Abarbanel J, Herishanu Y, Rosenberg P, Eylath U
J Neurol. 1978 May 18;218(2):137-44.
The phenytoin plasma levels were measured in 45 epileptic patients whose only treatment was phenytoin. The plasma of 20 other patients receiving both phenytoin and phenobarbital was also tested for concentration of these two drugs and 18 patients treated with phenytoin, phenobarbital and primidone were investigated in the same way. The results were used to calculate the plasma levels of phenytoin in relation to dosage and to measure the effect of the simultaneous use of phenobarbital on the phenytoin plasma levels and of primidone together with phenobarbital on phenytoin concentration. The results led to the following conclusions: The population of epileptic patients can be divided into 2 groups. In the first group the patients reach equilibrium at the relatively high phenytoin plasma level for a given dose of phenytoin, and in the second group the phenytoin plasma level tends to be significantly lower for parallel dosages. Both groups, in their behavior, obey mathematically an exponential graph specific for each group. Phenobarbital tends to lower the plasma phenytoin level when the two drugs are used simultaneously. It is also possible, by the graphs produced, to calculate the expected phenytoin plasma levels when using the drugs together. Primidone and phenobarbital together decrease the phenytoin level much more than expected from the effect of phenobarbital alone.
对45例仅接受苯妥英治疗的癫痫患者测定了苯妥英血浆水平。还对另外20例同时接受苯妥英和苯巴比妥治疗的患者的血浆进行了这两种药物浓度的检测，并以同样的方式对18例接受苯妥英、苯巴比妥和扑米酮治疗的患者进行了研究。结果用于计算与剂量相关的苯妥英血浆水平，并测定同时使用苯巴比妥对苯妥英血浆水平的影响以及扑米酮与苯巴比妥同时使用对苯妥英浓度的影响。结果得出以下结论：癫痫患者群体可分为两组。在第一组中，对于给定剂量的苯妥英，患者在相对较高的苯妥英血浆水平达到平衡，而在第二组中，对于平行剂量，苯妥英血浆水平往往显著较低。两组在行为上在数学上都符合各自特定的指数图。当同时使用这两种药物时，苯巴比妥倾向于降低血浆苯妥英水平。通过所绘制的图表，也可以计算出同时使用这些药物时预期的苯妥英血浆水平。扑米酮和苯巴比妥一起降低苯妥英水平的程度比仅使用苯巴比妥的效果所预期的要大得多。
