抗凝药与大麻素的药物相互作用:一个系统性审查
Maureen A Smythe1,2, Wendy Wu3, Candice L Garwood1,4
1Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA.
Pharmacotherapy
|September 23, 2023
概括
大麻素可能会改变华法林抗凝作用,增加出血风险. 缺乏与其他抗凝剂相互作用的证据,但需要对大麻和华法林进行进一步的研究.
科学领域:
- 药理学 药理学是指药理学的学科.
- 药物相互作用 药物相互作用
- 大麻素研究 研究 大麻素研究
背景情况:
- 抗凝剂对于治疗血栓栓塞性疾病至关重要.
- 包括delta-9-tetrahydrocannabinol (THC) 和cannabidiol (CBD) 在内的大麻素越来越多地被使用,这引发了对潜在药物相互作用的担忧.
- 大麻素对抗凝血剂有效性和安全性的影响需要进行彻底的调查.
研究的目的:
- 系统地审查有关大麻素和抗凝剂之间的药物相互作用的现有证据.
- 评估大麻素暴露后可能发生改变的抗凝效应,特别是出血或血栓形成的可能性.
- 为了识别可能会受到同步使用大麻素影响的特定抗凝剂.
主要方法:
- 在六个主要数据库 (EMBASE,PubMed,Web of Science,Scopus,PsycINFO,CINAHL) 进行了全面的文献搜索,截至2023年5月.
- 搜索术语包括"大麻"",抗凝剂"",药物相互作用"和相关的关键词.
- 研究对与出血,血栓形成和抗凝强度的定量变化相关的结果进行了选.
主要成果:
- 总共有959个引用被确定,其中519个独特的引用被选.
- 发现大麻素和抗凝剂 (不包括华法林) 之间的相互作用的证据是不存在的.
- 七个病例报告详细介绍了与华法林的潜在相互作用,涉及高剂量或未知的大麻素剂量. 在7例病例中,有6例显示国际正常化比率 (INR) 增加,其中有1例出血. 四个病例需要减少华法林剂量.
结论:
- 非常低质量的数据表明,华法林和THC和CBD之间存在潜在的药物相互作用.
- 临床医生应该意识到这种潜在的相互作用,因为它可能导致抗凝变化和增加出血风险.
- 需要进一步的药物相互作用研究来澄清大麻素和华法林之间的关系.
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