  Google Scholar 

  • Koch TR, Platoff G (1990) Suitability of collection tubes with separator gels for therapeutic drug monitoring. Ther Drug Monitor 12:277–280

    Article  CAS  Google Scholar 

  • Kubotsu K, Goto S, Fujita M, Tuchiya H, Kid M, Takano S, Matsuura S, Sakurabayashi I (1992) Automated homogeneous liposome immunoasssay systems for anticonvulsant drugs. Clin Chem 38:808–812

    PubMed  CAS  Google Scholar 

  • Kumps A (1982) Therapeutic drug monitoring: A comprehensive and critical review of analytical methods for anticonvulsant drugs. J Neurol 228:1–16

    Article  PubMed  CAS  Google Scholar 

  • Kurze S, Hamwi A, Soregi G, Schweiger CR, Vukovich TH (1995) Comparison of FPIA and CEDIA method for determination of digitoxin, theophylline and phenytoin. Ther Drug Monit 17:391

    Article  Google Scholar 

  • Lee Kong-Joo, Heo GS, Kim NJ, Moon DC (1992) Analysis of antiepileptic drugs in human plasma using micellar electrokinetic capillary chromatography. J Chromatogr A 608:243–250

    Article  CAS  Google Scholar 

  • Li D, Nichols J (1997) Specimen collection and stability for therapeutic drug monitoring. AACC Therapeutic Drug Monitoring and Toxicology In-Service training and continuing education program. 8:3–9

    Google Scholar 

  • Liu H, Montoya JL, Forman LJ, Eggers CM, Barham CF, Delgado M (1992) Determination of free valproic acid and evaluation of the Centrifree system and comparison between HPLC and EIA. Ther Drug Monit 14:513–521

    Article  PubMed  CAS  Google Scholar 

  • Lloyd DK (1996) Capillary electrophoretic analysis of drugs in body fluids: sample pre-treatment and methods for direct injection of biofluids. J Chromatogr A 735:29–42

    Article  PubMed  CAS  Google Scholar 

  • Lunte SM, Radzik DM (eds) (1996) Pharmaceutical and biomedical applications of capillary electrophoresis. Progress in pharmaceutical and biomedical analysis. Vol 2, Elsevier Science, Oxford

    Google Scholar 

  • Mauro LS, Mauro VF (1991) Effect of serum separator tubes on free and total phenytoin and carbamazepine serum concentrations. Ther Drug Monit 13:240–243

    Article  PubMed  CAS  Google Scholar 

  • McMaster MC (1994) HPLC: a practical users’ guide. Wiley, New York

    Google Scholar 

  • Mei Z, Williams J (1997) Simultaneous determination of phenytoin and carbamazepine in human hair by high performance liquid chromatography. Ther Drug Monit 19:92–94

    Article  PubMed  CAS  Google Scholar 

  • Meijer JWA, Rambeck B, Reidmann M (1983) Antiepileptic drug monitoring by chromatographic methods and immunometric techniques — Comparison of analytical performance, practicability and economy. Ther Drug Monit 5:39–53

    Article  PubMed  CAS  Google Scholar 

  • Miles MV, Howlett CM, Tennison MB, Greenwood RS, Cross RE (1989) Determination of n-desmethylmethsuximide serum concentrations using enzyme multiplied and fluorescence polarisation immunoassays. Ther Drug Monit 11:337–342

    Article  PubMed  CAS  Google Scholar 

  • Miles MV, Tennison MB, Greenwood RS, Benoit SE, Thorn MD, Messenheimer JA, Ehle AL (1990) Evaluation of the Ames Seralyser for the determination of carbamazepine, phenobarbital and phenytoin concentrations in saliva. Ther Drug Monit 12:501–510

    Article  PubMed  CAS  Google Scholar 

  • Nagarajan L, Schramm T, Appleton DB, Burke CJ, Eadie MJ (1993) Plasma vigabatrin enantiomer ratios in adults and children. Clin Exper Neurol 30:127–136

    CAS  Google Scholar 

  • Naylor S, Benson LM, Tomlinson AJ (1996) Application of capillary electrophoresis and related techniques to drug metabolism studies. J Chromatogr A 735:415–438

    Article  PubMed  CAS  Google Scholar 

  • Nielsen IM, Gram L, Dam M (1992) Comparison of the Acculevel and TDx: evaluation of on-site monitoring of antiepileptic drugs. Epilepsia 33:558–563

    Article  PubMed  CAS  Google Scholar 

  • Niessen W, Vandergreef J (1992). Liquid chromatography-mass spectrometry. Marcel Dekker, New York

    Google Scholar 

  • O’Connell MT, Ratnaraj N, Elyas AA, Doheny MH, Darsot S, Patsalos PN (1995) A comparison of the OPUS and TDx analysers for antiepileptic drug monitoring. Ther Drug Monit 17:549–555

