Haemodialysis significantly reduces serum levetiracetam levels inducing epileptic seizures: Case report.

WHAT IS KNOWN AND OBJECTIVE: Levetiracetam is used in the treatment of some forms of epilepsy. In renal impairment and patients on chronic haemodialysis, dose adjustment is required. We report a case. CASE DESCRIPTION: This case report describes a woman on levetiracetam treatment who presented with generalized tonic-clonic seizures during a haemodialysis session. We report on treatment adjustment and on the impact of dialysis on levetiracetam levels. WHAT IS NEW AND CONCLUSION: Haemodialysis reduces serum levetiracetam concentration and can lead to subtherapeutic levels. Close monitoring is necessary when dialysis is used on patients receiving anticonvulsant drugs that are extensively eliminated by the procedure.

[Effect of the concomitant administration of indomethacin or ibuprofen on amikacin pharmacokinetics in premature newborns]. / Efecto de la administración concomitante de indometacina o ibuprofeno en la farmacocinética de amikacina en neonatos prematuros.

OBJECTIVE: To evaluate whether the concomitant administration of ibuprofen or indomethacin plus amikacin may alter the latter drug s pharmacokinetic parameters, and hence amikacin plasma levels. METHOD: Retrospective cohort study performed by reviewing the medical records of premature children with persistent ductus arteriosus receiving amikacin and ibuprofen, or amikacin and indomethacin. They were divided up into three groups: group 1: treatment with amikacin went before indomethacin or ibuprofen; group 2: simultaneously treated with amikacin and indomethacin; group 3: simultaneously treated with amikacin and ibuprofen. Pharmacokinetic parameters, distribution volume, and amikacin clearance were measured using the PKS program (a non-linear regression method). Half life was determined from previous parameters. RESULTS: Twenty-eight patients were included. No statistically significant differences were found among pharmacokinetic parameters corresponding to each study group. CONCLUSIONS: Further studies are needed with a greater number of patients and currently recommended doses to assess the influence of indomethacin and ibuprofen in the pharmacokinetics of amikacin in premature children with persistent ductus arteriosus.