29.下列何者會降低benzodiazepines之療效？
(A)fluvoxamine
(B)phenytoin
(C)omeprazole
(D)ritonavir

Benzodiazepines為2C19受質, 3A4受質

(A)fluvoxamine是2C19 inhibitor

(B)phenytoin是2C19 inducer(次要), 1A2 inducer, 3A4 inducer(主要),

                          2C9受質, 2C19受質, 3A4受質

(C)omeprazole是2C19 inhibitor, 1A2 inhibitor, 3A4 inhibitor

(D)ritonavir是2C19受質, 3A4 inhibitor(併用其他抗HIV，抑制代謝增強藥效)

參考 : FDA FOOD & DRUG 

(謝謝留下回覆，補充一下主要跟次要)

回樓上

參考 : FDA FOOD & DRUG 還有 Uptodate 

BZD是3A4和2C19 受質 都有

Phenytoin是3A4和2C19 incducer

我上面的回覆沒有錯，我是記得有2C19才這樣回覆

補充一下Phenytoin是3A4(主要)，2C19(次要)，1A2(次要) inducer

(已更）感謝樓上樓下回覆補充

BZD大部分是CYP3A4的受質；Phenytoin主要是strong CYP3A4 inducer。

Phenytoin:

Substrate of CYP2C19 (major), CYP2C9 (major), CYP3A4 (minor); 

Induces CYP1A2 (weak), CYP2B6 (weak), CYP3A4 (strong), P-glycoprotein/ABCB1, UGT1A1, UGT1A4

Ref: Uptodate