    Article  PubMed  Google Scholar 

  • Oles KS, Penry JK, Dyer RD (1989) Evaluation of an enzyme immunochromatography method for carbamazepine: a comparison with enzyme-multiplied immunoassay technique, fluorescence polarisation immunoassay and high performance liquid chromatography. Ther Drug Monit 11:471–476

    PubMed  CAS  Google Scholar 

  • Paton RD, Logan RW (1986) Salivary drug measurement: A cautionary tale. Lancet 1340

    Google Scholar 

  • Pichini S, Altieri I, Zuccaro P, Pacifici R (1996) Drug monitoring in non-conventional biological fluids and matrices. Clin Pharmacokinet 30:211–228

    Article  PubMed  CAS  Google Scholar 

  • Price CP, Newman DJ (1996) Principles and practice of immunoassay. 2nd edn, Stockton Press, New York

    Google Scholar 

  • Rainey PM, Rogers KE, Roberts WL (1996) Metabolite and matrix interference in phenytoin immunoassays. Clin Chem 42:1645–1653

    PubMed  CAS  Google Scholar 

  • Rambeck B, May TW, Jurgens U, Blankenhorn V, Jurges U, Korn-Merker E, Salke-Kellermann A (1994) Comparison of phenytoin and carbamazepine serum concentrations measured by high performance liquid chromatography, the standard TDx assay, the Enzyme Multiplied Immunoassay Technique and a new patient-side immunoassay cartridge system. Ther Drug Monit 16:608–612

    Article  PubMed  CAS  Google Scholar 

  • Reidenberg P, Glue P, Banfield C et al. (1993) Pharmacokinetic interaction studies between felbamate and vigabatrin. Br J Clin Pharmacol 40:157–160

    Google Scholar 

  • Reidmann M, Rambeck B, Meijer JWA (1981) Quantitative simultaneous determination of eight common antiepileptic drugs and metabolites by liquid chromatography. Ther Drug Monit 3:397–413

    Article  Google Scholar 

  • Rettenmeier AW, Howald WN, Levy RH, Witek DJ, Gordon WP, Porubek DJ, Baillie TA (1989) Quantitative metabolic profiling of valproic acid in humans using automated gas chromatographic/mass spectrometric techniques. Biomed Environ Mass Spectrom 18:192–199

    Article  PubMed  CAS  Google Scholar 

  • Rey E, Pons G, Richard MO et al. (1990) Pharmacokinetics of the individual enantiomers of vigabatrin (gamma-vinyl GABA) in epileptic children. Br J Clin Pharmacol 30:253–257

    PubMed  CAS  Google Scholar 

  • Romanyshyn LA, Wichmann JK, Kucharczyk N, Shumaker RC, Ward D, Sofia RD (1994) Simultaneous determination of felbamate, primidone, phenobarbital, carbamazepine, two carbamazepine metabolites, phenytoin and one phenytoin metabolite in human plasma by high-performance liquid chromatography. Ther Drug Monit 16:90–99

    Article  PubMed  CAS  Google Scholar 

  • Rosenzweig B (1996) Capillary electrophoresis: A new methodology for therapeutic drug monitoring and drugs of abuse. AACC Continuing Education Therapeutic Drug Monitoring and Toxicology 17:143–160

    Google Scholar 

  • Salmain M, Vessieres A, Brossier P, Butler IS, Jaouen G (1992) Carbonyl metalloim-munoassay (CMIA) a new type of non-radioisotope immunoassay. Principles and application to phenobarbital assay. J Immunol Methods 148:65–75

    Article  PubMed  CAS  Google Scholar 

  • Sasse EA (1997) Immunoassays and immunoassay analysers for analytical toxicology. In: Wong SHY, Sunshine I (eds) Handbook of analytical therapeutic drug monitoring and toxicology. CRC Press, Boca Raton, pp. 223–235

    Google Scholar 

  • Schmutz A, Thormann W (1993) Determination of phenobarbital, ethosuximide and primidone in human serum by micellar electrokinetic capillary chromatography with direct sample injection. Ther Drug Monit 15:310–316

    Article  PubMed  CAS  Google Scholar 

  • Schramm TM, McKinnon GE, Eadie MJ (1993) Gas chromatographic assay of vigabatrin enantiomers in plasma. J Chromatogr B Biomed Appl 616:39–44

    Article  CAS  Google Scholar 

  • Schramm W, Annesley TM, Seigel GJ, Sackellares JC, Smith RH (1991) Measurement of phenytoin and carbamazepine in ultrafiltrate of saliva. Ther Drug Monit 13:452–460

