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甲状腺疾病中奥沙西泮的药代动力学

Oxazepam pharmacokinetics in thyroid disease.

作者信息

Scott A K, Khir A S, Bewsher P D, Hawksworth G M

出版信息

Br J Clin Pharmacol. 1984 Jan;17(1):49-53. doi: 10.1111/j.1365-2125.1984.tb04998.x.

Abstract

The pharmacokinetics of oxazepam, a drug mainly eliminated by a single step glucuronidation reaction, were studied in seven hyperthyroid and six hypothyroid patients before and after treatment. Oxazepam elimination half-life was shorter and apparent oral clearance higher in untreated hyperthyroid patients than after treatment. There was no significant change in oxazepam elimination in hypothyroid subjects. Time to peak concentration (tmax) was reduced in the hyperthyroid state. Hypothyroidism had no significant effect on tmax. Serum bilirubin concentration was lower in the patients while hyperthyroid before treatment than when euthyroid and also lower than in the hypothyroid patients. There was no significant correlation between serum bilirubin concentrations and oxazepam elimination. These results suggest that glucuronyl transferase activity is increased in hyperthyroidism but is not altered in most patients with hypothyroidism. The extent of increase in glucuronyl transferase activity is similar to that produced by enzyme inducing drugs.

摘要

奥沙西泮是一种主要通过单步葡萄糖醛酸化反应消除的药物,对7例甲状腺功能亢进患者和6例甲状腺功能减退患者在治疗前后的药代动力学进行了研究。未经治疗的甲状腺功能亢进患者中,奥沙西泮的消除半衰期较短,口服表观清除率较高,治疗后则相反。甲状腺功能减退患者的奥沙西泮消除无显著变化。甲状腺功能亢进状态下,达峰时间(tmax)缩短。甲状腺功能减退对tmax无显著影响。治疗前甲状腺功能亢进的患者血清胆红素浓度低于甲状腺功能正常时,也低于甲状腺功能减退患者。血清胆红素浓度与奥沙西泮消除之间无显著相关性。这些结果表明,甲状腺功能亢进时葡萄糖醛酸转移酶活性增加,但大多数甲状腺功能减退患者该酶活性未改变。葡萄糖醛酸转移酶活性增加的程度与酶诱导药物产生的程度相似。

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