迅速定量法（ＦＰＩＡ法）による急性ベンゾジアゼピン系薬物中毒における体内動態予測

Abstract

One of the important therapeutic indices in acute drug poisoning is the prediction of the drug's pharmacokinetic parameters. At present, there are many data available concerning therapeutic drugs and it is possible to search data banks for the pharmacokinetic parameters of these drugs. However, there are few data available on the drugs concerning the pharmacokinetic parameters in acute drug poisoning which occurs when drugs are ingested in extremely large doses. Therefore, to establish an appropriate treatment for acute drug poisoning, the concentrations of benzodiazepines (BZDs) in the sera of patients with acute BZD (triazolam, nitrazepam) poisoning were measured at intervals and the elimination rate constants were estimated. Comparisons of the BZDs concentrations measured and those predicted were made. To assess the elimination rate of BZDs when patients were subjected to hemoperfusion in the management of acute BZD poisoning, the concentrations of BZDs in the sera of patients were measured before and after they underwent direct hemoperfusion. To determine promptly BZDs in serum, a fluorescence polarization immunoassay (FPIA) using a TDx analyzer system (Abbott) was performed and each sample was reexamined and identified by high-performance liquid chromatography (HPLC).Prediction of pharmacokinetic parameters following the rapid determination of drug in the sera of patients with acute drug poisoning is helpful for confirming a clinical diagnosis and selecting an appropriate treatment. this is because the elimination half-life of the drug in a patient who has ingested extremely high doses is not the same as that after ingestion of a therapeutic dose of the drug.