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病例男性、48岁,体重90公斤.因难以控制的原发性癫癎大发作服苯妥英钠100毫克,日4次,苯巴比妥30毫克,日3次,已二年.但每周仍有1-2次癫癎发作.多次血清苯妥英水平测定其值低,为2.8-6.3微克/毫升.而巴比妥达到治疗浓度(10-20微克/毫升).在进行本研究前两周,病人每天服苯妥英钠400毫克,测定24小时尿的5-对羟苯基-5-乙内酰脲(HPPH,苯妥英的最主要代谢产物).结果表明口服剂量的74%(294.8毫克)转化为HPPH,说明药物吸收正常而代谢加速.为了观察苯妥英代谢的药物动力学而收病人入院,整个住院过程中每日服苯巴比
Case Male, 48 years old, weighing 90 kg. Due to uncontrolled onset of primary epilepsy, 100 mg of sodium phenytoin, 4 times a day, phenobarbital 30 mg, 3 times a day, has been two years, but still There were 1-2 episodes of epilepsy and the serum phenytoin level was low at 2.8-6.3 μg / ml for several times, whereas barbital reached the therapeutic concentration (10-20 μg / ml). Two weeks prior to the study , Patients treated 400 mg of phenytoin daily and measured 24-hour urinary 5-hydroxyphenyl-5-hydantoin (HPPH, the major metabolite of phenytoin) Results showed that 74% (294.8 mg) of the oral dose was converted For HPPH, indicating normal absorption of the drug and accelerated metabolism.In order to observe the pharmacokinetics of phenytoin and received the patient admitted to the hospital throughout the course of daily phenobarbital