Rodin E A, DeSousa G, Haidukewych D, Lodhi R, Berchou R C
Arch Neurol. 1981 Apr;38(4):240-2. doi: 10.1001/archneur.1981.00510040066011.
A dissociation of free vs bound phenytoin levels is frequently observed in the presence of therapeutic doses of valproate sodium. This leads at times to symptoms and signs of phenytoin intoxication despite "therapeutic" plasma levels. The importance of supplementing bound levels with free levels is stressed when combined therapy of this type is used in epileptic patients.
在使用治疗剂量的丙戊酸钠时,经常会观察到游离苯妥英水平与结合苯妥英水平的解离。这有时会导致尽管血浆水平处于“治疗范围”,但仍出现苯妥英中毒的症状和体征。当在癫痫患者中使用这种联合治疗时,强调用游离水平补充结合水平的重要性。