September 2016

An AACC/CAP Educational Newsletter for Toxicology Laboratories
CFTN is registered with the U.S. Library of Congress, ISSN 2374-9679

Newer Anti-Epileptic Drugs

TDM for Second Generation of AEDs Remains a Work in Progress

By Matthew D. Krasowski, MD, PhD

Medications used to treat and prevent seizures--anti-epileptic drugs (AEDs)--are among the most common drugs for which therapeutic drug monitoring (TDM) is performed (1). The first generation AEDs, including carbamazepine, phenobarbital, phenoytoin, primidone, and valproic acid, were introduced prior to 1990 and are still in use today to varying degrees (2).

NACB Creates Guideline on Tests for Monitoring Pain Management

By Paul J. Jannetto, PhD, and Loralie J. Langman, PhD

The National Academy of Clinical Biochemistry (NACB) recently released a draft of a new laboratory medicine practice guideline (LMPG) on the use of Laboratory tests to monitor drug therapy in pain management patients. The comment period closed on Sept. 6, but the guideline, "Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients," can be viewed on the ACC website (1).


Gabapentin and Pregabalin:

Although They Were Thought to Pose Little Risk, their Abuse is Growing

By Christine Snozek, PhD

A study presented at the 2016 AACC annual meeting in Philadelphia highlights a growing concern in pain management patients and other populations: the abuse of nonopioid medications such as the anti-epileptic drugs (AEDs) gabapentin and pregabalin. These drugs, often used to treat neuropathic pain, drug or alcohol withdrawal and other nonsiezure indications, were originally thought to have minimal risk of abuse.