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題 名 | Valproic Acid血中濃度因併用Carbapenem類藥品而顯著下降--案例報告=Case Report: The Concurrent Use of Valproic Acid and Carbapenem Causing Significant Changes in the Plasma Concentration of Valproic Acid |
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作 者 | 陳成桃; 李權芳; 徐世寧; 陳智德; | 書刊名 | 藥學雜誌 |
卷 期 | 26:4=105 2010.12[民99.12] |
頁 次 | 頁117-123 |
分類號 | 418.21 |
關鍵詞 | 抗癲癇藥物; 藥物交互作用; 癲癇發作; Valproic acid; Carbapenem; |
語 文 | 中文(Chinese) |
中文摘要 | 抗癲癇藥物 valproic acid常用於治療各種類型的癲癇。 Valproic acid會與多種藥物產生交互作用,有些交互作用甚至會導致 valproic acid藥物血中濃度產生明顯變化。例如 carbapenem類抗生素與 valproic acid併用時會明顯降低 valproic acid的血中濃度,而有可能導致原本控制良好的癲癇再次發作。 本文是報導一位 84歲男性病患,因泌尿道感染( UTI)及尿路性敗血症(Urosepsis)而住院治療。在住院期間,病患同時併用 carbapenem與valproic acid,(valproic sodium/valproic acid tab 500 mg,1 tab qdpc及ertapenem sodium inj 1 g, 1 vial qd)併用五天之後,病患癲癇發作( Seizure attack),當時測得 valproic acid血中濃度為20.18 µg/mL。後來醫生提高 valproic acid劑量為每日 1200 mg,不過還是持續與同屬 carbepanem類的另一種抗生素 meropenem inj 0.25 g 4 vial q8h併用,在併用七天之後,病患的 valproic acid降至 3.27 µg/mL。此病患在 carbapenem與valproic acid併用期間, valproic acid血中濃度明顯降低並且發生癲癇。 |
英文摘要 | Valproic acid is used to treat various types of epilepsies. Valproic acid interacts with many drugs, some interactions causing significant changes in the plasma concentration of valproic acid. For example, the concurrent use of valproic acid with carbapenem will decrease the concentration of valproic acid in plasma, and may induce a seizure in well-controlled epilepsy. In this case, an 84 year old male was admitted to hospital due to a UTI and urosepsis. During his stay in hospital, the patient was simultaneously given carbapenem and valproic acid (valproic sodium/valproic acid tab 500 mg, 1 tab qdpc and ertapenem sodium inj 1 g, 1 vial qd). After 5 days of concurrent usage, the patient had a seizure, the plasma concentration of valproic acid being 20.18 µg/ mL at the time. The doctor then increased the dosage of valproic acid to 1200 mg daily, but continued to concurrently administer another type of carbapenem (meropenem inj 0.25 g, 4 vial q8h). After 7 days, the patient's plasma concentration of valproic acid dropped to 3.27 µg/mL. During the period of concurrent use of carbapenem and valproic acid, there was an obvious decrease in the patient's plasma concentration of valproic acid and the patient had a seizure. |
本系統中英文摘要資訊取自各篇刊載內容。