Kuranari M, Chiba S, Ashikari Y, Kodama Y, Sakata T, Takeyama M
Department of Clinical Pharmacy, Oita Medical University, Japan.
J Clin Pharm Ther. 1996 Apr;21(2):83-7. doi: 10.1111/j.1365-2710.1996.tb00005.x.
The interaction between clearance of phenytoin, valproic acid, phenobarbital and carbamazepine, and changes in body weight was determined in a 19-year-old obese woman with epilepsy (body weight 93 kg, BMI 36.3 kg/m2). The patient, who was given daily oral doses of 100 mg phenobarbital, 350 mg phenytoin, 800 mg valproic acid and 800 mg carbamazepine over 5 months was hospitalized for obesity treatment. The daily dosage of each drug was held constant during treatment of the obesity. Blood samples were taken five times. Weight reduction was 7 kg (7.5%) over 46 days. Estimation of the pharmacokinetic parameters in each drug was performed by Higuchi's Bayesian program, PEDA Pearson's correlation coefficient (r) between clearance and body weight was calculated for each drug. High positive correlations were found between clearance and body weight for phenytoin (r = 0.800) and valproic acid (r = 0.785), but not for phenobarbital (r = -0.227) and carbamazepine (r = 0.152). Clearance of phenytoin and valproic acid may be potentially affected by small changes in body weight.
在一名19岁的癫痫肥胖女性患者（体重93千克，体重指数36.3千克/平方米）中，确定了苯妥英、丙戊酸、苯巴比妥和卡马西平的清除率与体重变化之间的相互作用。该患者在5个月内每日口服100毫克苯巴比妥、350毫克苯妥英、800毫克丙戊酸和800毫克卡马西平，因肥胖治疗而住院。在肥胖治疗期间，每种药物的每日剂量保持不变。采集了五次血样。在46天内体重减轻了7千克（7.5%）。通过Higuchi贝叶斯程序对每种药物的药代动力学参数进行估计，计算每种药物清除率与体重之间的PEDA皮尔逊相关系数（r）。发现苯妥英（r = 0.800）和丙戊酸（r = 0.785）的清除率与体重之间存在高度正相关，但苯巴比妥（r = -0.227）和卡马西平（r = 0.152）不存在。苯妥英和丙戊酸的清除率可能会受到体重微小变化的潜在影响。
