This case report describes the pharmacokinetics of levetiracetam in a critically ill patient supported on venovenous membrane oxygenation. While levetiracetam has emerged as a first line option to treat seizures in critically ill patients, there is limited information available regarding the impact of extracorporeal membrane oxygenation on the pharmacokinetics of this medication. This report contributes to the limited body of literature describing the pharmacokinetics of medications in extracorporeal membrane oxygenation.
BrophyGMBellRClaassenJ, et al.Guidelines for the evaluation and management of status epilepticus. Neurocritical Care2012; 17(1): 3–23.
2.
GlauserTShinnarSGlossD, et al.Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American epilepsy society. Epilepsy Curr2016; 16(1): 48–61.
3.
UCB, Inc. Levetiracetam (Package insert). Smyrna, GA: UCB, Inc, 2008.
4.
NauKMDivertieGDValentinoAK, et al.Safety and efficacy of levetiracetam for critically ill patients with seizures. Neurocritical Care2009; 11: 34–37.
5.
PatelJSKoodaKIgneriLA. A narrative review of the impact of extracorporeal membrane oxygenation on the pharmacokinetics and pharmacodynamics of critical care therapies. Ann Pharmacother2023; 57(6): 706–726.
6.
PatsalosPN. Clinical pharmacokinetics of levetiracetam. Clin Pharmacokinet2004; 43(11): 707–724.
7.
NaikGSKodagaliRMathewBS, et al.Therapeutic drug monitoring of levetiracetam and lamotrigine: is there a need?Ther Drug Monit2015; 37(4): 437–444.
8.
DzierbaALAbramsDBrodieD. Medicating patients during extracorporeal membrane oxygenation: the evidence is building. Crit Care2017; 21: 66.
9.
NeiSDWittwerEKashaniKB, et al.Levetiracetam pharmacokinetics in a patient receiving continuous venovenous hemofiltration and venoarterial extracorporeal membrane oxygenation. Pharma2015; 35(8): e127–e130.
10.
ShekarKFraserJFSmithMT, et al.Pharmacokinetic changes in patients receiving extracorporeal membrane oxygenation. J Crit Care2012; 27: 741e9–741e18.
11.
Bilbao-MeseguerIBarrasaHAsin-PrietoE, et al.Population pharmacokinetics of levetiracetam and dosing evaluation in critically ill patients with normal or augmented renal function. Pharmaceutics2021; 13: 1690.
12.
OngCLGohPSJTeoMM, et al.Pharmacokinetics of levetiracetam in neurosurgical ICU patients. J Crit Care2021; 64: 255–261.
13.
SpencerDDJacobiJJuenkeJM, et al.Steady-state pharmacokinetics of intravenous levetiracetam in neurocritical care patients. Pharmacotherapy2011; 31(10): 934–941.
14.
UdyAARobertsJAShorrAF, et al.Augmented renal clearance in septic and traumatized patients with normal plasma creatinine concentrations: identifying at-risk patients. Crit Care2013; 17(1): R35.
15.
LaRochelleJMMurvantMDCreelAM, et al.Levetiracetam use during extracorporeal membrane oxygenation in an adolescent patient. Crit Care Shock2016; 19: 41–43.
ChhunSJullienVReyE, et al.Population pharmacokinetics of levetiracetam and dosing recommendation in children with epilepsy. Epilepsia2009; 50(5): 1150–1157.
18.
PatsalosPNBerryDJBourgeoisBF, et al.Antiepileptic drugs – best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, ILAE commission on therapeutic strategies. Epilepsia2008; 49(7): 1239–1276.