Elliott H W
Br J Anaesth. 1976 Oct;48(10):1017-23. doi: 10.1093/bja/48.10.1017.
The metabolism of lorazepam by man and four other species is reviewed. Lorazepam and its metabolites in blood, urine and faeces were identified by thin-layer and gas chromatography and by mass spectrometry. The principal metabolite in man, dog, pig and cat is the glucuronide, but the rat produces other metabolites after small doses of lorazepam, and significant amounts of the glucuronide only after high doses. Since all metabolites, except the glucuronide, occur in small quantities only in man, most studies in man have been confined to an estimation of gree and conjugated lorazepam. Blood concentrations of unconjugated lorazepam peak at 1-4 h, significant concentrations persisting for 24 h and decreasing slowly over the next 24 h. About 95% of a dose of lorazepam was accounted for in urine and faeces over a period of 5 days; 74.5% was excreted in the urine as lorazepam glucuronide and 13.5% as minor metabolites. The excretory half-life was 12 h. The blood concentrations and excretion rates are compatible with the clinical effects of lorazepam.
本文综述了人及其他四种动物对劳拉西泮的代谢情况。通过薄层色谱、气相色谱及质谱法对血液、尿液和粪便中的劳拉西泮及其代谢产物进行了鉴定。人、狗、猪和猫体内的主要代谢产物是葡萄糖醛酸结合物,但大鼠在小剂量服用劳拉西泮后会产生其他代谢产物,只有在大剂量服用后才会产生大量的葡萄糖醛酸结合物。由于除葡萄糖醛酸结合物外的所有代谢产物在人体内含量都很少,因此大多数人体研究都局限于对游离型和结合型劳拉西泮的评估。未结合的劳拉西泮血药浓度在1 - 4小时达到峰值,有效浓度持续24小时,并在接下来的24小时内缓慢下降。在5天的时间里,约95%的劳拉西泮剂量可在尿液和粪便中找到;74.5%以劳拉西泮葡萄糖醛酸结合物的形式经尿液排泄,13.5%以次要代谢产物的形式排泄。排泄半衰期为12小时。血药浓度和排泄率与劳拉西泮的临床效果相符。