Soriano Sulpicio G, Martyn J A Jeevendra
Harvard Medical School and Children's Hospital, Boston, Massachusetts 02115, USA.
Clin Pharmacokinet. 2004;43(2):71-81. doi: 10.2165/00003088-200443020-00001.
Prolonged administration of antiepileptic drugs is associated with several drug interactions. In the field of anaesthesia and critical care, patients exhibit both sensitivity and resistance to non-depolarising neuromuscular blockers (NDNMBs) after acute and long-term administration of antiepileptic drugs, respectively. Although antiepileptic therapy alone has only mild neuromuscular effects, acutely administered antiepileptic drugs can potentiate the neuromuscular effects of NDNMBs as a result of direct pre- and post-junctional effects. Resistance to NDNMBs during long-term antiepileptic therapy is due to multiple factors operating alone or in combination, including induction of hepatic drug metabolism, increased protein binding of the NDNMBs and/or upregulation of acetylcholine receptors.
长期服用抗癫痫药物会引发多种药物相互作用。在麻醉和重症监护领域，患者在分别急性和长期服用抗癫痫药物后，对非去极化神经肌肉阻滞剂（NDNMBs）会表现出敏感性和耐受性。虽然单独的抗癫痫治疗仅有轻微的神经肌肉效应，但急性给药的抗癫痫药物由于对神经肌肉接头前和接头后的直接作用，会增强NDNMBs的神经肌肉效应。长期抗癫痫治疗期间对NDNMBs产生耐受性是由于多种因素单独或共同作用的结果，这些因素包括肝药代谢的诱导、NDNMBs蛋白结合增加和/或乙酰胆碱受体上调。
