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癫痫是一种由多病因引起的慢性反复发作性神经系统常见病,长期合理服用抗癫痫药物(AEDs)是治疗癫痫的最有效方法。通常一种AEDs就能有效控制癫痫发作,但难治性癫痫需要多种AEDs联合使用。已知临床上各药物间相互作用能引起疗效降低或中毒等不良反应。细胞色素P450(CYP)酶系在AEDs的代谢中发挥最重要作用。AEDs中尤其传统的AEDs均部分或全部经肝脏CYP酶系代谢。该文概述CYP酶系及其亚型及对AEDs联用时相互作用的影响,为指导临床合理用药,充分发挥药物的疗效,减少或避免不良反应的发生及个体化用药提供科学依据。
Epilepsy is a common cause of chronic recurrent nervous system caused by multiple etiology. Long-term rational use of antiepileptic drugs (AEDs) is the most effective treatment of epilepsy. Usually an AEDs can effectively control seizures, but refractory epilepsy need a combination of multiple AEDs. It is known that the interaction between various drugs in clinic can cause adverse effects such as decreased efficacy or poisoning. Cytochrome P450 (CYP) enzymes play the most important role in the metabolism of AEDs. Particularly traditional AEDs in AEDs are partially or completely metabolized by the liver CYP enzymes. This article summarizes the effects of CYP enzymes and its subtypes on the interaction of AEDs, and provides a scientific basis for guiding clinical rational drug use, giving full play to the efficacy of drugs, reducing or avoiding the occurrence of adverse reactions and individualized drug use.