通过TDM分析1例药物中毒

来源 :中国临床药学杂志 | 被引量 : 0次 | 上传用户:zhegeyonghukeyi
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[病例]女,18a,临床诊断为癫痫.曾用卡马西平(carbamazepine,CBZ)、苯巴比妥(phenobarbi-tal,PB)、苯妥英钠(phenytoinum natricum.DPH)治疗多次效果不佳,仍时有发作.经报纸介绍汇款至山西运城某医院购得中药制剂癫痫灵片和癫草灵片(运卫药准字89).用药情况如下:癫草灵片每次1片tid;癫痫灵片,每次1片tid.同时停用CBZ、PB、DPH等药物.除此药外病人未服用其他药物.用药2wk后病情得以控制,继续服用二月余,病人主诉全身乏力.腿软以至行走困难,终日嗜睡.经我院门诊治疗后减量至:癫草灵片每次1片qd;癫痫灵片每次1片qd,减量后乏力嗜睡等症状有明显改善.根据病人减低剂量前症状,怀疑可能是药物中毒,于减量后d10进行TDM监测,用反相HPLC法测得血清中CBZ谷浓度为8.08μg/ml:PB谷浓度为 [Case] ​​Female, 18a, clinically diagnosed as epilepsy. Previously treated with carbamazepine (CBZ), phenobarbi-tal (PB) and phenytoinum natricum (DPH) There are still seizures. Remitted to the newspaper by the newspaper to buy a hospital in Shanxi Yuncheng epilepsy tablets and Epilepsy tablets (Yun Wei medicine quasi-89). Drugs are as follows: Epilepsy tablets each tid; epilepsy Tablets, each time a tablet tid.At the same time disabled CBZ, PB, DPH and other drugs.In addition to this drug patients did not take other drugs .2wk medication to control the disease, continue to take more than February, the patient complained of generalized weakness. As well as difficult to walk all day long drowsiness after treatment by our hospital reduction to: Ephedra gelatine one qd each time; epilepsy tablets every one qd, fatigue, drowsiness and other symptoms have been significantly reduced.According to the patient to reduce Dose before the symptoms, may be suspected of drug poisoning, T10 reduction in the monitoring of T10, using reverse phase HPLC method measured in the serum CBZ trough concentration of 8.08μg / ml: PB trough concentration of
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