癫痫患者苯妥英的治疗监测

Therapeutic drug monitoring of pheytoin in epileptic subjects

特殊癫痫患者ＤＰＨ的给药方案主要依据临床效应，无须强调靶范围。群体药动学参数是优化个体给药的前提，稳态Ｂａｙｅｓｉａｎ法能较准确的预测给药速率，非稳态Ｂａｙｅｓｉａｎ法能估算Ｖｍａｘ、Ｋｍ、Ｖｄ、Ｆ，并预测中毒患者停药后何时恢复用药及用药剂量。游离浓度较总浓度更好地指导临床治疗，超滤法结合ＦＰＩＡ适用于常规监测ＤＰＨ游离浓度。唾液可取代血液样品用于游离药物监测。

osage adjustment of phenytoin(DPH)in particular epileptic is on the basis of clinical effct. It is not necessary tosharply define the target concentration strategy. Advantageous individual regiment based on representative DPH populationpharmacokinetic parameters.Steady-state Bayesian approach can more precisely predict DPH dosage rate than others.Non-steady-state Bayesian approach can estimate Vmax,Km,Vd,F.The inportance of this method lies in its potential to predict fu-ture serum DPH concentrations and/or dose requirements in the many clinicai situations. Free DPH concentration is a better in-dicator in guiding clinical therapy,Combining ultrafilter method with FPIA can routinely monitor DPH free concentration. Itis feasible to replace blood samples with saliva for free drug monitoring.