糖尿病合并房颤患者使用艾塞那肽与华法林相互作用分析

发布时间：2018-03-07 06:31

本文选题：型糖尿病　切入点：艾塞那肽　出处：《中国药学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的各种糖尿病药物层出不穷,与华法林联用发生药物相互作用是临床药师需关注的,艾塞那肽作为新型降糖药,与华法林联用的报道少,本研究拟探讨二者之间相互作用及可能机制,指导患者合理和个体化用药。方法通过对一例糖尿病合并房颤患者联用华法林与艾塞那肽进行病例分析,介绍艾塞那肽作为新型2型糖尿病药物的特点,并分析艾塞那肽与华法林的相互作用。结果患者使用艾塞那肽后INR值从2.13降至1.57,艾塞那肽加量后INR值降至1.43,停药后INR值呈上升趋势,出院时INR值1.78。出院后随访INR值已经恢复至2~3。结论房颤时血液易在心房内淤积而形成血栓,糖尿病患者高凝状态发生血栓的危险性增加,临床上糖尿病合并房颤患者比例大。华法林是目前应用最广泛的口服抗凝药之一,影响因素较多,使用时需要监测凝血酶原时间国际标准化比值(INR)。艾塞那肽因减缓胃排空从而影响华法林的吸收导致INR值降低,两药联用时应密切监测INR值,及时调整华法林剂量。
[Abstract]:Objective A variety of diabetes drugs emerge in endlessly. Clinical pharmacists should pay attention to the drug interaction with warfarin. As a new type of hypoglycemic drug, Isenapeptide is rarely reported in combination with warfarin. The purpose of this study was to explore the interaction and possible mechanism between the two drugs and to guide the patients to use rational and individualized drugs. Methods A case study was carried out in a diabetic patient with atrial fibrillation treated with warfarin and Isenapeptide. This paper introduces the characteristics of Isenapeptide as a new type 2 diabetic drug. The interaction between Isenapeptide and warfarin was analyzed. Results the INR value decreased from 2.13 to 1.57, the INR value decreased to 1.43 after the addition of Isenapeptide, and the INR value increased after withdrawal. The INR value at discharge was 1.78. The INR value of follow-up had recovered to 2 / 3 after discharge. Conclusion the blood is prone to clot in the atrium during atrial fibrillation, and the risk of thrombus in hypercoagulant state is increased in patients with diabetes mellitus. Warfarin is one of the most widely used oral anticoagulants. It is necessary to monitor the international standardized ratio of prothrombin time (INRN) when used. Isenapeptide can decrease the INR value because of slowing gastric emptying and affecting the absorption of warfarin. When the two drugs are combined, the INR value should be monitored closely and the warfarin dose should be adjusted in time.
【作者单位】：中国医学科学院北京协和医院药剂科;镇江市第一人民医院;中国医学科学院北京协和医院内分泌科;
【分类号】：R587.1;R541.75

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