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Clinical Drug Investigation
Erschienen in: Clinical Drug Investigation 1/2017

01.01.2017 | Review Article

Antiepileptic Drug Removal by Continuous Renal Replacement Therapy: A Review of the Literature

verfasst von: Sherif Hanafy Mahmoud

Erschienen in: Clinical Drug Investigation | Ausgabe 1/2017

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Abstract

Continuous renal replacement therapy (CRRT) is used for managing acute kidney injury in critically ill patients. Removal of antiepileptic drugs (AEDs) by CRRT could be significant and may complicate patients’ intensive care unit stay. The objective of the current review was to summarize the available evidence for AED removal by CRRT. An electronic literature search of PubMed (1946 to May 2016), Medline (1946 to May 2016), and Embase (1974 to May 2016) databases for studies discussing AED removal by CRRT was conducted. A total of 31 case reports discussing 32 patients were found. AEDs reported were levetiracetam (n = 3), valproic acid (n = 9), carbamazepine (n = 10), phenytoin (n = 3), phenobarbital (n = 4), lacosamide (n = 1), gabapentin (n = 1), and topiramate (n = 1). Two-thirds of the reports were about using CRRT in drug overdose and one-third was about AED removal by CRRT during therapy. Based on the current limited evidence and pharmacokinetic characteristics of AEDs, renally eliminated AEDs and/or AEDs with limited protein binding such as levetiracetam are more likely to be removed by CRRT than AEDs that are mainly metabolized and extensively protein bound such as carbamazepine. In conclusion, there is not enough evidence to provide robust dosing recommendations for AEDs in patients undergoing CRRT. Further studies are needed.
Literatur
1.
Aronoff GR, American College of Physicians. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th ed. Philadelphia: American College of Physicians; 2007.
2.
Bugge JF. Pharmacokinetics and drug dosing adjustments during continuous venovenous hemofiltration or hemodiafiltration in critically ill patients. Acta Anaesthesiol Scand. 2001;45:929–34.CrossRefPubMed
3.
Matzke GR, Aronoff GR, Atkinson AJ Jr, et al. Drug dosing consideration in patients with acute and chronic kidney disease-a clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2011;80:1122–37.CrossRefPubMed
4.
Bohler J, Donauer J, Keller F. Pharmacokinetic principles during continuous renal replacement therapy: drugs and dosage. Kidney Int. 1999;56:S24–8.CrossRef
5.
Nolin TD, Aronoff GR, Fissell WH, et al. Pharmacokinetic assessment in patients receiving continuous RRT: perspectives from the Kidney Health Initiative. Clin J Am Soc Nephrol. 2015;10:159–64.CrossRefPubMed
6.
Louie JM, Raphael KL, Barker B. Levetiracetam use with continuous renal replacement therapy. Ann Pharmacother. 2015;49:1079–80.CrossRefPubMed
7.
Nei SD, Wittwer ED, Kashani KB, Frazee EN. Levetiracetam pharmacokinetics in a patient receiving continuous venovenous hemofiltration and venoarterial extracorporeal membrane oxygenation. Pharmacotherapy. 2015;35:e127–30.CrossRefPubMed
8.
New AM, Nei SD, Kashani KB, Rabinstein AA, Frazee EN. Levetiracetam Pharmacokinetics During Continuous Venovenous Hemofiltration and Acute Liver Dysfunction. Neurocrit Care. 2016;25:141–4.CrossRefPubMed
9.
Golper TA, Saad AM. Gentamicin and phenytoin sieving through hollow-fiber polysulfone hemofilters. Kidney Int. 1986;30:937–43.CrossRefPubMed
10.
Oltrogge KM, Peppard WJ, Saleh M, Regner KR, Herrmann DJ. Phenytoin removal by continuous venovenous hemofiltration. Ann Pharmacother. 2013;47:1218–22.CrossRefPubMed
11.
De Maat MMR, Van Leeuwen HJ, Edelbroek PM. High unbound fraction of valproic acid in a hypoalbuminemic critically ill patient on renal replacement therapy. Ann Pharmacother. 2011;45:e18.CrossRefPubMed
12.
Goncalves JA, Santos C, Montalban JM. et al [Continuous venovenous haemodiafiltration as a solution for acute intoxication with sodium valproate]. Nefrologia. 2010;30:134–5.PubMed
13.
Boucher BA, Wood GC, Swanson JM. Pharmacokinetic changes in critical illness. Crit Care Clin. 2006;22:255–71, vi.
14.
Guddati AK, Zafar Z, Cheng JT, Mohan S. Treatment of gabapentin-induced myoclonus with continuous renal replacement therapy. Indian J Nephrol. 2012;22:59–61.CrossRefPubMedPubMedCentral
15.
