Guidry J R, Eastwood T F, Curry S C
West J Med. 1989 Jun;150(6):659-61.
Phenytoin absorption is reportedly significantly altered in the presence of continuously administered enteral feedings, resulting in subtherapeutic serum phenytoin concentrations and loss of seizure control. We administered 500 mg of phenytoin as the suspension to five volunteers who were not receiving enteral feeding, again while they ingested protein hydrolysate enteral feedings hourly, and again during hourly ingestions of meat-base enteral feeding. Serum phenytoin concentrations, measured 3, 6, 9, 12, and 24 hours after phenytoin ingestion, were lowest with protein hydrolysate feedings. Mean serum phenytoin concentrations were consistently higher with the meat-base feeding than with the protein hydrolysate formula, although levels did not reach those of the control period. These data are in keeping with our previous observation that it is easier to attain therapeutic serum phenytoin concentrations in patients receiving a meat-base enteral feeding than in those receiving a protein hydrolysate formula.
据报道，在持续给予肠内营养的情况下，苯妥英的吸收会发生显著改变，导致苯妥英血清浓度低于治疗水平，癫痫控制失效。我们给5名未接受肠内营养的志愿者服用了500毫克苯妥英悬浮液，之后让他们每小时摄入蛋白水解物肠内营养，再次服用苯妥英悬浮液，然后又让他们每小时摄入肉类基础肠内营养并再次服用苯妥英悬浮液。在摄入苯妥英后3、6、9、12和24小时测量的苯妥英血清浓度，在摄入蛋白水解物肠内营养时最低。与蛋白水解物配方相比，肉类基础肠内营养时的平均苯妥英血清浓度一直较高，尽管该水平未达到对照期的水平。这些数据与我们之前的观察结果一致，即接受肉类基础肠内营养的患者比接受蛋白水解物配方的患者更容易达到苯妥英治疗性血清浓度。
