Autori stanovovali koncentrácie niektorých antiepileptík (karbamazepínu a kyseliny valproovej) v sére matky a v materskom mlieku s následným poradenstvom ohľadom dojčenia. Doteraz vyšetrili hladiny karbamazepínu v sére a materskom mlieku u 14 rodičiek a hladiny kyseliny valproovej v sére a materskom mlieku u 20 rodičiek. Priemerná hodnota hladina karbamazepínu v sére matiek v tomto súbore bola 5,578 µg/ml, v materskom mlieku bola 1,173 µg/ml. Pomer hladiny karbamazepínu v sére a mlieku matky (M/P) bol priemerne 0,179, maximálny pomer bol 0,5, minimálny pomer bol 0,03. Žiadny z pomerov hladín karbamazepínu v plazme a mlieku matky nebol v pásme kontraindikácie dojčenia. U žiadneho z novorodencov neboli zistené nežiaduce účinky liečby karbamazepínom. Priemerná hodnota hladiny kyseliny valproovej v sére matiek v tomto súbore bola 57,715 µg/ml, v materskom mlieku bola 2,896 µg/ml. Žiadna z dojčiacich matiek nemala nameranú hladinu kyseliny valproovej vyššiu, ako je maximálna terapeutická hladina, všetky sa väčšinou pohybovali v dolných terapeutických hladinách. U žiadneho z detí, ktoré matka počas užívania kyseliny valproovej doj čila, neboli zistené nežiaduce účinky tejto terapie. Viac ako povolených 15 % hladiny kyseliny valproovej v materskom mlieku zo sérovej hladiny kyseliny valproovej autori zistili u dvoch dojčiacich matiek, teda im doporučili prerušiť dojčenie.

The authors determined the concentrations of some antiepileptic drugs (carbamazepine and valproic acid) in the serum of mother and in mother's milk with subsequent advisory activity concerning breast feeding. Until now the authors examined the levels of carbamazepine in mother's milk of 14 mothers (women who have just given birth) and the levels of valproic acid in 20 such subjects. The mean level of carbamazepine in the serum of mother of our group was 5.578 µg/ml and that of the milk was 1.174 µg/ml. The ration of the level of carbamazepine in the milk and serum of the mothers was on the average179, maximum ratio being 0.5 and the minimum ratio 0.03. None of the ratios of the levels of carbamazepine in the plasma and milk was in the range of contraindication for breast feeding. None of the suckling children was found to suffer from untoward effects of the therapy with carbamazepine. The mean value of valoproic acid in the serum of mothers in this group was 57.715 µg/ml, the value in the mother's milk being 2.896 µg/ml. None of the breast feeding mothers had a higher level of valproic acid that the maximum therapeutic level, the levels were mostly in the area of lower therapeutic levels. None of the children whose mothers was taking valproic acid in the course of breastfeeding suffered from side effects of the therapy. More than the 15% of admitted level of valproic acid the mother's milk from the serum level of valproic acid was observed in two breastfeeding mothers and they were recommended to stop the breastfeeding.

Novorodenecká klinika FN Nitra FSV a ZUKF Nitra

Antiepileptic drugs and lactation

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