Blum RA, Comstock TJ, Sica DA, et al. Pharmacokinetics of gabapentin in subjects with various degrees of renal function. Clin Pharmacol Ther. 1994;56:154–9.CrossRefPubMed
16.
Patsalos PN. Clinical pharmacokinetics of levetiracetam. Clin Pharmacokinet. 2004;43:707–24.CrossRefPubMed
17.
Bauer LA. Applied clinical pharmacokinetics. 2nd ed. New York: McGraw-Hill Medical; 2008. p. xiv, 826.
18.
Chung YK, Chang KY, Park HS, et al. Severe carbamazepine intoxication unresponsive to albumin-enhanced continuous venovenous hemodiafiltration with low dialysate flow. Hemodial Int. 2014;18:551–5.CrossRefPubMed
19.
Payette A, Ghannoum M, Madore F, Albert M, Troyanov S, Bouchard J. Carbamazepine poisoning treated by multiple extracorporeal treatments. Clin Nephrol. 2015;83:184–8.CrossRefPubMed
20.
Smollin CG, Petrie MS, Kearney T. Carbamazepine and carbamazepine-10,11-epoxide clearance measurements during continuous venovenous hemofiltration in a massive overdose. Clin Toxicol (Phila). 2016;54:424–7.CrossRef
21.
Choi JS, Kim CS, Bae EH, et al. Enhanced clearance of carbamazepine using albumin-containing dialysate during CVVHDF. Intensive Care Med. 2013;39:159–60.CrossRefPubMed
22.
Harder JL, Heung M, Vilay AM, Mueller BA, Segal JH. Carbamazepine and the active epoxide metabolite are effectively cleared by hemodialysis followed by continuous venovenous hemodialysis in an acute overdose. Hemodial Int. 2011;15:412–5.CrossRefPubMed
23.
Ghannoum M, Yates C, Galvao TF, et al. Extracorporeal treatment for carbamazepine poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila). 2014;52:993–1004.CrossRef
24.
Ritschel WA, Kearns GL, American Pharmacists Association. Handbook of basic pharmacokinetics—including clinical applications. 7th ed. Washington, D.C.: American Pharmacists Association; 2009.
25.
Brunet S, Leblanc M, Geadah D, Parent D, Courteau S, Cardinal J. Diffusive and convective solute clearances during continuous renal replacement therapy at various dialysate and ultrafiltration flow rates. Am J Kidney Dis. 1999;34:486–92.CrossRefPubMed
26.
Ruhe M, Grautoff S, Kahler J, Pohle T. Suicide attempt by means of phenobarbital overdose: Effective treatment with continuous veno-venous hemodialysis [German]. Medizinische Klinik-Intensivmedizin und Notfallmedizin. 2016;111:141–4.CrossRef
27.
Browning L, Parker D Jr, Liu-DeRyke X, Shah A, Coplin WM, Rhoney DH. Possible removal of topiramate by continuous renal replacement therapy. J Neurol Sci. 2010;288:186–9.CrossRefPubMed
28.
Rosenborg S, Saraste L, Wide K. High phenobarbital clearance during continuous renal replacement therapy: a case report and pharmacokinetic analysis. Medicine (Baltimore). 2014;93:e46.CrossRef
29.
Boyd M, Proschek C, Kazzi Z. Massive lacosamide overdose treated with continuous renal replacement therapy. Clin Toxicol. 2014;52(7):757–8.
30.
Ghannoum M, Laliberte M, Nolin TD, et al. Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila). 2015;53:454–65.CrossRef
31.
Patsalos PN, Berry DJ, Bourgeois BF, et al. Antiepileptic drugs–best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia. 2008;49:1239–76.CrossRefPubMed
32.
Tsubo T, Sakai I, Okawa H, Ishihara H, Matsuki A. Ketamine and midazolam kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction syndrome. Intensive Care Med. 2001;27:1087–90.CrossRefPubMed
33.
Swart EL, de Jongh J, Zuideveld KP, Danhof M, Thijs LG, Strack van Schijndel RJ. Population pharmacokinetics of lorazepam and midazolam and their metabolites in intensive care patients on continuous venovenous hemofiltration. Am J Kidney Dis. 2005;45:360–71.CrossRefPubMed
34.
Bolon M, Bastien O, Flamens C, Paulus S, Boulieu R. Midazolam disposition in patients undergoing continuous venovenous hemodialysis. J Clin Pharmacol. 2001;41:959–62.CrossRefPubMed
35.
Bironneau E, Garrec F, Kergueris MF, Testa A, Nicolas F. Hemodiafiltration in pentobarbital poisoning. Ren Fail. 1996;18:299–303.CrossRefPubMed
36.
Jana S, Chakravarty C, Taraphder A, Ramasubban S. Successful use of sustained low efficiency dialysis in a case of severe phenobarbital poisoning. Indian J Crit Care Med. 2014;18:530–2.CrossRefPubMedPubMedCentral
37.
Khan F, Menon U, Sagastume R, Eugene Ramsay R. Clearance of valproic acid by continuous renal replacement therapy in a patient with status epilepticus. Epilepsy Curr. 2014;14:230–1.
