药代动力学的药物相互作用与苯妥英(第一部分)。
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国家RL,埃文斯,米尔恩RW光碟
药代动力学的药物相互作用与苯妥英(第一部分)。
Pharmacokinet。1990年1月,18 (1):37-60。
- PubMed ID
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2178849 (在PubMed]
- 文摘
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苯妥英,主要用作抗惊厥的代理,有相对较低的治疗指数,监测血浆苯妥英浓度常被用来帮助指导治疗。有属性,使它参与药代动力学的相互作用,大量的报道。这些属性包括:低溶解度和胃肠道吸收的速度;血浆蛋白结合的程度相对较高;由于饱和的间隙非线性氧化生物转化;和诱导肝微粒体酶的能力。因为它的狭窄的治疗范围,药物的相互作用导致血浆苯妥英浓度的改变可能是临床上重要的。等交互往往是最初报道或苯妥英中毒病例的有效性下降。药物可能会修改苯妥英的药物动力学通过改变其吸收,血浆蛋白质绑定,或肝生物转化;吸收和/或生物转化的改变可能导致游离血浆苯妥英两个浓度发生变化,因此,临床效果。 Preparations which may decrease the gastrointestinal absorption of phenytoin include nutritional formulae and charcoal. There are many reports of drugs which may increase (e.g. folic acid, dexamethasone and rifampicin) or decrease (e.g. valproic acid, sulthiame, isoniazid, cimetidine, phenylbutazone, chloramphenicol and some sulphonamides) the metabolism of phenytoin. It is important to bear in mind that, as a result of its non-linear clearance, changes in phenytoin absorption and/or biotransformation will lead to more than proportionate changes in plasma drug concentration. Drugs which may displace phenytoin from plasma albumin include valproic acid, salicylic acid, phenylbutazone and some sulphonamides. Although an alteration in the unbound fraction of phenytoin in plasma would not, in itself, be expected to alter the unbound plasma phenytoin concentration, the interpretation of total plasma concentrations for therapeutic drug monitoring may be confounded. Some drugs appear to alter phenytoin pharmacokinetics via dual mechanisms (e.g. valproic acid and phenylbutazone), while for other compounds the mechanism of interaction has not been fully elucidated. Phenytoin has been reported to alter the pharmacokinetics of a large number of drugs. The majority of these interactions arise because phenytoin is a potent inducer of cytochrome P450 microsomal enzymes, and therefore may increase the clearance of drugs which are extensively metabolised; drugs affected include carbamazepine, theophylline, methadone, prednisolone, dexamethasone, metyrapone and several cardiac antiarrhythmic agents. With all of these, the resultant decrease in plasma concentrations may be clinically important.(ABSTRACT TRUNCATED AT 400 WORDS)
DrugBank数据引用了这篇文章
- 药物
- 药物的相互作用Learn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
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药物 交互 整合药物之间
在您的软件的交互Fosphenytoin 利眠宁 的血清浓度Fosphenytoin时可以增加结合利眠宁。 苯妥英 利眠宁 苯妥英的血清浓度可以增加时结合利眠宁。
