大剂量中枢抑制药物中毒病人的代谢动力学研究

 目的：通过对大剂量中枢抑制药物中毒患者体内代谢动力学过程的分析研究，了解该类药物在超大剂量服药后体内代谢及清除的特点，从而为临床抢救提供依据，也为某些药物在超过治疗剂量后体内处置过程的研究提供参考。方法：对临床严重中毒的患者首先经定性确证，且血中药物浓度达到中毒或致死范围，临床资料完整的病例进行连续血浓度定量监测，血药浓度-时间数据用3P87药动学程序进行模型拟合并计算药动学参数。结果：在大多数肝肾功能正常的青壮年患者中，尽管所服剂量大，血中浓度很高，吸收相的参数与文献值相比差异较大，少数患者出现双峰现象，但消除半衰期改变不大，甚至小于文献值，且代谢符合线性动力学过程。结论：大剂量中枢抑制药物中毒的患者在血药浓度监测下，根据血清中药物浓度及其患者的代谢和排泄情况，采用相应的治疗措施，绝大多数患者体内的药物仍然按线性动力学过程代谢，且代谢半衰期比文献正常值缩短，一般患者预后良好。

Pharmacokinetics of overdose central depressants in poison patients

OBJECTIVE: To study pharmacokinetics of central depressants in poison patients who took overdose of the drugs. METHODS: After qualitative and quantitative determination, we selected the patient whose seurm drug concentration was in the range of toxic or lethat concentration as subjects drug plasma concentration monitoring was done in the patients with adequate clinical date. 3P87 (pharmacokinetics program) was used for analysis of metabolism process and parameters of kinetics. RESULTS: The parameters of pharmacokinetics in absorption phase were different from reference normal values, although a large dose of these agents were taken and plasma drug concentration was very high. The halflife elimination time (t_1/2) was similar to or shorter than normal values. Drug metabolic process was linear kinetics. CONCLUSIONS: The drug metabolic process in pioson patients who had taken overdose central depressants were linear kinetics. The t_1/2 was similar to or shorter than normal values. The prognosis of patients was good if therapy was taken in time with the help of drug concentration monitoring.