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目的:为临床合理应用苯妥英钠,防止其中毒的发生提供参考。方法:收集我院门诊及住院患者苯妥英钠血药浓度监测数据,总结发现的中毒案例,对其中毒影响因素进行分析。结果:苯妥英钠中毒的发生存在个体差异,通常其血药浓度超过20μg.mL-1时极易引起中毒。中毒症状与其血药浓度有密切联系,而其血药浓度的异常又与剂量、制剂生物利用度、药物相互作用及患者生理、病理等情况相关。结论:应用苯妥英钠须在血药浓度监测下实施个体化给药方案,并应与临床症状相结合,及时调整方案,才能有效保证患者的用药安全。
Objective: To provide a reference for the clinical rational use of phenytoin to prevent its poisoning. Methods: The monitoring data of phenytoin blood concentration in outpatients and inpatients in our hospital were collected, the cases of poisoning were summarized, and the influencing factors of poisoning were analyzed. Results: The occurrence of phenytoin sodium there are individual differences, usually when the plasma concentration exceeds 20μg.mL-1 easily lead to poisoning. Symptoms of poisoning are closely related to their plasma concentration, and the abnormality of their plasma concentration is related to the dose, the bioavailability of the drug, the drug interaction and the patient’s physiology and pathology. Conclusion: The application of phenytoin sodium should be carried out in the plasma concentration monitoring individualized dosing regimen, and should be combined with clinical symptoms, timely adjustment of the program, in order to effectively ensure the safety of patients medication.