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治疗药物监测是近十年来临床医学发展最快的学科之一,其中抗癫痫药物浓度监测对癫痫的治疗是近年来的重要进展,可用作指导治疗和监测疗效。在抗癫痫药物中,苯妥英钠(DPH)至今仍为治疗全身强直阵挛发作(大发作)与部分发作的首选药物之一。近年来,根据药物代谢动力学的研究表明,DPH具有饱和代谢动力学的特点。即稳态血浓度与口服剂量间不是直线关系,特别是当血浓度接近治疗范围的时候更为突出。血清有效浓度范围较小,病人对药物的反应个体差异较大,因此对DPH血浓监测就显得特别重要。现就DPH浓度监测的临床应用问题分述如下。
Therapeutic drug monitoring is one of the fastest growing clinical medical sciences in recent ten years. The treatment of epilepsy by antiepileptic drug concentration monitoring is an important progress in recent years and can be used as a guide to treatment and monitor the curative effect. Among antiepileptic drugs, phenytoin sodium (DPH) is still one of the first choice drugs for the treatment of generalized menopausal (major) and partial seizures. In recent years, studies based on pharmacokinetics have shown that DPH has a characteristic of saturated metabolic kinetics. That steady-state blood concentration and oral dose is not a linear relationship, especially when the blood concentration close to the treatment when the more prominent. Serum effective concentration range is small, the patient’s response to the drug individual differences, so monitoring of DPH blood concentration is particularly important. Now on the clinical application of DPH concentration monitoring issues are described below.