Anca Dana Buzoianu 1, Octavia Sabin 1, Corina Ioana Bocşan 1, Claudia Militaru 1
1 Department of Clinical Pharmacology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Abstract
One of the currently studied hypotheses concerning the resistance to the treatment of epilepsy is the overexpression of efflux transporters such as P-glycoprotein at the intestinal and blood-brain barrier that prevents achieving an optimal drug concentration in the brain. MDR1 gene variations affect the expression and function of P-gp, as demonstrated by the association between ABCB1 gene polymorphism and the risk of drug-resistance in patients with lymphoproliferative disorders. P-gp is a major determining factor for the availability and effect of in vivo drugs and is involved in drug interactions that may become clinically relevant, such as the variability between the absorption and biodistribution of carbamazepine and phenytoin. There are few studies on refractory epilepsy, with contradictory results and conducted on different ethnic populations. The introduction of pharmacogenetic studies in medical practice, with the purpose of better prescribing antiepileptics and reducing refractory cases requires strong evidence to support investigations such as genotyping.