Urashima Y, Urashima K, Ohnishi M, Matsushita K, Suzuki K, Kurachi K, Nishihara M, Katsumata T, Myotoku M, Ikeda K, Hirotani Y
Pharmazie. 2019 Sep 1;74(9):559-562. doi: 10.1691/ph.2019.9532.
The gastrointestinal absorption of phenytoin (PHT), an antiepileptic drug, is often affected by its interaction with co-administered enteral nutrients through a nasogastric (NG) tube, resulting in decreased plasma PHT concentration. In this study, we measured the recovery rate (%) of PHT (Aleviatin powder) passed through an NG tube when co-administered with distilled water or enteral nutrients (F2, Racol NF, Ensure Liquid and Renalen LP). We also measured plasma PHT levels in rats, after oral co-administration of PHT with enteral nutrients. We demonstrate that PHT recovery rate was close to 100 % in all cases after passage through the NG tube. In the rat study, the AUC of PHT concentration after oral administration significantly decreased when it was co-administered with F2 and Racol NF compared to distilled water. However, the AUC of PHT was unchanged when co-administered with F2 2 h after initial PHT administration. We therefore conclude that the co-administration of PHT with F2 and Racol NF caused a reduction in the absorption of PHT from the gastrointestinal tract to the blood, without adsorption to the NG tube. The administration of enteral nutrients 2 h after PHT is one clear way to prevent a decrease in plasma PHT concentration.
抗癫痫药物苯妥英（PHT）的胃肠道吸收常受其通过鼻胃管（NG）与同时给予的肠内营养物质相互作用的影响，导致血浆PHT浓度降低。在本研究中，我们测定了PHT（Aleviatin粉末）与蒸馏水或肠内营养物质（F2、Racol NF、安素液和瑞能LP）同时给药时通过NG管后的回收率（%）。我们还测定了大鼠口服PHT与肠内营养物质共同给药后的血浆PHT水平。我们证明，PHT通过NG管后在所有情况下的回收率均接近100%。在大鼠研究中，与蒸馏水相比，PHT与F2和Racol NF共同给药时口服后PHT浓度的AUC显著降低。然而，在最初给予PHT 2小时后与F2共同给药时，PHT的AUC没有变化。因此，我们得出结论，PHT与F2和Racol NF共同给药会导致PHT从胃肠道到血液的吸收减少，而不会吸附到NG管上。在PHT给药2小时后给予肠内营养物质是防止血浆PHT浓度降低的一种明确方法。
