Jann M W, Fidone G S
Clin Pharm. 1986 Oct;5(10):817-20.
Serum concentrations of the anticonvulsants phenytoin, phenobarbital, and carbamazepine were compared before and after patients received influenza vaccine. Serum drug concentrations were measured in patients at a state school for the mentally retarded who were receiving continuous anticonvulsant therapy with only one of the study drugs and taking no other medication regularly. Patients with hepatic or renal disease or other medical problems were excluded. All study patients had steady-state serum concentrations of the anticonvulsants before they were vaccinated with Influenza Virus Vaccine, USP, Types A and B, Whole Virus. Trough serum concentrations of anticonvulsants were measured by enzyme-mediated immunoassay technique immediately before vaccination and on days 7, 14, and 28. Data were excluded for patients who required dosage adjustments because of toxicity or seizures. On day 7, mean serum concentrations of phenytoin (15.16 +/- 5.52 micrograms/mL, n = 8) and phenobarbital (17.25 +/- 6.77 micrograms/mL, n = 27) were significantly higher than at baseline. Mean carbamazepine concentrations on day 7 (6.89 +/- 2.18 micrograms/mL, n = 20) were not significantly greater than baseline; however, there was a significant increase from day 7 to day 14. In patients who are receiving phenytoin, phenobarbital, or other drugs metabolized by the cytochrome P-450 system, serum concentrations of these drugs may increase as a result of influenza vaccination, and dosage adjustments may be necessary.
比较了患者接种流感疫苗前后抗惊厥药物苯妥英、苯巴比妥和卡马西平的血清浓度。在一所智障人士公立学校中，对正在接受仅一种研究药物的持续抗惊厥治疗且未规律服用其他药物的患者测定血清药物浓度。排除患有肝脏或肾脏疾病或其他医学问题的患者。所有研究患者在接种美国药典甲型和乙型全病毒流感病毒疫苗之前，抗惊厥药物的血清浓度均处于稳态。在接种前以及接种后第7天、第14天和第28天，通过酶介导免疫测定技术测量抗惊厥药物的谷浓度血清。因毒性或癫痫发作而需要调整剂量的患者的数据被排除。在第7天，苯妥英（15.16±5.52微克/毫升，n = 8）和苯巴比妥（17.25±6.77微克/毫升，n = 27）的平均血清浓度显著高于基线水平。第7天卡马西平的平均浓度（6.89±2.18微克/毫升，n = 20）与基线水平相比无显著升高；然而，从第7天到第14天有显著升高。正在接受苯妥英、苯巴比妥或其他由细胞色素P - 450系统代谢的药物治疗的患者，流感疫苗接种可能导致这些药物的血清浓度升高，可能需要调整剂量。
