TY - JOUR
T1 - Effect of carbamazepine or phenytoin therapy on blood level of intravenously administered midazolam
T2 - a prospective cohort study
AU - Hayashi, Tomoko
AU - Higuchi, Hitoshi
AU - Tomoyasu, Yumiko
AU - Maruhama, Minako
AU - Maeda, Shigeru
AU - Miyawaki, Takuya
N1 - Funding Information:
No fund. This work was supported by the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Publisher Copyright:
© 2015, Japanese Society of Anesthesiologists.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Dental treatment of intellectually disabled patients is frequently performed under general anesthesia or sedation. Many of these patients have epilepsy and are medicated with antiepileptic drugs (AEDs). Carbamazepine (CBZ) and phenytoin (PHT) are known to promote the metabolism of midazolam, and the blood levels of midazolam in patients medicated with CBZ or PHT may be different from those in healthy individuals. In this study, we clarified the influences of CBZ and PHT on the blood level of intravenously administered midazolam in patients medicated with CBZ or PHT. The subjects were divided into the following groups: not medicated with AEDs (control group), medicated with only CBZ or PHT (mono CBZ/PHT group), and medicated with CBZ or PHT or both and other AEDs (poly CBZ/PHT group). General anesthesia was achieved using midazolam, propofol, and remifentanil, and then the blood midazolam level was measured at 10, 30, and 60 min after intravenous midazolam administration. According to the results, the blood midazolam level was significantly lower in the mono and poly CBZ/PHT groups than in the control group. This finding suggests that intravenously administered midazolam may have a weaker effect in patients medicated with CBZ or PHT.
AB - Dental treatment of intellectually disabled patients is frequently performed under general anesthesia or sedation. Many of these patients have epilepsy and are medicated with antiepileptic drugs (AEDs). Carbamazepine (CBZ) and phenytoin (PHT) are known to promote the metabolism of midazolam, and the blood levels of midazolam in patients medicated with CBZ or PHT may be different from those in healthy individuals. In this study, we clarified the influences of CBZ and PHT on the blood level of intravenously administered midazolam in patients medicated with CBZ or PHT. The subjects were divided into the following groups: not medicated with AEDs (control group), medicated with only CBZ or PHT (mono CBZ/PHT group), and medicated with CBZ or PHT or both and other AEDs (poly CBZ/PHT group). General anesthesia was achieved using midazolam, propofol, and remifentanil, and then the blood midazolam level was measured at 10, 30, and 60 min after intravenous midazolam administration. According to the results, the blood midazolam level was significantly lower in the mono and poly CBZ/PHT groups than in the control group. This finding suggests that intravenously administered midazolam may have a weaker effect in patients medicated with CBZ or PHT.
KW - Carbamazepine
KW - Drug interactions
KW - Midazolam
KW - Phenytoin
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U2 - 10.1007/s00540-015-2063-3
DO - 10.1007/s00540-015-2063-3
M3 - Article
C2 - 26272251
AN - SCOPUS:84957437889
SN - 0913-8668
VL - 30
SP - 166
EP - 169
JO - Journal of Anesthesia
JF - Journal of Anesthesia
IS - 1
ER -