PMID: 15385837Sep 24, 2004Paper

Dosage recommendation of phenytoin for patients with epilepsy with different CYP2C9/CYP2C19 polymorphisms

Therapeutic Drug Monitoring
Chin-Chuan HungHorng-Huei Liou

Abstract

To search for the optimal dosage of phenytoin in patients with epilepsy based on the metabolic activities of CYP2C9 and CYP2C19 polymorphisms, a total of 169 patients receiving phenytoin treatment for more than 1 month were recruited. Phenytoin concentration, serum albumin, liver function tests, and renal function tests were measured. CYP2C9 and CYP2C19 polymorphisms were genotyped by PCR-RFLP analysis, and NONMEM models were built to evaluate factors that would affect phenytoin metabolism. Patients were divided into 5 groups according to genotyping results (G1 to G5). Compared with extensive metabolizers in both CYP2C9 and CYP2C19 (G1), the Vmax (mg/kg/d) was 8.29% and 36.96% lower in CYP2C19 poor metabolizers (G3) and CYP2C9 poor metabolizers (G4), respectively. For the patient who was identified as a poor metabolizer in both CYP2C19 and CYP2C9 (G5), the Vmax was 45.75% lower than that of G1. In respect to Km (mg/L), it was 15.09% higher in G3 and 27.36% higher in G4 compared with that in G1. The Km of G5 was 91.71% higher than that of G1. The results revealed that the CYP2C9 and CYP2C19 polymorphisms have dramatic effects on the population pharmacokinetic parameters of phenytoin, especially for CYP2C9. Based on the Vm and Km...Continue Reading

References

Oct 1, 1995·Clinical Pharmacology and Therapeutics·S M de MoraisH H Zhou
Apr 1, 1994·Therapeutic Drug Monitoring·Y SuzukiP D Walson
Jan 1, 1995·Drug Metabolism Reviews·T I Edeki, D A Brase
Aug 1, 1996·Pharmacogenetics·T H Sullivan-KloseJ A Goldstein
Oct 1, 1996·Pharmacogenetics·M J StubbinsC R Wolf
Nov 14, 1997·Pharmacogenetics·K NasuT Ishizaki
Jul 21, 1999·Epilepsy Research·A E RettieR H Levy
Apr 12, 2001·British Journal of Clinical Pharmacology·Y R YoonJ G Shin
Oct 27, 2001·British Journal of Clinical Pharmacology·M G ScordoM Ingelman-Sundberg

❮ Previous
Next ❯

Citations

Jun 29, 2010·European Journal of Clinical Pharmacology·Guillermo GervasiniJuan Antonio Carrillo
Jul 26, 2005·Journal of Human Genetics·Barkur S Shastry
Nov 5, 2010·International Journal of Clinical Pharmacy·Bob WilffertUNKNOWN KNMP working group Pharmacogenetics
Mar 3, 2011·International Journal of Clinical Pharmacy·Bob WilffertUNKNOWN KNMP working group Pharmacogenetics
Nov 26, 2008·Neurocritical Care·Lauren K McCluggageMalcolm Ross Bullock
Jan 25, 2013·Clinical Pharmacokinetics·Anne-Charlotte CastellanUNKNOWN Genophar Working Group
Apr 17, 2013·Molecular Diagnosis & Therapy·C F SamerJ A Desmeules
Mar 1, 2006·The Pharmacogenomics Journal·D J DlugosT N Ferraro
Sep 27, 2006·Pharmacogenetics and Genomics·Sarah K TateHorng-Huei Liou
Jul 17, 2008·Epilepsia·Wolfgang LöscherDieter Schmidt
May 12, 2011·Drug Metabolism and Drug Interactions·Marisol LópezAdrián Llerena
May 20, 2009·Pharmacogenomics·Dalia Kasperaviciūte, Sanjay M Sisodiya
Oct 20, 2011·Pharmacogenomics·Gianpiero L CavalleriNorman Delanty
Oct 23, 2012·Indian Journal of Pharmacology·Melvin GeorgeChandrasekaran Adithan
Jun 15, 2007·Pharmacogenomics·Rubin LubomirovAmalio Telenti
Jun 12, 2009·Drug Metabolism Reviews·Shu-Feng ZhouBalram Chowbay
Jun 4, 2015·Expert Opinion on Drug Metabolism & Toxicology·Valentina Franco, Emilio Perucca
Oct 31, 2015·Seizure : the Journal of the British Epilepsy Association·Hannah BatchelorDaniel B Hawcutt
Oct 30, 2008·Pharmacotherapy·Sandrina L von WinckelmannLudo Willems
Mar 15, 2011·British Journal of Clinical Pharmacology·Tony AntoniouDavid N Juurlink
Jul 21, 2010·British Journal of Clinical Pharmacology·Daniel F B Wright, Evan J Begg
Oct 15, 2014·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Aydan OzkaynakciFiliz Yilmaz Onat
Jan 10, 2013·Seizure : the Journal of the British Epilepsy Association·Carlos A TwardowschyCarlos Silvado
Apr 22, 2011·Journal of Pharmacy Practice·Eljim P Tesoro, Gretchen M Brophy
Jun 21, 2006·Journal of Psychopharmacology·Francis E LotrichBruce G Pollock
Aug 22, 2006·Basic & Clinical Pharmacology & Toxicology·Markus JoergerJ H Beijnen
Nov 3, 2005·Nature Reviews. Drug Discovery·Russell A WilkeJason H Moore
Dec 5, 2006·Expert Review of Molecular Diagnostics·Roberta MelisGwendolyn A McMillin
Mar 1, 2008·Expert Review of Clinical Pharmacology·Amalia M Issa
Sep 1, 2008·Expert Review of Clinical Pharmacology·Sunao KanekoHiroto Iwasa
Jun 4, 2010·Critical Care Medicine·Philip E Empey
Aug 8, 2014·Clinical Pharmacology and Therapeutics·K E CaudleUNKNOWN Clinical Pharmacogenetics Implementation Consortium

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.