[使用吸入性皮质类固醇治疗的库辛综合征:应避免的药物相互作用]
M Briard1, C Godet2, D Mouren3
1AP-HP Nord-Université Paris-Cité, hôpital Bichat-Claude Bernard, service de pharmacie, 75018 Paris, France.
Revue des maladies respiratoires
|September 24, 2023
概括
药物相互作用可能导致库辛综合征. 这一案例凸显了吸入酸 (FP) 与抗真菌药物和抗生素药物结合导致皮质类固醇水平升高的情况,导致阳性化的库辛综合征.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 肺部病理学 肺部病理学
背景情况:
- 库辛综合征可能是由药物相互作用引起的,特别是吸入性皮质类固醇.
- 强大的细胞P450酶抑制剂可以增加全身皮质类固醇水平.
研究的目的:
- 报告一个临床病例的阳性化库辛综合征.
- 为了确定导致综合征的药物相互作用.
- 建议更安全的治疗替代方案.
主要方法:
- 一个29岁的女性患有喘,阿斯伯吉洛症和Mycobacterium xenopi感染的病例报告.
- 对并发药物的分析:吸入的化 (FP),伊特拉科纳 (ITZ),莫西弗洛克萨 (MXF),乙墨 (EMB) 和克拉里斯罗米 (CLR).
- 监测临床症状和血皮质类固醇度.
主要成果:
- 患者在开始ITZ,MXF,EMB和CLR治疗四个月后出现了库辛综合征.
- 这种综合征归因于FP,ITZ和CLR之间的相互作用,增加了血皮质类固醇水平.
- 停止FP和ITZ,以及补充皮,导致了有利的结果.
结论:
- 吸入性流他 propionate (FP) 和强大的CYP3A4抑制剂,如伊特拉科纳和克拉里斯罗米的同时使用,可能会导致阳性化的库辛综合征.
- 建议在接受CYP3A4抑制剂治疗的患者中避免FP.
- 由于其不同的物理化学性质,贝克洛马可能是一个更安全的替代品.
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