特尔比纳芬和瑞斯佩里顿的药物相互作用有助于法医精神病患者的临床变化
Jamie Reynolds1, Nicole Gramlich1
1PGY2 Psychiatric Pharmacy Resident, Center for Behavioral Medicine, Kansas City, Missouri.
The mental health clinician
|July 14, 2023
概括
药物相互作用可能会影响抗精神病药物的有效性. 一项案例研究表明,CYP2D6抑制剂特比纳可能会延长RISPERIDONE的使用时间.
科学领域:
- 药理学 药理学是指药理学的学科.
- 精神病学是一个精神病学.
- 药物新陈代谢 药物新陈代谢
背景情况:
- 风险是一种非典型的抗精神病药物,通过其母化合物和活性代谢物9-基风险 (9-OHR,paliperidone) 发挥作用.
- 里斯佩里的肝脏代谢转化为9-OHR主要由细胞染色体P450 2D6 (CYP2D6) 酶进行介导.
- 由于代谢干扰,RISPERIDONE与9-OHR的比例变化可能会影响临床结果.
研究的目的:
- 举报一个案例,说明药物相互作用如何延迟患者对抗精神病剂量调整的反应.
- 研究CYP2D6抑制对RISPERIDONE和9-OHR水平和临床症状的潜在影响.
主要方法:
- 一名法医精神病患者从口服Risperidone转换为长效注射配方.
- 患者经历了症状恶化,需要增加注射剂量的剂量.
- 在与已知的CYP2D6抑制剂特比纳芬联合服用之前,期间和之后,对星和9-OHR的血度进行了监测.
主要成果:
- 病人的精神症状恶化与开始使用特尔比纳治疗相吻合.
- 药物度数据表明,在特尔比纳治疗期间,RISPERIDONE/9-OHR比率发生了变化.
- 终止特比纳后,临床情况有所改善,与正常化药物水平相关.
结论:
- 同时服用CYP2D6抑制剂,如特比纳,可能会延长达到RISPERIDONE治疗反应的时间.
- 监测药物度和临床状况至关重要,当存在潜在的药物相互作用影响RISPERIDONE代谢时.
- 这一案例突显了CYP2D6基因型和药物相互作用在治疗RISPERIDONE患者的临床意义.
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