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Clinical Chemistry 49: 1198-1201, 2003; 10.1373/49.7.1198
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(Clinical Chemistry. 2003;49:1198-1201.)
© 2003 American Association for Clinical Chemistry, Inc.

Technical Briefs

Procedure for the Monitoring of Gabapentin with 2,4,6-Trinitrobenzene Sulfonic Acid Derivatization Followed by HPLC with Ultraviolet Detection

JoEtta M. Juenke1,a, Paul I. Brown1, Gwendolyn A. McMillin1,2 and Francis M. Urry1,2

1 ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories Inc, 500 Chipeta Way, Salt Lake City, UT 84108

2 Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84108

aauthor for correspondence: fax 801-584-5207, e-mail juenkejm@aruplab.com

The first 300 words of the full text of this article appear below.

Gabapentin is a novel anticonvulsant drug that was introduced in the early 1990s and later approved (1995) for use in the US as an adjunctive treatment of partial seizures with or without secondary generalization in persons >3 years of age. Although structurally similar to {gamma}-aminobutyric acid (GABA), gabapentin does not interact with GABA receptors, nor is it converted to GABA or a GABA agonist (1). Gabapentin is widely studied therapeutically. Its initial and approved use as adjunctive epileptic therapy has been broadened, with many additional indications. These include treatment for neuropathic pain after spinal cord injury (2)(3)(4), posttraumatic stress disorder (5), poststroke pain syndrome (6)(7)(8), alcohol withdrawal(9), migraine therapy (10), hot flashes associated with prostate cancer treatment (11), and postoperative pain after cancer surgery (12)(13).

The general mechanism by which gabapentin exerts its anticonvulsant action is unknown. It is not appreciably metabolized in the liver, nor does it induce liver enzymes. It circulates relatively unbound in serum, with a protein bound fraction of ~3%. It has a volume of distribution of ~58 L. Because gabapentin does not bind to protein, it can be removed by hemodialysis if medically necessary. Gabapentin is renally eliminated with an elimination half-life of ~6 h and clearance proportional to creatinine clearance. Impaired renal function substantially decreases the clearance of gabapentin (14). Gabapentin exhibits saturable absorption, making it a nonlinear drug and kinetically less predictable. A dose–response pattern is apparent for plasma gabapentin concentrations and for clinical effects within the dosage range 600-1800 mg/day. Seizure control has not been seen with trough plasma concentrations <2 mg/L. A majority of patients at suggested doses fall within a 2–10 mg/L . . . [Full Text of this Article]






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