Czuczwar S J, Małek U, Kleinrok Z
Department of Pharmacology, Medical School, Lublin, Poland.
Neuropharmacology. 1990 Oct;29(10):943-8. doi: 10.1016/0028-3908(90)90145-h.
Among three calcium channel inhibitors studied, nifedipine (20 mg/kg) moderately inhibited pentylenetetrazol (115 mg/kg, s.c.)-induced convulsions, whilst diltiazem (up to 20 mg/kg) and verapamil (up to 20 mg/kg) were without effect. The combinations of nifedipine (10 and 20 mg/kg) with valproate (100 mg/kg) or phenobarbital (6.25 mg/kg) resulted in significant protection against pentylenetetrazol-induced seizures. Combined treatment of nifedipine (5-20 mg/kg) with ethosuximide (100 mg/kg) also provided a clearcut anticonvulsant action. The antiepileptic drugs alone, in the above doses, were ineffective. The combination of diltiazem (10-20 mg/kg) and ethosuximide (100 mg/kg) produced protection against pentylenetetrazol, comparable to that of ethosuximide (200 mg/kg) alone. No pharmacokinetic interactions were found in the case of ethosuximide, whilst nifedipine (10 mg/kg) increased the levels of phenobarbital and valproate in plasma. The combination of diltiazem with the remaining antiepileptics were ineffective. Verapamil (up to 20 mg/kg) was without effect upon the action of the antiepileptic drugs tested. Finally, none of the calcium channel inhibitors studied influenced the action of diazepam (0.2 mg/kg). It may be concluded that combinations of ethosuximide, with either nifedipine or diltiazem, may be promising for the treatment of absence epilepsy.
在所研究的三种钙通道抑制剂中,硝苯地平(20毫克/千克)可中度抑制戊四氮(115毫克/千克,皮下注射)诱发的惊厥,而地尔硫䓬(剂量高达20毫克/千克)和维拉帕米(剂量高达20毫克/千克)则无此作用。硝苯地平(10和20毫克/千克)与丙戊酸盐(100毫克/千克)或苯巴比妥(6.25毫克/千克)联合使用,可显著预防戊四氮诱发的癫痫发作。硝苯地平(5 - 20毫克/千克)与乙琥胺(100毫克/千克)联合治疗也具有明确的抗惊厥作用。上述剂量的单一抗癫痫药物无效。地尔硫䓬(10 - 20毫克/千克)与乙琥胺(100毫克/千克)联合使用对戊四氮产生的保护作用,与单独使用乙琥胺(200毫克/千克)相当。在乙琥胺的情况下未发现药代动力学相互作用,而硝苯地平(10毫克/千克)可提高血浆中苯巴比妥和丙戊酸盐的水平。地尔硫䓬与其余抗癫痫药物联合使用无效。维拉帕米(剂量高达20毫克/千克)对所测试的抗癫痫药物的作用无影响。最后,所研究的钙通道抑制剂均未影响地西泮(0.2毫克/千克)的作用。可以得出结论,乙琥胺与硝苯地平或地尔硫䓬联合使用可能对失神性癫痫的治疗有前景。