苯妥英在严重中毒时的复杂处置模式。

A complex pattern of disposition of phenytoin in severe intoxication.

作者信息

Pruitt A W, Zwiren G T, Patterson J H, Dayton P G, Cook C E, Wall M E

出版信息

Clin Pharmacol Ther. 1975 Jul;18(1):112-20. doi: 10.1002/cpt1975181112.

DOI:10.1002/cpt1975181112

Abstract

A 5-year-old child developed phenytoin (diphenylhydantoin, DPH) toxicity after receiving 500 mg of the drug daily for 3 weeks. Plasma, urine, and duodenal fluid were collected for assay of DPH and its metabolites. The peak plasma concentration of DPH was 108 mug/ml, and the decline in plasma level did not fit first-order kinetics. The para-hydroxy, meta-hydroxy, and dihydrodiol metabolites of DPH were measured in urine; duodenal aspirate contained both DPH and the para-hydroxy metabolite. Plasma pH may affect distribution of DPH since in vitro binding of DPH to human albumin increased as pH increased.

摘要

一名5岁儿童在每天服用500毫克苯妥英（二苯乙内酰脲，DPH）3周后出现苯妥英中毒。采集血浆、尿液和十二指肠液用于检测DPH及其代谢产物。DPH的血浆峰值浓度为108微克/毫升，血浆水平的下降不符合一级动力学。在尿液中检测了DPH的对羟基、间羟基和二氢二醇代谢产物；十二指肠抽吸物中既含有DPH也含有对羟基代谢产物。血浆pH值可能影响DPH的分布，因为在体外，DPH与人白蛋白的结合随着pH值升高而增加。