Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.
Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona, USA.
Clin Pharmacol Ther. 2021 Feb;109(2):302-309. doi: 10.1002/cpt.2008. Epub 2020 Sep 6.
Phenytoin is an antiepileptic drug with a narrow therapeutic index and large interpatient pharmacokinetic variability, partly due to genetic variation in CYP2C9. Furthermore, the variant allele HLA-B*15:02 is associated with an increased risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in response to phenytoin treatment. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for the use of phenytoin based on CYP2C9 and/or HLA-B genotypes (updates on cpicpgx.org).
苯妥英是一种抗癫痫药物，治疗指数较窄，个体间药代动力学变异性较大，部分原因是 CYP2C9 的遗传变异。此外，变异等位基因 HLA-B*15:02 与苯妥英治疗后史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的风险增加相关。我们总结了已发表文献中的证据，支持这些关联，并根据 CYP2C9 和/或 HLA-B 基因型提供苯妥英使用的治疗建议（在 cpicpgx.org 上更新）。
