Abstract
To test the value of measuring salivary levels to predict serum levels in anticonvulsive treated children, serum ph and pr levels were compared to salivary levels before and after stimulation of salivary flow with chewing gum. The drug levels were measured by an enzyme immunoassay (EMIT).A high linear correlation (r >.90)between serum and saliva ph levels was found.The saliva/serum ratio was independent of serum levels in the range 0.4 to 16mg/1 averaging 0.1 and was not significantly influenced by the mode of saliva sampling. When serum ph levels exceeded 16-18mg/1,a slight but significant increase of the saliva/serum ratio was seen. Salivary pr levels were markedly dependent on the procedure of saliva sampling. In non-stimulated saliva pr levels averaged 114% of the serum levels, and decreased significantly,to 70% (p<.01),while salivary flow was stimulated. Pr levels in non-stimulated and in stimulated saliva,respectively,were closely correlated to serum levels (r>.90).The saliva/serum ratios were independent of serum pr levels in the range 1 to 15mg/1. The increase of the saliva/serum ratio of ph at high serum ph levels and the marked influence of the procedure of saliva sampling on salivary pr levels have to be considered, when drug monitoring is performed in saliva samples.
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Bartels, H., Günther, E. Salivary levels of phenytoin (ph) and primidone (pr)in epileptic children. Pediatr Res 13, 74 (1979). https://doi.org/10.1203/00006450-197901000-00029
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DOI: https://doi.org/10.1203/00006450-197901000-00029