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Fluconazole-induced...
Fluconazole-induced intoxication with phenytoin in a patient with ultra-high activity of CYP2C9
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- Helldén, Anders (författare)
- Karolinska Institutet
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- Bergman, Ulf (författare)
- Karolinska Institutet
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- Engström Hellgren, Karin (författare)
- Karolinska Institutet
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Masquelier, Michèle (författare)
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- Nilsson Remahl, Ingela (författare)
- Karolinska Institutet
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Odar-Cederlöf, Ingegerd (författare)
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Ramsjö, Margareta (författare)
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- Bertilsson, Leif (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2010-04-20
- 2010
- Engelska.
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Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 66:8, s. 791-5
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- PURPOSE: The cytochrome P450 enzyme CYP2C9 metabolizes several important drugs, such as warfarin and oral antidiabetic drugs. The enzyme is polymorphic, and all known alleles, for example, CYP2C9*2 and*3, give decreased activity. Ultra-high activity of the enzyme has not yet been reported.METHODS: We present a patient with Behçet's disease who required treatment with high doses of phenytoin. When fluconazole, a potent inhibitor of CYP2C9, was added to the treatment regimen, the patient developed ataxia, tremor, fatigue, slurred speech and somnolence, indicating phenytoin intoxication. On suspicion of ultra-high activity of CYP2C9, a phenotyping test for CYP2C9 with losartan was performed.RESULTS: The patient was shown to have a higher activity of CYP2C9 than any of the 190 healthy Swedish Caucasians used as controls.CONCLUSIONS: Our finding of an ultrarapid metabolism of losartan and phenytoin may apply to other CYP2C9 substrates, where inhibition of CYP2C9 may cause severe adverse drug reactions.
Nyckelord
- Bechet's disease
- Losartan
- Ultrarapid metabolizer
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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