Seizures Clinical Trial
Official title:
The Role of Drug Metabolizing Enzymes in the Pathogenesis Adverse Drug Reactions in Children
The purpose of the study is to examine the individual metabolic profiles of pediatric patients receiving carbamazepine or valproate therapy, in an attempt to determine identities of the reactive metabolites or, alternatively, the identities of those metabolites that serve as potential precursors to reactive species.
Adverse drug reactions can be broadly defined as any undesirable response associated with
therapeutic drug use. A simple and clinically useful classification is to divide adverse
events into those that are dose-dependent and largely predictable from the known
pharmacologic properties of the compound in question, and those that are dependent on
characteristics unique to susceptible individuals, or idiosyncratic in nature.
The long term objective of this research is to characterize the mechanisms responsible for
the pathogenesis of idiosyncratic hypersensitivity reactions in children, particularly those
involving carbamazepine and other aromatic anticonvulsants.
The study is divided into two phases. Phase 1 of the study involves collecting urine from 50
patients taking CBZ therapeutically. Participants will be asked to provide a spot urine
sample during routine health visits. The urine will be analyzed for the presence of CBZ and
its metabolites. In Phase 2 of the study, urine will be collected from patients taking either
CBZ or VPA therapeutically. If blood samples are drawn from these patients for medical
purposes not related to this study the residual blood sample will be recovered before it is
discarded for use in genotyping analysis. Participants will be asked to provide a urine
sample covering one complete dosing interval of CBZ or VPA (preferably overnight). Patients
will also be followed longitudinally, with urine collections at each clinic visit over at
least a two year period.
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