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Pharmacokinetic considerations for anti-epileptic drugs in children

Alberto Verrotti1, Giulia Iapadre1, Giulia Di Donato1

  • 1a Department of Pediatrics , University of L'Aquila , L'Aquila , Italy.

Expert Opinion on Drug Metabolism & Toxicology
|January 29, 2019
PubMed

Insights

Pediatric epilepsy treatment requires careful antiepileptic drug (AED) selection due to age-related pharmacokinetic changes. Monitoring drug levels and using extended-release formulations can optimize therapy in children.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology
  • Pharmacokinetics

Background:

  • Epilepsy is a common neurological disorder in children.
  • Selecting appropriate antiepileptic drugs (AEDs) and dosing regimens is challenging in pediatric populations.
  • Age-related physiological changes significantly impact AED pharmacokinetics.

Purpose of the Study:

  • To review the pharmacokinetic characteristics of AEDs in children.
  • To highlight age-related factors influencing AEDs treatment response.
  • To discuss strategies for optimizing AED therapy in pediatric patients.

Main Methods:

  • Literature review focusing on AED pharmacokinetics in children.
  • Analysis of age-related physiological changes affecting drug absorption, distribution, metabolism, and excretion.
  • Examination of therapeutic drug monitoring and formulation strategies.

Main Results:

  • Pediatric physiological changes (body composition, metabolism, renal function) alter AED pharmacokinetic profiles (absorption, volume of distribution, half-life, clearance).
  • These alterations can lead to varied treatment responses in children.
  • Therapeutic drug concentration monitoring and extended-release formulations are key tools for managing variability.

Conclusions:

  • Optimizing AED therapy in children necessitates understanding age-specific pharmacokinetic variability.
  • Therapeutic drug monitoring and appropriate formulation selection are crucial for individualized treatment.
  • Future decision-support systems will further enhance precision in pediatric AED management.
Abstract

Keywords:
Pharmacokineticsantiepileptic drugschildrenclearanceepilepsymetabolismneonatespaediatrictherapeutic drug monitoringtherapy

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