Abstract
Recognition that one acute dosage or regimen of dosages of anti-epileptic drugs can seldom predict a desired intensity, onset and/or duration of the therapeutic effect together with the progress in the analytical procedures to determine these drugs in body fluids have strongly stimulated the development of clinical pharmacokinetics. The availability of drug concentrations in body fluids has improved the possibility of monitoring patients on chronic medication. Clearance data calculated on collections of parameters (concentrations, dosage-interval and body weight or body surface) have opened the possibility to establish individual dosage regimens for a single drug or combination of drugs. To cure a disease, suppress (abnormal) physiological functions or support biochemical processes of an individual, a certain amount of one drug or a combination of drugs in the body will be required. The concentration reached in the biological environment where the pharmacological activity is thought to be located as well as in other areas of the body will depend on the regional physiological and physico-chemical characteristics of organs, tissues and their constituent elements. Flow of body fluids largely controls dispersion of drugs through the body. Diffusion controls the distribution of drugs in inadequately perfused body regions. Binding, generally considered an extremely rapid process, will largely control the ultimate regional, cellular and subcellular differences in concentration. The higher the affinity for extravascular, extra- or intracellular body constituents the lower the plasma concentration.
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van der Kleijn, E., Guelen, P.J.M., van Wijk, C., Baars, I. (1975). Clinical Pharmacokinetics in Monitoring Chronic Medication with Anti-Epileptic Drugs. In: Schneider, H., Janz, D., Gardner-Thorpe, C., Meinardi, H., Sherwin, A.L. (eds) Clinical Pharmacology of Anti-Epileptic Drugs. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85921-2_2
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