摘要
目的:分析美罗培南联用丙戊酸钠(VPA)导致癫痫加重的原因,探讨临床可行的个体化治疗方案。方法:通过3例癫痫合并感染的患儿给予美罗培南联用VPA后的病情变化情况,进行病例分析和讨论。结果:持续使用美罗培南可显著降低癫痫患儿体内VPA血药浓度,使患儿处于癫痫发作的风险中,用药期间调整VPA剂量或剂型均未能提高VPA血药浓度。停用美罗培南后,VPA血药浓度也未能即刻恢复,血药浓度恢复存在个体差异性。结论:在临床治疗过程中,应评估药物风险/获益,尽可能避免美罗培南和VPA联用,一旦联用需监测血药浓度;可考虑联合其他抗癫痫药物,制订个体化替代治疗方案。
Objective:To analyze the causes of aggravation of epilepsy induced by meropenem combined with sodium valproate(VPA),and to explore the clinically feasible individualized treatment regimen.Methods:Case analysis and discussion were carried out among 3 cases of epilepsy co-infected children after administered with a combination of meropenem and VPA.Results:Continuous use of meropenem significantly reduced VPA concentrations in children with epilepsy,putting children at risk for seizures.During this period,adjustment of VPA dose or dosage form failed to improve VPA blood concentration.After discontinuation of meropenem,the VPA concentration did not recover immediately,and there were individual differences in concentration recovery.Conclusion:In the course of clinical treatment,the risk/benefit ratio of the drug should be evaluated,and the combination of two drugs should be avoided as much as possible.Once combined,the blood concentration of the drug should be monitored,and other antiepileptic drugs should be combined to make an individualized alternative treatment strategy.
作者
倪铭
杨巧玲
孙华君
黄建权
胡文娟
Ni Ming;Yang Qiaoling;Sun Huajun;Huang Jianquan;Hu Wenjuan(Shanghai Children’s Hospital,Shanghai Jiao Tong University,Shanghai 200040,China;Shaoxing Maternity and Child Health Care Hospital,Zhejiang Shaoxing 312000,China)
出处
《儿科药学杂志》
CAS
2023年第6期12-15,共4页
Journal of Pediatric Pharmacy
关键词
美罗培南
丙戊酸钠
相互作用
血药浓度
meropenem
sodium valproate
interaction
blood concentration