38.
Narayan R, Rizzo M, Cole M. Successful treatment of severe carbamazepine toxicity with 5 % albumin-enhanced continuous venovenous hemodialysis. J Artif Organs. 2014;17:206–9.CrossRefPubMed
39.
Vo M, Zhang J, Melhem S, Polderman KH, Shutter LA. Extracorporeal therapy for the management of phenytoin toxicity. Neurocrit Care. 2014;1:S135.
40.
Ray S, Skellett S. Valproate toxicity in a child: two novel observations. Clin Toxicol. 2013;51:60.CrossRef
41.
42.
Goktas U, Kati I, Yuce HH. Management of a severe carbamazepine overdose with continuous venovenous hemodiafiltration. Am J Emerg Med. 2010;28(260):e1–2.
43.
Luzhnikov EA, Sukhodolova GN, Ostapenko YN, Kovalenko LA, Kovalchuk AS, Dolginov DM. A case of successful therapy in acute valproic acid poisoning in a child using hemodiafiltration. Clin Toxicol. 2010;48(3):248.
44.
Jacobs FM, Pinot G, Prat D, Pilorge C, Brivet FG. Valproic acid overdose and continuous venovenous haemodiafiltration. NDT Plus. 2008;1:60–1.
45.
Khan E, Huggan P, Celi L, Macginley R, Schollum J, Walker R. Sustained low-efficiency dialysis with filtration (SLEDD-f) in the management of acute sodium valproate intoxication. Hemodial Int. 2008;12:211–4.CrossRefPubMed
46.
Lal R, Faiz S, Garg RK, Baweja KS, Guntupalli J, Finkel KW. Use of continuous venovenous hemodiafiltration in a case of severe phenobarbital poisoning. Am J Kidney Dis. 2006;48:e13–5.CrossRefPubMed
47.
Yildiz TS, Toprak DG, Arisoy ES, Solak M, Toker K. Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient. Paediatr Anaesth. 2006;16:1176–8.PubMed
48.
Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: a case report and review of the literature. Semin Dial. 2005;18:62–6.
49.
Askenazi DJ, Goldstein SL, Chang IF, Elenberg E, Feig DI. Management of a severe carbamazepine overdose using albumin-enhanced continuous venovenous hemodialysis. Pediatrics. 2004;113:406–9.CrossRefPubMed
50.
Kay TD, Playford HR, Johnson DW. Hemodialysis versus continuous veno-venous hemodiafiltration in the management of severe valproate overdose. Clin Nephrol. 2003;59:56–8.CrossRefPubMed
51.
Patsalos PN. The clinical pharmacology profile of the new antiepileptic drug perampanel: a novel noncompetitive AMPA receptor antagonist. Epilepsia. 2015;56:12–27.CrossRefPubMed
52.
Tompson DJ, Crean CS. Clinical pharmacokinetics of retigabine/ezogabine. Curr Clin Pharmacol. 2013;8:319–31.CrossRefPubMed
53.
Leppik IE. Zonisamide: chemistry, mechanism of action, and pharmacokinetics. Seizure. 2004;13 Suppl 1:S5–9, (discussion S10).
54.
Gustavson LE, Mengel HB. Pharmacokinetics of tiagabine, a gamma-aminobutyric acid-uptake inhibitor, in healthy subjects after single and multiple doses. Epilepsia. 1995;36:605–11.CrossRefPubMed
55.
Perucca E, Cloyd J, Critchley D, Fuseau E. Rufinamide: clinical pharmacokinetics and concentration-response relationships in patients with epilepsy. Epilepsia. 2008;49:1123–41.CrossRefPubMed
56.
Levy RH, Lin HS, Blehaut HM, Tor JA. Pharmacokinetics of stiripentol in normal man: evidence of nonlinearity. J Clin Pharmacol. 1983;23:523–33.CrossRefPubMed
57.
Rolan P, Sargentini-Maier ML, Pigeolet E, Stockis A. The pharmacokinetics, CNS pharmacodynamics and adverse event profile of brivaracetam after multiple increasing oral doses in healthy men. Br J Clin Pharmacol. 2008;66:71–5.CrossRefPubMedPubMedCentral
58.
May TW, Korn-Merker E, Rambeck B. Clinical pharmacokinetics of oxcarbazepine. Clin Pharmacokinet. 2003;42:1023–42.CrossRefPubMed
59.
Kellinghaus C. Lacosamide as treatment for partial epilepsy: mechanisms of action, pharmacology, effects, and safety. Ther Clin Risk Manag. 2009;5:757–66.CrossRefPubMedPubMedCentral
60.
Greenaway C, Ratnaraj N, Sander JW, Patsalos PN. Saliva and serum lacosamide concentrations in patients with epilepsy. Epilepsia. 2011;52:258–63.PubMed
61.
Asconape JJ. Use of antiepileptic drugs in hepatic and renal disease. Handb Clin Neurol. 2014;119:417–32.CrossRefPubMed
Metadaten
Titel
Antiepileptic Drug Removal by Continuous Renal Replacement Therapy: A Review of the Literature
verfasst von
Sherif Hanafy Mahmoud
Publikationsdatum
01.01.2017
Verlag
Springer International Publishing
Erschienen in
Clinical Drug Investigation / Ausgabe 1/2017
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-016-0457-0

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