华法林和抗生素:药物相互作用和临床考虑
Alexis J Vega1, Caitlin Smith1, Hannah Grace Matejowsky1
1School of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
Life (Basel, Switzerland)
|August 26, 2023
概括
华法林和抗生素的相互作用会增加出血风险. 密切监测和剂量调整对于接受华法林和抗生素治疗的患者至关重要,如青素衍生物,诺基诺,TMP-SMX,类或利法.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 药物相互作用 药物相互作用
背景情况:
- 华法林治疗因药物相互作用而复杂,特别是抗生素影响其新陈代谢.
- 服用华法林的患者在与某些抗生素同时服用时容易出现严重出血.
- 细胞染色体P450-2C9是华法林代谢中的关键酶,受到各种抗生素的影响.
研究的目的:
- 审查华法林与不同类抗生素之间的相互作用.
- 突出这些相互作用对国际规范化比率 (INR) 的影响.
- 提供关于在抗生素联合使用期间管理华法林治疗的指导.
主要方法:
- 关于华法林与抗生素相互作用的现有研究的叙述性综述.
- 对INR值报告的变化进行分析.
- 确定特定的抗生素类别及其对华法林的影响.
主要成果:
- 青素衍生物,诺基诺,TMP-SMX和类药物显著增加了INR.
- 利法因诱导细胞染色体P-450而降低了INR.
- 类素和阿莫西西林/克劳兰酸盐增加了INR,但没有影响P450.0细胞染色体.
结论:
- 与华法林同时使用抗生素治疗需要对患者进行密切监测,以防止严重出血.
- 华法林的剂量降低可能有利于使用细胞色素P450抑制剂 (例如,青素衍生物,诺基诺,TMP-SMX,宏化物).
- 服用华法林和利法的患者需要密切监测,可能需要增加华法林剂量以防止高凝血.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
Combined Effects of Drugs: Synergism
4.0K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
4.0K
Factors Affecting Protein-Drug Binding: Drug Interactions
195
Drug interactions are a critical aspect of pharmacology and can occur when two or more drugs compete for the same binding site. This competition can result in one drug displacing another, altering the effect of the displaced drug. Drug interactions are complex processes that rely heavily on how much of the displacer drug is present and how strongly it can bind to the same sites as the displaced drug.
Displacement interactions can have varying outcomes, ranging from toxicity to virtually...
Displacement interactions can have varying outcomes, ranging from toxicity to virtually...
195
Anticoagulant Drugs: Low-Molecular-Weight Heparins
751
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
751
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Protein-Drug Binding: Mechanism and Kinetics
590
Protein-drug binding refers to the interaction between drugs and proteins within the body. This binding process can occur intracellularly, involving drug interactions with enzymes or receptors within cells, or extracellularly, involving plasma proteins in the blood.
Various forces drive these interactions, including hydrogen bonds, hydrophobic interactions, ionic bonds, electrostatic interactions, and van der Waals forces. These bonds enable drugs to bind to specific sites on proteins,...
Various forces drive these interactions, including hydrogen bonds, hydrophobic interactions, ionic bonds, electrostatic interactions, and van der Waals forces. These bonds enable drugs to bind to specific sites on proteins,...
590


