新型抗癫痫药物的治疗药物监测研究进展

发布时间：2018-04-21 02:28

本文选题：抗癫痫药物 + 治疗药物监测　；参考：《中国药房》2017年35期

【摘要】：目的:了解我国新型抗癫痫药物的治疗药物监测(TDM)研究进展。方法:查阅近年来国内外相关文献,就我国已上市的新型抗癫痫药物进行TDM的必要性、方法及样本选择、特点及联合用药的研究进行归纳和总结。结果:抗癫痫药物有必要进行TDM。拉莫三嗪由于受到基因多态性和患者年龄、肾功能以及是否妊娠的影响,建议进行TDM,血药浓度的参考范围为3～14 mg/L;奥卡西平和托吡酯受到与其他酶诱导剂联用以及肾功能不全、儿童、妊娠期妇女等人群的影响,建议进行TDM,血药浓度的参考范围分别为3～35 mg/L和5～20 mg/L;左乙拉西坦受到儿童、妊娠期妇女、老年人、肾功能不全等人群影响,建议进行TDM,血药浓度的参考范围为12～46 mg/L;加巴喷丁和普瑞巴林更多用于神经痛的治疗,在临床上已较少进行TDM。TDM的方法有免疫法和色谱分析法,其中免疫法易被类似结构化合物干扰,而色谱分析法具有较高的特异性和灵敏度。结论:大部分新型抗癫痫药物在临床使用时可通过TDM及时调整并优化给药方案,降低不良反应发生率,使患者得到更安全、合理的药物治疗。
[Abstract]:Objective: to investigate the research progress of new antiepileptic drugs (TDM) in China. Methods: the necessity, method, sample selection, characteristics and research of combined use of new antiepileptic drugs in China were summarized and summarized by referring to the relevant literatures at home and abroad in recent years. Results: antiepileptic drugs were necessary for TDM. Because of genetic polymorphisms, age, renal function and pregnancy, lamotrigine is recommended for TDM with a reference range of 314 mg / L, O'Casey and topiramate being combined with other enzyme inducers, and renal dysfunction. The influence of children, pregnant women and other people, it is suggested that TDM, the reference range of blood drug concentration is 30.35 mg/L and 50.20 mg / L, respectively; the effect of levoethiracetam is affected by children, pregnant women, the elderly, renal insufficiency and so on. It was suggested that TDM should be performed with a reference range of 12 ~ 46 mg / L; gabapentin and PreBahrain were more commonly used in the treatment of neuralgia. In clinical practice, there were fewer TDM.TDM methods such as immunoassay and chromatographic analysis. The immunoassay is easily interfered by similar structural compounds, while chromatographic analysis has high specificity and sensitivity. Conclusion: most of the new antiepileptic drugs can be adjusted and optimized by TDM in clinical use to reduce the incidence of adverse reactions and make the patients get more safe and reasonable drug treatment.
【作者单位】：上海交通大学医学院附属瑞金医院药剂科;
【基金】：上海市临床药学重点专科建设项目
【分类号】：R969

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