    Article  PubMed  CAS  Google Scholar 

  • Schwenzer K, Liu-Allison L, Motter K (1995) Application of the new monoclonal COBAS FP phenytoin and valproic acid reagents for the analysis of free phenytoin and free valproic acid on the Cobas Integra and Cobas Farah. Ther Drug Monit 17:409

    Article  Google Scholar 

  • Scott RPW (1994) Liquid chromatography for the analyst. Marcel Dekker, New York

    Google Scholar 

  • Sheean G, Schramm T, Anderson DS, Eadie MJ (1992) Vigabatrin plasma enantiomer concentrations and clinical effects. Clin Exp Neurol 29:107–116

    PubMed  CAS  Google Scholar 

  • Shihabi ZK (1992) Clinical applictions of capillary electrophoresis. Ann Clin Lab Sci 22:398–405

    PubMed  CAS  Google Scholar 

  • Shihabi ZK, Oles KS (1994) Felbamate measured in serum by two methods: HPLC and capillary electrophoresis. Clin Chem 40:1904–1908

    PubMed  CAS  Google Scholar 

  • Shintani H, Polanski J (eds) (1996) Analytical applications of capillary electrophoresis. Blackie Academic, London

    Google Scholar 

  • Smith RM (ed) (1988) Supercritical fluid chromatography. Royal Society of Chemistry, London

    Google Scholar 

  • Snyder LR, Glajch JL, Kirkland JJ (1988) Practical HPLC method development. Wiley, New York

    Google Scholar 

  • Srinivas NR, Shyu WC, Barbhaiya RH (1995) Gas chromatographic determination of enantiomers as diastereoisomers following pre-column derivatisation and applications to pharmacokinetic studies: a review. Biomed Chromatogr 9:1–9

    Article  PubMed  CAS  Google Scholar 

  • Subramanian G (ed) (1994) A practical approach to chiral separations by liquid chromatography. VCH, Weinheim

    Google Scholar 

  • Taylor EH, Ackerman BH (1987) Free drug monitoring by liquid chromatography and implications for therapeutic drug monitoring. J Liq Chromatogr 10:323–343

    Article  CAS  Google Scholar 

  • Tsanaclis LM, Wilson JF, Williams J, Perrett JE, Richens A (1990) Comparison of human, bovine and new-born calf serum in the preparation of external quality assurance samples for therapeutic drugs. Ther Drug Monit 12:373–377

    Article  PubMed  CAS  Google Scholar 

  • Van der Weide J, Luiting HK, Veerfkind AH (1993) Evaluation of the cloned enzyme donor immunoassay for measurement of phenytoin and phenobarbital in serum. Ther Drug Monit 15:344–348

    Article  PubMed  Google Scholar 

  • Varenne A, Vessieres A, Brossier P, Jaouen G (1994) Application of the non-radioisotopic carbonyl metallo-immunoassay (CMIA) to diphenylhydantoin. Res Commun Chem Pathol Pharmacol 84:81–92

    PubMed  CAS  Google Scholar 

  • Varenne A, Vessieres A, Salmain M, Brossier P, Jaouen G (1995) Production of specific antibodies and development of a non-isotopic immunoassay for carbamazepine by the carbonyl metallo-immunoassay (CMIA) method. J Immunol Methods 186:195–204

    Article  PubMed  CAS  Google Scholar 

  • Wild D (ed) (1993) The immunoassay handbook. MacMillan, London

    Google Scholar 

  • Wilson JF, Tsanaclis TM, Williams J, Tedstone JE, Richens A (1989) Evaluation of assay techniques for the measurement of antiepileptic drugs in serum: A study based on external quality assurance measurements. Ther Drug Monit 11:185–195

    Article  PubMed  CAS  Google Scholar 

  • Witte DL (1993) Matrix effects in therapeutic drug monitoring surveys. Proposed protocol to identify error components and quality improvement opportunities. Arch Pathol Lab Med 117:373–380

    PubMed  CAS  Google Scholar 

  • Wong SHY (1993) Advances in chromatography for clinical drug analysis: supercritical fluid chromatography, capillary electrophoresis, and selected high-performance liquid chromatography techniques. Ther Drug Monit 15:576–580

    PubMed  CAS  Google Scholar 

  • Wright JD, Boudinot FD, Ujhelyi MR (1996) Measurement and analysis of unbound drug concentrations. Clin Pharmacokinet 30:445–462

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hooper, W.D., Johnson, L.P. (1999). Measurement of Anticonvulsants and Their Metabolites in Biological Fluids. In: Eadie, M.J., Vajda, F.J.E. (eds) Antiepileptic Drugs. Handbook of Experimental Pharmacology, vol 138. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60072-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60072-2_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64244-9

  • Online ISBN: 978-3-642-60072-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics