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Changes in Serum Anticonvulsant Levels with Febrile Illness in Children with Epilepsy

Published online by Cambridge University Press:  18 September 2015

Keith J. Goulden ,
Peter R. Camfield ,
Carol S. Camfield ,
John A.R. Tibbles ,
Joseph M. Dooley ,
Albert D. Fraser  and
Kenneth W. Renton
Keith J. Goulden
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Peter R. Camfield*
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Carol S. Camfield
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
John A.R. Tibbles
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Joseph M. Dooley
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Albert D. Fraser
Affiliation:
Department of Pathology, Dalhousie University and Toxicology Laboratory, Victoria General Hospital, Halifax
Kenneth W. Renton
Affiliation:
Department of Pharmacology, Dalhousie University, Halifax
*
I.W.K. Hospital for Children, 5850 University Ave., Halifax, N.S., Canada B3J 3G9
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Abstract:

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Changes in anticonvulsant serum levels during intercurrent illness may cause toxicity or decreased seizure control in children with epilepsy. We studied prospectively the effect of intercurrent illness and its treatment in 111 children being treated with AC monotherapy. Free fraction and total serum AC levels were determined when the child was well, on the fifth day of any illness with fever and one month after recovery. There were 55 episodes of febrile illness in 39 children during the study period. Twelve illnesses were associated with significant increases or decreases in serum AC levels; 7 children became clinically toxic; 1 child had increased seizures during illness. The mechanisms of AC level changes appeared to include interaction with antibiotics, with antipyretics or with viral illness. Amoxycillin and acetaminophen did not appear to interact with the AC's used. Physicians caring for children with epilepsy should be aware of the frequency and complexity of potential interactions between intercurrent febrile illness and anticonvulsant medication.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 15 , Issue 3 , August 1988 , pp. 281 - 285
Copyright
Copyright © Canadian Neurological Sciences Federation 1988

References

REFERENCES

1.Goulden, KJ.Effect of febrile illness and its treatment on anticonvulsant levels in children. Can Med Assoc J 1986; 134: 1337–1339.Google ScholarPubMed
2.Neuvonen, PJ, Lehtovaara, R, Bardy, A, et al. Antipyretic analgesics in patients on antiepileptic drug therapy. Eur J Clin Pharmacol 1979; 15: 263–268.CrossRefGoogle ScholarPubMed
3.Soldin, SJ, Hill, JG.Rapid micromethod for measuring anticonvulsant drugs in serum by high performance liquid chromatography. Clin Chem 1976; 22: 856–859.CrossRefGoogle ScholarPubMed
4.Godolphin, W, Trepanier, J, Farrell, K.Serum and plasma for total and free anticonvulsant analyses: Effects on EMIT and ultrafiltration devices. Ther Drug Monit 1983; 5: 319–323.CrossRefGoogle ScholarPubMed
5.Bland, JM, Altmann, DG.Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.CrossRefGoogle ScholarPubMed
6.Goulden, KJ, Dooley, JM, Camfield, PR, et al. Clinical valproate toxicity induced by acetylsalicylic acid. Neurology 1987; 37: 1392–1394.CrossRefGoogle ScholarPubMed
7.Dingle, JH, Badger, GF, Jordan, WS Jr. Illness in the home. Cleveland: Case Western Reserve Univ Press, 1964.Google Scholar
8.Monto, AS, Ullman, BM.Acute respiratory illness in an American community: The Tecumseh study. JAMA 1974; 227: 164–169.CrossRefGoogle Scholar
9.Bell, JA, Huebner, RJ, Rosen, L, et al. Illness and microbial experiences of nursery school children at Junior Village. Am J Hyg 1961; 74: 267–292.Google Scholar
10.Treating fever in your child [pamphlet]. Health Protection Branch, Health and Welfare Canada.Google Scholar
11.Newman, J.Evaluation of sponging to reduce body temperature in febrile children. Can Med Assoc J 1985; 132: 641–642.Google ScholarPubMed
12.Remington, PL, Rowley, D, McGee, H, et al. Decreasing trends in Reye Syndrome and aspirin use in Michigan, 1979 to 1984. Pediatrics 1986; 77: 93–98.CrossRefGoogle ScholarPubMed
13.Farrell, K, Orr, JM, Abbott, FS, et al. The effect of acetylsalicylic acid on serum free valproate concentrations and valproate clearance in children. J Pediatr 1982; 101: 142–144.CrossRefGoogle ScholarPubMed
14.Paxton, JW.Effects of aspirin on salivary and serum phenytoin kinetics in healthy subjects. Clin Pharmacol Ther 1980; 170–178.CrossRefGoogle ScholarPubMed
15.Dershewitz, RA, Levin, GS.The effect of the Tylenol scare on parent’s use of over-the-counter drugs. Clin Pediatr 1983; 23: 445–448.CrossRefGoogle Scholar
16.Wroblewski, BA, Singer, WD, Whyte, J.Carbamazepine-erythromycin interaction: Case studies and clinical significance. JAMA 1986; 255: 1165–1167.CrossRefGoogle ScholarPubMed
17.Goulden, KJ, Camfield, PR, Dooley, JM, et al. Severe carbamazepine intoxication after coadministration of erythromycin. J Pediatr 1986; 109: 135–138.CrossRefGoogle ScholarPubMed
18.Riva, R, Albani, F, Ambrosetto, G, et al. Diurnal fluctuations in free and total steady-state plasma levels of carbamazepine and correlation with intermittent side effects. Epilepsia 1984; 25: 476–481.CrossRefGoogle ScholarPubMed
19.Hansen, JM, Kampmann, JP, Sierbaek-Nielsen, K, et al. The effect of different sulphonamides on phenytoin metabolism in man. Acta Med Scand (Suppl) 1979; 624: 106–110.CrossRefGoogle ScholarPubMed
20.Leppik, IE, Fisher, J, Kriel, R, et al. Altered phenytoin clearance with febrile illness. Neurology 1986; 36: 1367–1370.CrossRefGoogle ScholarPubMed
21.Levine, M, Jones, MW.Toxic reaction to phenytoin following a viral infection [C]. Can Med Assoc J 1983; 128: 1270–1271.Google ScholarPubMed
22.Chang, KC, Bell, TD, Lauer, BA, et al. Altered theophylline pharmacokinetics during acute respiratory virus illness. Lancet 1978; 1: 1132–1133.CrossRefGoogle Scholar
23.Levy, RH, Schmidt, D.Utility of free level monitoring of antiepileptic drugs. Epilepsia 1985; 26: 199–205.CrossRefGoogle ScholarPubMed