24.下列何項藥品組合較不易發生藥品交互作用？
(A)valproate－phenytoin
(B)valproate－gabapentin
(C)carbamazepine－tiagabine
(D)valproate－lamotrigine

Gabapentin原型由腎臟排泄，不易引起交互作用

經腎排除的抗癲癇藥(口訣：謹慎揹LG牌的TV)：

Concurrent use of LAMOTRIGINE and VALPROIC ACID may result in increased lamotrigine exposure and increased risk of severe, potentially life-threatening rash.

Concomitant use of lamotrigine (metabolized predominantly by glucuronic acid conjugation) with valproate, which is known to inhibit glucuronidation, has resulted in a 2-fold increase in plasma concentrations of lamotrigine.

Dose decreases of lamotrigine may be necessary to maintain efficacy,  

Ref. Micromedex 是major哦哦哦 

共筆寫說Tiagabine蛋白結合率高，但不會取代Carbamazapine或phenytoin，UpToDate上的DDI在說是因CYP inducer的關係

Topiramate、Vigabatrin有肝也有腎