Specimen Information

Type

Red, Plain

Volume

1.0 ml

Transport Info

Centrifuge and immediately transfer serum to separate plastic tube
Refrigerated

Fasting Required?

False

Clinical Significance

Quantitate 10-hydroxyoxcarbazepine in serum to monitor administration of oxcarbazepine (Trileptal).

The majority of epileptic patients have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic agent, but one third of people with epilepsy suffer from partial seizures that are not controlled with a single-drug regime. Oxcarbazepine (Trileptal) is a 10-keto analogue of carbamazepine. The drug is intended to be used as monotherapy or adjunctive therapy in the treatment of partial seizures in adults with epilepsy and as adjunctive therapy in the treatment of partial seizures in the children. Oxcarbazepine (Trileptal) is rapidly reduced to its mono-hydroxy metabolite (MHD) by liver enzymes in vivo and its pharmacological activity is mainly exerted through the metabolite, MHD. The precise mechanism of action is unknown, however, in vitro electrophysiological studies show that oxcarbazepine and metabolite produce blockade of voltage-sensitive sodium channels, resulting in stabilization of hyperexcited neural membranes, inhibition of repetitive neuronal firing and diminution of propagation of synaptic impulses. These actions are thought to be important to prevent seizures in the intact brain. The drug also demonstrates increased potassium conductance and modulation of high-voltage activated calcium channels. It is cleared by kidney mainly in the form of metabolite.