Hydzik Piotr, Gomółka Ewa, Wilimowska Jolanta
Oddzial (Kliniczny) Toksykologii i Chorób Srodowiskowych, WSS im. L. Rydygiera w Krakowie.
Przegl Lek. 2007;64(4-5):304-7.
Two cases (woman and man) of the extended suicidal poisonings with carbamazepine and phenothiazine derivatives are presented. Drug's blood concentrations during poisoning were monitored. We examine correlation between patient's general status and the drug's blood concentrations, carbamazepine and phenothiazine derivatives interaction due to young, healthy people who received no earlier treatment.
blood samples for toxicological examinations were collected at 0, 12, 24 and 48 hours after admission. Carbamazepine was determined using FPIA method and phenothiazines derivatives by HPLC-DAD. The highest blood concentrations were for carbamazepine: 30.92 mg/l (woman) and 20.95 ng/ml (man); for phenothiazine derivatives: 927 ng/ml (woman) and 733 ng/ ml (man).
In both cases severe central nervous depression was observed due to summed action of the drugs. Sex and individual differences in cytochromes activities should have influence to carbamazepine metabolism and faster elimination time in woman. In the case of phenothiazine derivatives faster elimination time in man was observed. The differences in elimination times between compared drugs confirm their different metabolic routes.
本文介绍了两例（一女一男）因卡马西平和吩噻嗪衍生物导致的长期自杀性中毒案例。对中毒期间药物的血药浓度进行了监测。我们研究了患者一般状况与血药浓度之间的相关性，以及由于年轻健康且未接受过早期治疗的人群中卡马西平和吩噻嗪衍生物之间的相互作用。
入院后0、12、24和48小时采集用于毒理学检查的血样。采用荧光偏振免疫分析（FPIA）法测定卡马西平，采用高效液相色谱-二极管阵列检测法（HPLC-DAD）测定吩噻嗪衍生物。卡马西平的最高血药浓度为：30.92毫克/升（女性）和20.95纳克/毫升（男性）；吩噻嗪衍生物的最高血药浓度为：927纳克/毫升（女性）和733纳克/毫升（男性）。
在这两例病例中，由于药物的联合作用，均观察到严重的中枢神经抑制。细胞色素活性的性别和个体差异应会影响卡马西平的代谢，且女性的消除时间更快。在吩噻嗪衍生物方面，观察到男性的消除时间更快。所比较药物之间消除时间的差异证实了它们不同的代谢途径。
