苯妥英钠与丙戊酸钠药物动力学的相互影响及其临床意义

Phenytoin-valproate interaction: Pharmacokinetles and clinical significance

本文采用美国雅培公司产免疫荧光偏振分析仪,在4例成人癫痫中较详细地观察了PHT与VAL单用和合用,在不同时间中血清及唾液药物浓度。实验表明:(1)PHT与VAL合用时,各自的血清浓度较两药单用时明显降低。(2)PHT与VAL合用时,PHT的唾液浓度与血清浓度比值明显大于单用PHT时的比值,说明两药合用时PHT游离部分增加。(3)单用PHT达稳态血浓度时,PHT的唾液浓度与血清浓度的相关性优于两药合用时。(4)单用VAL达稳态血浓度,VAL的唾液浓度与血清浓度无相关性。文章对上述结果的临床意义进行讨论。

Using TDX-fluorescence polarized analyser, Concentration of phenytoin valproate both in blood serum and in saliva were determined singly and in combination. Results indicated as follows. When phenytoin and valproate were given simultaneously, concentration in blood serum was decreased as compared with separate administration. Ratio of phenytoin concentration between serum and saliva was increasef during combined administration. This suggested that proportion of free phenytoin was increased in combination of these two drugs. When a steady blood concentration was obtained, correspondency of concentration between saliva and serum with phenytoin alone was better than in conbination, whereas for valproate had not this correspondency whether used singly or in conjuction. This paper also discuss the clinical significance about those results.