Pharmacology of antiepileptic drugs in the neonatal period and early childhood

Abstract

Te aim of this review article is to elucidate the profound effect of developmental characteristics of newborns and infants on the dosing regimen of antiepileptic drugs (AEDs). AEDs have different mechanisms of action that can broadly be grouped in three categories. Te pharmacokinetics of AEDs are largely affected by developmental changes in absorption, distribution, metabolism and excretion. Te cytochrome P450 enzymes represent an important component of the drug metabolism and vary widely with the child’s development and genetics. In the light of this, an important path is paved by a new science–pharmacogenetics, the study of drug response in relation to specifc genes, which is becoming increasingly important in adjusting the drug dosage. Some recommendations regarding the genetic profle have already been approved but are not yet implemented into daily clinical practice. Considering both, the developmental changes and AED characteristics, an optimal dosage with minimal adverse effects may be achieved.

Keywords

• seizures
• epileptic status
• developmental pharmacology
• newborn
• infant
• child
• antiepileptic drugs
• adverse effects