Pisani F D, Di Perri R G
Neurology. 1981 Apr;31(4):467-70. doi: 10.1212/wnl.31.4_part_2.467.
Plasma and saliva phenytoin was evaluated at fixed-time intervals after intravenous (IV) administration of 800 mg valproate in epileptics chronically treated with phenytoin monotherapy. A significant fall in plasma and a concurrent significant increase of the drug in saliva (which reflects the free amount in plasma) were observed, with maximal changes occurring at 30 to 90 minutes after valproate infusion. Present data indicate that valproic acid is able to displace phenytoin from plasma proteins, suggesting a critical evaluation of the routine phenytoin plasma proteins, suggesting a critical evaluation of the routine phenytoin plasma levels (which reflect free + bound fraction) when this drug is administered concurrently with sodium valproate.
在长期接受苯妥英单药治疗的癫痫患者静脉注射800毫克丙戊酸盐后，在固定时间间隔对血浆和唾液中的苯妥英进行了评估。观察到血浆中苯妥英显著下降，同时唾液中该药物显著增加（唾液中的药物反映血浆中的游离量），丙戊酸盐输注后30至90分钟出现最大变化。目前的数据表明，丙戊酸能够将苯妥英从血浆蛋白中置换出来，这表明当该药物与丙戊酸钠同时给药时，需要对常规的苯妥英血浆水平（反映游离+结合部分）进行严格评估。
