The methods of estimating of drugs in body fluids provide a tool that enables us to throw light on many obscure relationships in pharmaceutical treatment now that we can study the pharmacokinetics and interaction of drugs in man many hypotheses based on clinical experience alone may well be eliminated or corroborated. Hence in most instances plasma unbound antiepileptic drug concentrations provide a better measure of potential pharmacological effect than do whole plasma drug concentrations ideally antiepileptic drug unbound concentrations in plasma or serum would always be measured for agents which bind to plasma proteins in clinical practice it usually . The comprehensive epilepsy center the neurological institute of new york columbia university new york new york usa most of the material contained in this review was presented at the 54th annual meeting of the american academy of neurology and was included in a syllabus prepared for the therapy in neurology course given on april 15 2002. Epilepsy is the tendency to have recurrent seizures unprovoked by systemic or acute neurologic insults slide 2 antiepileptic drugs aeds are those which decrease the frequency and or severity of seizures in people with epilepsy the older term anticonvulsant drug is still sometimes used as a synonym for aed but is less accurate because many seizures do not involve convulsive movements . Although older generation antiepileptic drugs aeds such as carbamazepine phenytoin and valproic acid continue to be widely used in the treatment of epilepsy these drugs have important shortcomings such as a highly variable and nonlinear pharmacokinetics a narrow therapeutic index suboptimal response rates and a propensity to cause significant adverse effects and drug interactions
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