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对认知功能有负面影响的药物 (第三部分):慢性病患者的抗菌剂
Sophie Liabeuf1,2, Gaye Hafez3, Vesna Pešić4
1Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens University Medical Center, Amiens, France.
Clinical kidney journal
|August 8, 2024
概括
抗菌剂 (AB) 可以通过直接的神经毒性和肠道微生物群变化对慢性病 (CKD) 患者的认知功能产生负面影响. 治疗药物监测对于管理AB和减少该人群中不良药物反应至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性病 (CKD) 患者容易感染,需要抗菌剂 (AB).
- 慢性瘤改变药物药理动力学,增加药物不良反应 (ADR) 的风险,包括神经认知效应.
- 抗菌剂是脆弱的CKD人群中ADR的重要原因.
研究的目的:
- 审查抗菌剂对慢性病患者认知功能的直接和间接影响.
- 检查常见的AB类对CKD患者中枢神经系统 (CNS) 的神经毒性影响.
- 探索大脑-肠-轴的背景下,ABs对中枢神经系统症状中的肠道微生物群调节的作用.
主要方法:
- 文献综述侧重于检查抗菌剂和CKD认知功能的研究.
- 分析特定的AB类 (β-乳酸,基诺,氨基糖化物,甲基) 对中枢神经系统的直接神经毒性影响.
- 研究AB诱导的肠道微生物群变化及其对中枢神经系统表现的影响.
主要成果:
- 抗菌剂可以对CKD患者中枢神经系统产生直接的神经毒性作用,特别是急性影响.
- ABs显著调节肠道微生物群组成,这可能会影响中枢神经系统症状.
- 大脑 - 肠 - 轴在调解CKD中AB诱导的认知障碍方面发挥着至关重要的作用.
结论:
- 了解CKD,AB和认知功能之间的复杂相互作用是必不可少的.
- 考虑到改变的药理动力学和脑-肠-轴的量身定制的治疗策略是必要的,以管理慢性病患者的AB.
- 建议对AB进行治疗药物监测,以尽量减少CKD患者的神经认知不良药物反应.
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