Midazolam Boosting With Cobicistat in a Patient With Drug-Resistant Epilepsy and Focal Status Epilepticus.

IF 2.8 4区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Therapeutic Drug Monitoring Pub Date : 2024-11-20 DOI:10.1097/FTD.0000000000001283
Tessa Born-Bondt van den, Niels Westra, Katarzyna Krzywicka, Harmen R Moes, Manon Schuls-Fouchier, Daan J Touw, Oude Munnink Thijs H
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Abstract

Background: This report presents the case of a patient with drug-resistant epilepsy. Despite treatment with 4 antiepileptic drugs, the patient experienced an increasing frequency of focal seizures, necessitating hospitalization, and continuous intravenous midazolam infusion.

Methods: Cobicistat was introduced as a pharmacokinetic booster to decrease the metabolic clearance of midazolam, leading to increased exposure and an extended half-life.

Results: Cobicistat boosting allowed the switch from intravenous to oral midazolam, and the patient was discharged on an oral midazolam regimen.

Conclusions: Cobicistat can be effectively used to boost midazolam exposure pharmacokinetically in patients with drug-resistant epilepsy who require stable midazolam blood concentrations.

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在一名耐药性癫痫和局灶性癫痫患者中使用咪达唑仑与考比司他联合治疗。
背景:本报告介绍了一名耐药性癫痫患者的病例。尽管接受了 4 种抗癫痫药物的治疗,但患者的局灶性癫痫发作频率不断增加,需要住院治疗,并持续静脉输注咪达唑仑:方法:引入考比司他(Cobicistat)作为药代动力学增效剂,以降低咪达唑仑的代谢清除率,从而增加暴露量并延长半衰期:结果:通过使用可比司他增效剂,患者可以从静脉注射咪达唑仑转为口服咪达唑仑,并以口服咪达唑仑治疗方案出院:结论:对于需要稳定咪达唑仑血药浓度的耐药性癫痫患者,可比司他能有效地从药代动力学角度增加咪达唑仑的暴露量。
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来源期刊
Therapeutic Drug Monitoring
Therapeutic Drug Monitoring 医学-毒理学
CiteScore
5.00
自引率
8.00%
发文量
213
审稿时长
4-8 weeks
期刊介绍: Therapeutic Drug Monitoring is a peer-reviewed, multidisciplinary journal directed to an audience of pharmacologists, clinical chemists, laboratorians, pharmacists, drug researchers and toxicologists. It fosters the exchange of knowledge among the various disciplines–clinical pharmacology, pathology, toxicology, analytical chemistry–that share a common interest in Therapeutic Drug Monitoring. The journal presents studies detailing the various factors that affect the rate and extent drugs are absorbed, metabolized, and excreted. Regular features include review articles on specific classes of drugs, original articles, case reports, technical notes, and continuing education articles.
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