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ID 13772
Eprint ID
13772
FullText URL
Thumnail 106_757.pdf 267 KB
Title Alternative
Influence of the combined treatment with phenytoin or valproate on serum concentration of carbamazepine
Author
Kishima, Miyuki
Yao, Kazuhisa
Yasuhara, Kanako
Suemaru, Katsuya
Furuno, Katsushi
Oishi, Ryozo
Gomita, Yutaka
Ohtahara, Shunsuke
Abstract
To clarify the pharmacokinetic interaction in poly-therapy for epilepsy, the serum concentration of carbamazepine (CZB) was measured in epileptic patients to whom CBZ had been prescribed chronically with or without phenytoin (PHT) and sodium valproate (VPA). The serum CBZ concentrations increased with increasing doses of CBZ, but increased less at higher doses. Chiliren (<12 yrs) showed lower serum CBZ concentrations than patients 12 years old and older. The L/D ratios (L : CBZ level, D : dose/body weight) were significantly decreased by the combined treatment with PHT and VPA in a dose-dependent manner, probably due to an induction of metabolizing enzyme. These findings suggest that especially in the case of change of the drug therapy from mono-therapy to mono therapy, careful monitoring of serum concentration is necessary.
Keywords
カルバマゼピン
フェニトイン
バルプロ酸
血清中濃度
薬物相互作用
Note
原著
Published Date
1994-08
Publication Title
岡山医学会雑誌
Publication Title Alternative
Journal of Okayama Medical Association
Volume
volume106
Issue
issue7-8
Publisher
岡山医学会
Publisher Alternative
Okayama Medical Association
Start Page
757
End Page
762
ISSN
0030-1558
NCID
AN00032489
Content Type
Journal Article
Official Url
https://www.jstage.jst.go.jp/article/joma1947/106/7-8/106_7-8_757/_article/-char/ja/
Related Url
http://www.okayama-u.ac.jp/user/oma/index.html
References
1) Bourgeois BFD : Problems of combination drug therapy in children. Epilepsia (1988) 29 (Suppl. 3), S20-S24.
2) 細川 清:てんかんに対する合理的薬物療法.医学のあゆみ(1991)156,310-315.
3) 古野勝志,福田 保,荒木泰典:Fluorostat System を用いたSLFIA法による血清中 Valproate の濃度測定.神経精神薬理(1985)7,35-40.
4) 扇谷 明:てんかんの薬物療法の新しい展開―成人―.MEDICO(1993)24,9-11.
5) 奥野武彦,浜田 泰,服部春生:てんかんの薬物療法の新しい展開―小児―.MEDICO(1993)24,12-14.
6) Reynolds EH : The prevention of chronic epilepsy. Epilepsia (1988) 29 (Suppl. 1), S25-S28.
7) Cloyd JC, Levy RH and Wedlund PH : Relationship between carbamazepine concentration and extent of enzyme autoinduction. Epilepsia (1986) 27, 592.
8) Bertilsson L, Hojor B, Tybring G, Osterloh J and Rane A : Autoinduction of carbamazepine metabolism in children examined by a stable isotope technique. Clin Pharamacol & Ther (1980) 27, 83-88.
9) 堀 了平,奥村勝彦,北澤式文,神代 昭,齋藤侑也,樋口 駿,水柿道直,山路 昭,力久忠昭,谷川原祐介:日本人における population pharmacokinetic parameters の推定 Ⅰ.パルプロ酸.薬剤学(1989)49,148-156.
10) 鈴木彰人,湯川栄二,大坪健司,家入一郎,手嶋大輔,樋口 駿,青山敏信:小児におけるカルバマゼピンおよびバルプロ酸の血中濃度―L/D比と年齢の関係および併用薬による影響―.病院薬学(1991)17,26-33.
11) 日高慎二,高村徳人,伊東健一,奥村 学,小野浩重,濱田有美子,瀬尾 量,前田共秀,鶴岡道雄:バルプロ酸およびカルバマゼピン服用患者の血清中薬物濃度に及ぼす他剤併用の影響.日本病院薬剤師会雑誌(1992)28,563-565.
12) Theodore WH, Narang PK, Holmes MD, Reeves P and Nice FJ : Carbamazepine and its epoxide : Relation of plasma levels to toxicity and seizure control. Ann Neurol (1989) 25, 194-196.
13) Cloys J : Pharmacokinetic pitfalls of present antiepileptic medications. Epilepsia (1991) 32 (Suppl. 5), S53-S65.
14) McKee PJW, Blacklaw J, Butler E, Gillham RA and Brodie MJ : Variability and clinical relevance of the interaction between sodium valproate and carbamazepine in epileptic patients. Epilepsy Res (1992) 11, 193-198.
15) Chapron DJ, LaPierre BA and Abou-Elkair M : Unmasking the significant enzyme-inducing effects of phenytoin on serum carbamazepine concentrations during phenytoin withdrawal. Ann Pharmacother (1993) 27, 708-711.
language
日本語
Copyright Holders
岡山医学会
File Version
publisher
Refereed
True
Eprints Journal Name
joma