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Эко-Вектор (Россия)

DETERMINATION OF THE LEVEL OF VALPROIC ACID IN THE BLOOD AGAINST THE BACKGROUND OF THE COMBINED USE OF VALPROATES WITH ERTAPENEM IN PEDIATRIC PRACTICE

DOI: https://doi.org/10.29296/25877313-2023-11-12
Issue: 
11
Year: 
2023

A.B. Strok
Ph.D. (Med.), Assistant of Department of General and Clinical Pharmacology
«Peoples' Friendship University of Russia (PFUR) named after Patrice Lumumba»;
Clinical Pharmacologist «Russian Children's Clinical Hospital is a Branch
of the «N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation» (Moscow, Russia)
E-mail: strok_ab@pfur.ru
M.S. Chenkurov
Ph.D. (Biol.), Assistant of Department of General and Clinical Pharmacology
«Peoples' Friendship University of Russia (PFUR) named after Patrice Lumumba» (Moscow, Russia)
E-mail: chenkurov_ms@pfur.ru
M.N. Kostyleva
Ph.D. (Med.), Head of Department of Clinical Pharmacology, Clinical Pharmacologist
«Russian Children's Clinical Hospital is a Branch
of the «N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation;
Associate Professor "N.I. Pirogov Russian National Research Medical University"
of the Ministry of Health of the Russian Federation (Moscow, Russia)
E-mail: mkostyleva@mail.ru
D.A. Umutkuzina
Clinical Pharmacologist,
City Clinical Hospital named after M.E. Zhadkevich (Moscow, Russia)
E-mail: umutkuzinada@gmail.com

The article presents a clinical case of the combined use of valproic acid and an antibacterial drug from the carbapenem group – ertapenem in a 15-year-old girl with epilepsy in a pediatric hospital. Therapeutic drug monitoring with an assessment of the level of valproic acid in blood plasma against the background of joint use with carbapenem (ertapenem) allowed to revise and adjust the prescribed antibacterial therapy, and later allowed to adjust the daily dose of sodium valproate in a child with epilepsy. The change of the antibacterial drug was accompanied by an increase in the level of valpro-ic acid in the blood plasma. The transition from intravenous administration of valproic acid to enteral administration of the drug was accompanied by a decrease in the concentration of valproic acid in blood plasma. The authors of the article presented data confirming the need for therapeutic drug moni-toring in children receiving valproic acid and beta-lactam antibiotic from the carbapenem group - ertapenem, based on the known mechanisms of famacokinetic interaction, as well as in patients whose management tactics are planned to change the dosage form of valproic acid.
Keywords: 
therapeutic drug monitoring
antiepileptic therapy
valproates
carbapenems
drug interaction
combination therapy
epilepsy.
References: 
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