* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Lacosamide (Vimpat) Drug Monitoring
Survey
Document related concepts
Compounding wikipedia , lookup
Polysubstance dependence wikipedia , lookup
Neuropsychopharmacology wikipedia , lookup
Adherence (medicine) wikipedia , lookup
List of comic book drugs wikipedia , lookup
Prescription drug prices in the United States wikipedia , lookup
Pharmacognosy wikipedia , lookup
Pharmaceutical industry wikipedia , lookup
Drug interaction wikipedia , lookup
Drug design wikipedia , lookup
Prescription costs wikipedia , lookup
Drug discovery wikipedia , lookup
Neuropharmacology wikipedia , lookup
Pharmacogenomics wikipedia , lookup
Transcript
Lacosamide (Vimpat) Drug Monitoring Indications for Ordering Optimize drug therapy and monitor patient adherence Test Description High performance liquid chromatography coupled with tandem mass spectrometry Tests to Consider Lacosamide, Serum or Plasma 2003182 • Predose (trough) concentration at steady state should be assessed Disease Overview Clinical issues Lacosamide is used in the treatment of • Partial-onset seizures • Diabetic neuropathic pain Physiology • Exact mechanism of action not well known • Functions by enhancing sodium channel slow inactivation without affecting the fast inactivation mechanism • Modulates the collapsing response mediator protein-2 (CRMP-2) o CRMP-2 is a phosphoprotein involved in neuronal differentiation and modulation of axonal overgrowth • Net drug result – stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing • Does not bind gamma-aminobutyric acid (GABA) receptors or glutamate targets Drug profile • Dose adjustments are recommended for patients with severe kidney impairment • Lacosamide should not be used in patients with o Severe liver impairment o Cardiac disease or cardiac conduction abnormalities Drug can cause dose-dependent PR-interval prolongation, increasing risk for atrioventricular block • Lacosamide use can result in abnormal results for alanine aminotransferase (ALT) Test Interpretation Analytical sensitivity – limit of detection is 0.5 µg/mL • Interferences from commonly used drugs and associated metabolites have not been observed Results • Concentration is reported • Therapeutic and toxic ranges are not well established o Proposed range for seizure control is 5.0-10.0 µg/mL using trough draw obtained <2 hours before the next dose o Approximated dose-related range is 2.5-18.0 µg/mL at doses of 200-600 mg/day o Critical values are not defined Limitations Lacosamide pharmacokinetics have not been studied in pediatric patients OCTOBER 2016 | © 2013 ARUP LABORATORIES | ARUP is a nonprofit enterprise of the University of Utah and its Department of Pathology. 500 Chipeta Way, Salt Lake City, UT 84108 | (800) 522-2787 | (801) 583-2787 | www.aruplab.com | www.arupconsult.com