氯氮平相关的癫痫持续状态中的苯妥英中毒

Phenytoin intoxication in a clozapine-related prolonged seizure.

作者信息

Gandelman-Marton Revital, Theitler Jacques, Klein Colin, Rabey Jose Martin

机构信息

Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.

出版信息

J Emerg Med. 2008 Nov;35(4):407-9. doi: 10.1016/j.jemermed.2007.06.012. Epub 2007 Oct 25.

DOI:10.1016/j.jemermed.2007.06.012

PMID:17961958

Abstract

Phenytoin is a first-line drug for the treatment of status epilepticus. We report a case of phenytoin intoxication after intravenous phenytoin loading in a patient with clozapine-related seizures. To our knowledge, this is the first description of phenytoin intoxication due to CYP2C9 inhibition by clozapine. This case report is important because it supports the use of a lower intravenous loading dose of phenytoin in patients with clozapine-related status epilepticus.

摘要

苯妥英钠是治疗癫痫持续状态的一线药物。我们报告了一例在患有氯氮平相关性癫痫发作的患者静脉注射苯妥英钠负荷量后发生苯妥英钠中毒的病例。据我们所知，这是首次描述因氯氮平抑制CYP2C9导致苯妥英钠中毒的情况。该病例报告很重要，因为它支持在患有氯氮平相关性癫痫持续状态的患者中使用较低的苯妥英钠静脉负荷剂量。