Resumen de Idoneidad de la monitorización de niveles de ácido valproico en un hospital infantil en México

Ana Luisa Robles Piedras, María Del Rosario Hernández Jerónimo, Alejandro Chehue Romero, Elena Guadalupe Olvera Hernández

• español

  Introducción: en México, la cuantificación de fármacos en plasma se utiliza para comprobar la toxicidad, el cumplimiento y la titulación de dosis en el tratamiento con fármacos anticonvulsivos como el ácido valproico (AVP), pero sin considerar los principios de farmacocinética debido a la ausencia de farmacéuticos clínicos en el Sistema de Salud.

  Método: el presente estudio es un análisis retrospectivo que incluye los datos de concentración plasmática de ácido valproico en pacientes pediátricos de 1 a 15 años de edad, con diagnóstico confiable de epilepsia.

  Resultados: se revisaron los archivos de 260 pacientes, se encontró que solo el 56,5% de los pacientes tenían niveles séricos en estado estacionario. Los niveles plasmáticos de AVP se encontraron a nivel subterapéutico en el 22% de los pacientes y el 15% tenían niveles tóxicos. El análisis muestra que los niños menores de cinco años aparecen como un grupo heterogéneo para las variables estudiadas.

  Conclusiones: debido a la falta de reconocimiento de los farmacéuticos clínicos en México, recomendamos que el mejor resultado clínico se evalúe mediante el monitoreo de los parámetros farmacocinéticos y no solo mediante la dosificación de prueba y error.

• English

  Introduction: in Mexico, plasma drug quantitation is used to check toxicity, compliance, and dose titration in treatment with antiepileptic drugs like valproic acid (AVP), but without considering the principles of pharmacokinetics due to the absence of clinical pharmacists into the Health System.

  Method: the present study is a retrospective analysis including the p Introduction: in Mexico, plasma drug quantitation is used to check toxicity, compliance, and dose titration in treatment with antiepileptic drugs like valproic acid (AVP), but without considering the principles of pharmacokinetics due to the absence of clinical pharmacists into the Health System.

  Method: the present study is a retrospective analysis including the plasmatic concentration data of AVP in pediatric patients of 1 to 15 years old, who had received a reliable diagnosis of epilepsy.

  Results: files of 260 patients were reviewed. It was found that only 56,5% of the patients had serum levels at steady state. The plasma AVP levels were found in sub-therapeutic level in 22% of patients and 15% had toxic levels. The analysis shows that children under five years of age appear as a heterogeneous group for the variables studied.

  Conclusions: due to the lack of recognition of clinical pharmacists in Mexico, we recommend that best clinical outcome can be evaluated only by monitoring pharmacokinetic parameters for variations appearing in individual patients, and not just through trial and error dosing.

  lasmatic concentration data of AVP in pediatric patients of 1 to 15 years old, who had received a reliable diagnosis of epilepsy.

  Results: files of 260 patients were reviewed. It was found that only 56,5% of the patients had serum levels at steady state. The plasma AVP levels were found in sub-therapeutic level in 22% of patients and 15% had toxic levels. The analysis shows that children under five years of age appear as a heterogeneous group for the variables studied.

  Conclusions: due to the lack of recognition of clinical pharmacists in Mexico, we recommend that best clinical outcome can be evaluated only by monitoring pharmacokinetic parameters for variations appearing in individual patients, and not just through trial and error dosing.