PEMANTAUAN KADAR OBAT ANTIEPILEPSI DALAM DARAH TERHADAP LUARAN KLINIS PASIEN EPILEPSI RAWAT JALAN: PENDEKATAN FARMAKOKINETIKA

Abstract

Therapeutic drug monitoring is an important part of epilepsy therapy management. The correct dosage is essential for controlling epileptic seizures and avoiding side effects, toxicity and treatment failure. This study aims to determine the level of antiepileptic drugs in the blood using a pharmacokinetic model and its effect on the clinical outcomes of epilepsy ambulatory patients at Prof. Dr. R.D. Kandou General Hospital in Manado. This study is an analytical observational study with a cross-sectional design. Data was collected retrospectively from the medical records of epilepsy patients who used antiepileptic drugs between July 2024 and July 2025. Data collection was conducted from July to September 2025 on 75 medical records that met the inclusion and exclusion criteria. The data was analysed statistically using the bivariate Chi-Square Test. The results showed no significant effect between antiepileptic drug levels in the blood and the clinical outcome of seizure-free duration (p>0.05), both for valproic acid (p=0.753) and phenytoin (p=0.533). In conclusion, although blood drug levels varied (too low, within the therapeutic range, or too high), these differences did not significantly affect the length of time patients remained seizure-free. Thus, decisions regarding dose adjustment can be based on clinical response, such as the presence or absence of seizures, side effect, and treatment adherence.

Keywords: therapeutic drug monitoring, antiepileptic, pharmacokinetics, clinical outcome