The effect of nonadherence on phenobarbital concentrations and recommendations on the replacement dose using Monte Carlo simulation
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Janthima Methaneethorn
Abstract
Objectives
To determine the impacts of missed phenobarbital (PB) doses on its pharmacokinetics and to investigate the appropriate replacement dosing scheme for various PB missed dose scenarios.
Methods
Monte Carlo simulations were performed using parameters from the selected population pharmacokinetic study. The impacts of missed PB dose and the proper replacement dosing scheme were assessed based on the percent deviation of simulated concentrations outside the reference range from the full adherence scenario.
Results
The impact of missed PB dose on its concentrations depended on the daily dose. The replacement with a respective regular dose and one and a half regular dose was appropriate for the one and two missed doses scenarios for patients receiving PB monotherapy. For patients receiving PB with valproic acid or phenytoin, the same replacement scheme was still appropriate. The results also indicated that weight did not influence the proper replacement dosing scheme.
Conclusions
The impacts of missed PB doses on its pharmacokinetics were identified and the proper replacement dosing schemes for different missed dose scenarios were proposed. These schemes should be implemented based on the clinician’s justification of the patient’s seizure control.
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Research funding: None declared.
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Author contributions: Single author contribution.
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Competing interests: Author states no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
References
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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- The effect of nonadherence on phenobarbital concentrations and recommendations on the replacement dose using Monte Carlo simulation
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Articles in the same Issue
- Frontmatter
- Review
- Impact of environmental toxicants exposure on gut-brain axis in Parkinson disease
- Original Articles
- The effect of nonadherence on phenobarbital concentrations and recommendations on the replacement dose using Monte Carlo simulation
- SLCO1B1 c.521T>C gene polymorphism decreases hypoglycemia risk in sulfonylurea-treated type 2 diabetic patients
- Association of VKORC1 and CYP2C9 single-nucleotide polymorphisms with warfarin dose adjustment in Saudi patients
- Effect of CYP2C9, PTGS-1 and PTGS-2 gene polymorphisms on the efficiency and safety of postoperative analgesia with ketoprofen
- No association between LDL receptor and CETP genetic variants and atorvastatin response in Jordanian hyperlipidemic patients
- Type 2 diabetes: an exploratory genetic association analysis of selected metabolizing enzymes and transporters and effects on cardiovascular and renal biomarkers
- Potential factors of Helicobacter pylori resistance to clarithromycin
- Letter to the Editor
- Phenylalanine monooxygenase and the ‘sulfoxidation polymorphism’; the salient points
