임상약리학회지 (Journal of Korean Society for Clinical Pharmacology and Therapeutics)

대한임상약리학회 (Korean Society for Clinical Pharmacology and Therapeutics)
권호 표지

한국 성인 간질 환자에서 혈중 Carbamazepine 및 Epoxide 대사물의 농도에 관한 연구

A Study on the Plasma Level of Carhamazepine and Its Epoxide in Adult Korean Patients with Epilepsy

  • 남현우 (보라매 병원 신경과) ;
  • 안성신 (서울대학교 의과대학 신경과학교실) ;
  • 이상건 (서울대학교 의과대학 신경과학교실) ;
  • 박경석 (서울대학교 의과대학 신경과학교실) ;
  • 홍근식 (서울대학교 의과대학 신경과학교실) ;
  • 신상구 (서울대학교 의과대학 약리학교실) ;
  • 장인진 (서울대학교 의과대학 약리학교실) ;
  • 김주한 (한양대학교 의과대학 신경과학교실) ;
  • 박현미 (가천의과대학교 신경과) ;
  • 임동석 (가천의과대학교 약리학과)
  • Nam, Hyun-Woo (Department of Neurology, Seoul Municipal Boramae Hospital) ;
  • Ahn, Sung-Shin (Departments of Neurology, College of Medicine, Seoul National University) ;
  • Lee, Sang-Kun (Departments of Neurology, College of Medicine, Seoul National University) ;
  • Park, Kyung-Seok (Departments of Neurology, College of Medicine, Seoul National University) ;
  • Hong, Keun-Sik (Departments of Neurology, College of Medicine, Seoul National University) ;
  • Shin, Sang-Goo (Departments of Pharmacology, College of Medicine, Seoul National University) ;
  • Jang, In-Jin (Departments of Pharmacology, College of Medicine, Seoul National University) ;
  • Kim, Ju-Han (Department of Neurology, College of Medicine, Hanyang University) ;
  • Park, Hyeon-Mi (Departments of Neurology, Gachon Medical School) ;
  • Yim, Dong-Seok (Departments of Pharmacology, Gachon Medical School)
  • 발행 : 2000.12.30

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초록

Background: Carbamazepine (CBZ) is one of the frequently prescribed drugs for partial or generalized epilepsy and its metabolite carbamazepine epoxide(CBZE) is known to have therapeutic effect and toxicity. To evaluate its metabolic pattern and influence of other antiepileptics in Korean patients, we measured the plasma concentrations of CBZ and CBZE in patients undergoing CBZ therapy with fixed doses more than three months. Methods : Blood samples from 110 adult patients on maintenance CBZ therapy with normal liver and kidney function were collected within the last three hours of their dose intervals. Total and free plasma concentration of CBZ and CBZE were measured by HPLC and factors influencing them were statistically persued. Results : CBZ and CBZE concentrations in 110 patients were distributed from 0.12 to 17.7 ${\mu}g/ml$, and $0{\sim}6.53{\mu}g/ml$, respectively. Free fractions of CBZ and CBZE were not influenced by dose or coadministration. Plasma concentration of CBZ and CBZE were significantly correlated with daily CBZ dose regardless of poly therapy. But the relationship between the concentration ratio and CBZ dose was significant only in monotherapy group. Poly therapy significantly increased plasma CBZE concentration and CBZE/CBZ ratio. The increase in CBZE/CBZ ratio was more evident than that of CBZE concentration itself. Those who were coadministered with valproate showed higher CBZE/CBZ ratio than monotherapy group. Conclusion: Coadministration of other antiepileptics with CBZ significantly increased the metabolic elimination of CBZ to its epoxide metabolite and the higher epoxide concentration observed in the poly therapy group makes it necessary for the clinicians to carefully monitor its adverse reactions even when the parent drug levels are in therapeutic range.

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