Quantitative analysis of electroencephalography (EEG) is used increasingly to evaluate the pharmacodynamics of benzodiazepines. The present study aimed to apply the EEG method as well as more traditional approaches to an interaction study of bromazepam and fluconazole. Twelve healthy male volunteers participated in a randomized, double-blind, four-way crossover study. The subjects received single oral or rectal doses of bromazepam (3 mg) after 4-day pretreatment of oral fluconazole (100 mg daily) or its placebo. Plasma bromazepam concentrations were measured before and 0.5, 1, 2, 3, 4, 6, 12, 22, 46, and 70 hours after bromazepam administration. Pharmacodynamic effects of bromazepam were assessed using self-rated drowsiness, continuous number addition test, and EEG. Fluconazole caused no significant changes in pharmacokinetics and pharmacodynamics of oral or rectal bromazepam. Rectal administration significantly increased AUC (1.7-fold, p < 0.0001) and Cmax (1.6-fold, p < 0.0001) of bromazepam. These changes following rectal dose may be due to avoidance of degradation occurring in the gastrointestinal tract. Rectal bromazepam also increased the area under the effect curves assessed by EEG (p < 0.05) and subjective drowsiness (p < 0.05). EEG effects were closely correlated with mean plasma bromazepam concentrations (r = 0.92, p < 0.001 for placebo; r = 0.89, p < 0.0001 for fluconazole). Thus, the EEG method provided pharmacodynamic data that clearly reflected the pharmacokinetics of bromazepam.

译文

脑电图(EEG)的定量分析越来越多地用于评估苯二氮卓类药物的药效学。本研究旨在将脑电图方法以及更传统的方法应用于溴马西m与氟康唑的相互作用研究。 12名健康的男性志愿者参加了一项随机,双盲,四向交叉研究。在口服氟康唑(每天100 mg)或其安慰剂治疗4天后,受试者接受单次口服或直肠剂量的溴西epa(3 mg)治疗。在给予溴马西m之前和之后0.5、1、2、3、4、6、12、22、46和70小时测量血浆溴马西m浓度。使用自我评定的嗜睡,连续数字加法测试和EEG评估了溴西epa的药效学作用。氟康唑在口服或直肠溴马西m的药代动力学和药效学方面未引起显着变化。直肠给药显着提高了溴西epa的AUC(1.7倍,p <0.0001)和Cmax(1.6倍,p <0.0001)。直肠剂量后的这些变化可能是由于避免了在胃肠道中发生降解。直肠溴马西m也增加了根据EEG(p <0.05)和主观嗜睡(p <0.05)评估的效果曲线下的面积。脑电图效果与平均血浆溴马西concentrations浓度密切相关(安慰剂r = 0.92,p <0.001;氟康唑r = 0.89,p <0.0001)。因此,EEG方法提供的药效学数据清楚地反映了溴马西m的药代动力学。

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