Clearance of phenytoin and valproic acid is affected by a small body weight reduction in an epileptic obese patient: A case study
Clearance of phenytoin and valproic acid is affected by a small body weight reduction in an epileptic obese patient: A case study
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DOI：
10.1111/j.1365-2710.1996.tb00005.x
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发表时间：
1996-04-01
影响因子：
2
通讯作者：
Takeyama, M
中科院分区：
文献类型：
--
作者：
Kuranari, M;Chiba, S;Takeyama, M
研究了一名19岁肥胖癫痫女性（体重93 kg， BMI 36.3 kg/m）的苯妥英、丙戊酸、苯巴比妥和卡马西平的清除率与体重变化之间的相互作用。患者每日口服苯巴比妥100 mg、苯妥英350 mg、丙戊酸800 mg、卡马西平800 mg，治疗肥胖5个月。在治疗肥胖期间，每种药物的日剂量保持不变。血样采集了五次。在46天内体重减轻了7公斤（7.5%）。采用Higuchi's Bayesian程序估计各药物的药代动力学参数，计算各药物清除率与体重之间的PEDA Pearson相关系数(r)。苯妥英（r = 0.800）和丙戊酸（r = 0.785）的清除率与体重呈正相关，而苯巴比妥（r = - 0.227）和卡马西平（r = 0.152）的清除率与体重呈正相关。苯妥英和丙戊酸的清除可能受到体重微小变化的潜在影响。
The interaction between clearance of phenytoin, valproic acid, phenobarbital and carbamazepine, and changes in body weight was determined in a 19-year-old obese woman with epilepsy (body weight 93 kg, BMI 36.3 kg/m(2)). The patient, who was given daily oral doses of 100 mg phenobarbital, 350 mg phenytoin, 800 mg valproic acid and 800 mg carbamazepine over 5 months was hospitalized for obesity treatment. The daily dosage of each drug was held constant during treatment of the obesity. Blood samples were taken five times. Weight reduction was 7 kg (7.5%) over 46 days. Estimation of the pharmacokinetic parameters in each drug was performed by Higuchi's Bayesian program, PEDA Pearson's correlation coefficient (r) between clearance and body weight Was calculated for each drug. High positive correlations were found between clearance and body weight for phenytoin (r = 0.800) and valproic acid (r = 0.785), but not for phenobarbital (r = - 0.227) and carbamazepine (r = 0.152). Clearance of phenytoin and valproic acid may be potentially affected by small changes in body weight.