论文部分内容阅读
一例患者由于癫痫发作又并发了细菌感染,在应用抗惊药苯妥英和苯巴比妥的基础上,加用了氯霉素,在治疗过程中出现苯妥英中毒。苯妥英中毒是由于氯霉素抑制了苯妥英的代谢。在未用氯霉素前,控制癫痫发作的抗惊药剂量:苯妥英为600 mg/天,苯巴比妥为250 mg/天,其平均血药浓度各为10.9 μg/ml 及30.5 μg/ml,计算其清除率各为38.2 ml/分及5.7.ml/分,但在加用氯霉素(600 mg,一天四次)后,二者血药浓度均明显上升,苯妥英甚至超过了20μg/ml 而出现中毒症状。在降低苯妥英剂量为469 mg/天,苯巴比妥为204 mg/天时,血药浓度分别为17.8μg/ml 和37.1 μg/ml,仍明显高于并用氯霉素之前。计算其清除率分别为18.9
A patient with sepsis and concurrent bacterial infection, the application of anti-shock drug phenytoin and phenobarbital based on the addition of chloramphenicol, phenytoin poisoning occurred during the course of treatment. Phenytoin poisoning is due to chloramphenicol inhibition of phenytoin metabolism. Before chloramphenicol was used, anticonvulsant doses to control seizures were phenytoin at 600 mg / day and phenobarbital at 250 mg / day with mean plasma concentrations of 10.9 μg / ml and 30.5 μg / ml, respectively , Respectively. The clearance rates were 38.2 ml / min and 5.7. ml / min respectively. However, the plasma concentrations of chloramphenicol (600 mg, four times a day) were significantly increased after treatment with phenytoin even exceeding 20 μg / ml and poisoning symptoms appear. The plasma concentration of phenytoin at 469 mg / day and phenobarbital at 204 mg / day was 17.8 μg / ml and 37.1 μg / ml, respectively, which were still significantly higher than those before chloramphenicol treatment. The clearance rates were calculated as 18.9