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Correlation between serum and salivary phenytoin concentrations in Thai epileptic children

Sahas Liamsuwan1, Ulailuk Jaiweerawattana

  • 1Division of Child Neurology, Queen Sirikit National Institute of Child Health, Department of Medical Services, Ministry of Public Health, College of Medicine, Rangsit University, Bangkok, Thailand. liamsuwan@hotmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|November 3, 2011
PubMed

Insights

Saliva can effectively monitor phenytoin levels in Thai children with epilepsy, showing a strong correlation with serum levels. This offers a less invasive alternative to blood tests for managing medication dosages.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology
  • Biomarker Analysis

Background:

  • Epilepsy management in children requires precise drug level monitoring.
  • Phenytoin is a common antiepileptic drug, but blood collection can be challenging in pediatric patients.
  • Exploring alternative, less invasive methods for phenytoin monitoring is crucial.

Purpose of the Study:

  • To investigate the correlation between serum and salivary phenytoin concentrations in Thai epileptic children.
  • To establish predictive equations for phenytoin levels based on saliva samples.

Main Methods:

  • Studied Thai children (5-12 years) with epilepsy on phenytoin monotherapy.
  • Collected blood and saliva samples for phenytoin level measurement using fluorescence-polarization immunoassay.
  • Excluded patients with specific health conditions or poor compliance.

Main Results:

  • A close linear correlation (R=0.880, R²=0.967) was found between serum and salivary phenytoin levels.
  • Equations were derived to predict serum and salivary phenytoin levels from drug dosage.
  • Adverse drug reactions were observed in 6.6% of patients.

Conclusions:

  • Salivary phenytoin monitoring is a viable and highly correlated alternative to serum monitoring in Thai children.
  • This approach can simplify drug management, reduce patient distress, and improve adherence.
  • The derived equations can aid in adjusting phenytoin dosage regimens in clinical practice.
Abstract

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