Document Detail


Effect of CYP2C19 genetic polymorphism on pharmacokinetics of phenytoin and phenobarbital in Japanese epileptic patients using Non-linear Mixed Effects Model approach.
MedLine Citation:
PMID:  16789993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To clarify the effect of genetic polymorphism of CYP2C19 on pharmacokinetics of phenytoin and phenobarbital using a Non-linear Mixed Effects Modelling analysis in Japanese epileptic patients. METHOD: A total of 326 serum phenytoin concentrations were collected from 132 patients, and a total of 144 serum phenobarbital concentrations were collected from 74 patients during their clinical routine care. RESULT: The maximal elimination rate of phenytoin decreased by 10.2% in patients with CYP2C19*1/*2 compared with patients with normal CYP2C19. The Michaelis-Menten constants in the patients with CYP2C19*1/*3 and the poor metabolizers of (CYP2C19*2/*2 or *2/*3 or *3/*3) were 27% and 54% higher than those for the patients with normal CYP2C19, respectively. The total body clearance of phenobarbital decreased by 19.3% in patients with CYP2C19*1/*3 or the poor metabolizers of CYP2C19 compared with patients with normal CYP2C19 or with CYP2C19*1/*2. CONCLUSION: These findings indicated that the genetic polymorphisms of CYP2C19 contribute to the pharmacokinetic variability of phenytoin and phenobarbital, the poor metabolizers of CYP2C19, which are relatively common in Asian groups.
Authors:
E Yukawa; K Mamiya
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  31     ISSN:  0269-4727     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-22     Completed Date:  2006-12-11     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  275-82     Citation Subset:  IM    
Affiliation:
Laboratory of Evidence-Based Pharmacotherapy, College of Pharmaceutical Sciences, Daiichi University, Minami-Ku, Fukuoka, Japan. yukawa@daiichi-cps.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Anticonvulsants / pharmacokinetics*
Aryl Hydrocarbon Hydroxylases / genetics*
DNA / genetics
Female
Gene Frequency
Genotype
Humans
Japan / epidemiology
Male
Middle Aged
Mixed Function Oxygenases / genetics*
Models, Statistical
Nonlinear Dynamics
Phenobarbital / pharmacokinetics*
Phenytoin / pharmacokinetics*
Polymorphism, Genetic
Population
Reverse Transcriptase Polymerase Chain Reaction
Chemical
Reg. No./Substance:
0/Anticonvulsants; 50-06-6/Phenobarbital; 57-41-0/Phenytoin; 9007-49-2/DNA; EC 1.-/Mixed Function Oxygenases; EC 1.14.14.1/Aryl Hydrocarbon Hydroxylases; EC 1.14.14.1/CYP2C19 protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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