Feldman R G, Pippenger C E
J Clin Pharmacol. 1976 Jan;16(1):51-9. doi: 10.1002/j.1552-4604.1976.tb01491.x.
This study was undertaken to determine the relationship of serum ACD levels to dosage in a group of patients who had been seizure free for at least two years. It demonstrated that some patients remain completely seizure free with DPH and/or phenobarbital serum concentrations which are well below the reported "optimal" therapeutic ranges. In addition, medicating patients with anti-convulsant drugs solely on the basis of mg/kg of body weight does not assure optimal ACD levels in any given patient. Certain patients can be maintained completely seizure free controlled with DPH and/or Pb levels of less than 10 micrograms/ml. There are several explanations for the medication concentrations observed in these patients: (1) patient noncompliance in ingestion of prescribed medication; (2) altered drug utilization; (3) a mild focus which is maintained under control with lower DPH levels than those necessary to control a more active focus; or (4) epilepsy in remission. Our observations emphasize the importance of individual regulation of medications for seizure control.
本研究旨在确定一组至少两年无癫痫发作患者的血清抗惊厥药物（ACD）水平与药物剂量之间的关系。研究表明，一些患者在苯妥英钠（DPH）和/或苯巴比妥血清浓度远低于报告的“最佳”治疗范围时仍完全无癫痫发作。此外，仅根据每千克体重的毫克数给患者使用抗惊厥药物并不能确保任何特定患者的ACD水平达到最佳。某些患者可以通过低于10微克/毫升的DPH和/或苯巴比妥（Pb）水平维持完全无癫痫发作。对于这些患者中观察到的药物浓度有几种解释：（1）患者未遵医嘱服药；（2）药物利用改变；（3）轻度病灶通过低于控制更活跃病灶所需的DPH水平得以控制；或（4）癫痫缓解。我们的观察强调了个体化调整药物以控制癫痫发作的重要性。
