アシピモックスとテルミサタン併用による重度の薬物誘発性肝損傷:症例報告と文献レビュー
1Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, China.
Medicine
|September 3, 2025
まとめ
このケーススタディでは,アシピモックスとテルミサタンを併用した重度の薬物誘発性肝損傷 (DILI) の詳細が示されています. 治療には これらの薬の投与を中止し サポートケアを行い 肝臓の機能が正常化しました
科学分野:
- ヘパトロジー
- 薬理学について
- 内科 医学
背景:
- 薬剤による肝損傷 (DILI) は急性肝不全の重要な原因です.
- アシピモックスは脂質減少に,テルミサルタンは高血圧に用いる.
- これらの薬の同時使用は,重度のDILIにつながる可能性があります.
研究 の 目的:
- アシピモックスとテルミサタン併用による重度のDILIの症例を報告する.
- DILIの潜在的なメカニズムと要因を分析する.
- 薬剤の組み合わせに対する 個別化された治療の重要性を強調する.
主な方法:
- アシピモックスとテルミサタンを服用した歴のある58歳の女性患者.
- DILIの診断は確認されました
- 治療には,薬物の離脱とグルココルチコイド,グルタチオン,S-アデノシルメチオニン,ビシクロールを含むサポート療法が含まれていました.
主要な成果:
- 患者はアシピモックスとテルミサタン併用による重度のDILIを経験しました.
- 患者さんの肝機能は正常化しました.
結論:
- アシピモックスとテルミサタン併用による重度の肝損傷の報告は初めてです.
- 年齢,性別,薬物相互作用,遺伝などの要因が DILI に影響する可能性があります.
- ポリファーマシーにおける正確で個別化された治療戦略の必要性を強調しています.
関連する概念動画
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
57
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
01:29Acute Kidney Injury III: Clinical Manifestations
90
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
90
01:22Acute Kidney Injury I: Introduction
72
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
72
01:29Acute Kidney Injury II: Pathophysiology
72
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
72
01:11Renal Failure: Dose Adjustments
152
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
152
01:16Hepatic Drug Excretion: Influencing Factors
214
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
214