Antiepileptika-Therapie bei Einschränkung der Nierenfunktion

Zusammenfassung

Antiepileptika werden in unterschiedlichem Grade renal eliminiert. Zwischen AED der 1. und der 2. Generation bestehen wesentliche Unterschiede hinsichtlich ihrer Verstoffwechslung. Diese Übersicht soll dazu dienen, pharmakokinetische Aspekte der Antiepileptikatherapie und ihre Relevanz zur Dosierungsanpassung bei Epilepsiepatienten mit Niereneinschränkungen zusammenzufassen. Insbesondere wird der Einfluss der Hämodialyse auf die Plasmaspiegel der AED einschließlich der entsprechenden Therapieoptionen im Hinblick auf Medikamentenwahl und - ersatz dargestellt. Diese Informationen können hilfreich sein, um Fluktuationen innerhalb der Wirksamkeit der Anfallskontrolle bei Patienten mit Niereneinschränkungen zu vermeiden.

Abstract

Antiepileptic drugs (AED) are renally eliminated to different degrees. There are important differences in the metabolism of first and second generation AEDs. The aim of this review is to provide a summary of the pharmacokinetics of AEDS and their relevance for dose adaptations in epilepsy patients with renal impairment. In particular, the effects of hemodialysis on AED plasma levels and options for therapeutic management with regard to drug selection and supplementation are discussed here. This information may serve to minimize fluctuations in the efficacy of seizure control in patients with renal impairment.

Schlüsselwörter

Epilepsie - Antiepileptika - Nierenerkrankung - Hämodialyse - Pharmakokinetik

Keywords

epilepsy - antiepileptic drug - renal impairment - hemodialysis - pharmakokinetics

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