丙戊酸与碳青霉烯类药物相互作用引起的癫痫发作。
Seizures from valproate-carbapenem interaction.
机构信息
Division of Pediatric Neurology, Nemour's Children's Clinic, and the Department of Neurology, Mayo Clinic, Jacksonville, Florida.
出版信息
Pediatr Neurol. 2013 Oct;49(4):279-81. doi: 10.1016/j.pediatrneurol.2013.03.022. Epub 2013 Aug 6.
BACKGROUND
Antiepileptic medication interactions can complicate the management of epilepsy, by either increasing or reducing the effective serum concentrations thereby causing adverse effects or loss of seizure control.
RESULTS
A 14-year-old girl with well-controlled juvenile absence epilepsy lost control of her seizures acutely following the administration of carbapenem for pneumonia. Serum valproate concentrations fell by 90% within 48 hours following carbapenem and returned to baseline following its discontinuation.
CONCLUSIONS
Awareness of this clinically significant interaction alters clinical practice by avoiding carbapenem or temporary use of adjunctive medication to prevent the clinical consequences of this significant drug interaction.
背景
抗癫痫药物相互作用可能会使癫痫的治疗复杂化，要么增加要么降低有效血清浓度，从而导致不良反应或失去对癫痫的控制。
结果
一名 14 岁女孩患有控制良好的青少年失神癫痫，在因肺炎给予碳青霉烯类药物治疗后，其癫痫发作突然失控。碳青霉烯类药物使用 48 小时内，血清丙戊酸浓度下降 90%，停药后恢复基线水平。
结论
对这种具有临床意义的相互作用的认识改变了临床实践，避免使用碳青霉烯类药物或暂时使用辅助药物，以防止这种严重药物相互作用的临床后果。
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