大环内酯类抗菌药物介导的药物相互作用临床试验文献评估

发布时间：2018-03-29 04:35

本文选题：药物相互作用　切入点：CYPA　出处：《中国药房》2017年05期

【摘要】：目的:评估大环内酯类抗菌药物红霉素、克拉霉素与阿奇霉素介导的药物相互作用,为临床合理用药提供参考。方法:检索PubMed、中国知网(CNKI)、万方等数据库中关于红霉素、克拉霉素与阿奇霉素介导的药物相互作用的临床试验文献,并搜集其药品说明书,采用美国食品与药物管理局(FDA)推荐的药物相互作用标准进行统计分析。结果:临床试验发现有20种药物与红霉素存在药物相互作用可能性,有强、中度和弱相互作用的分别为3、6、11种;22种药物与克拉霉素存在药物相互作用可能性,有强、中度或弱相互作用的分别为2、11、9种;5种药物与阿齐霉素存在药物相互作用可能性,且全部为弱相互作用。以咪达唑仑为CYP3A4底物评估三者介导的药物相互作用强度,发现克拉霉素、红霉素和阿奇霉素分别引起强、中度和弱相互作用。结论:红霉素和克拉霉素发生药物相互作用的可能性较阿奇霉素大,可能原因是红霉素和克拉霉素对CYP3A4抑制强度远大于阿奇霉素。
[Abstract]:Objective: to evaluate the interaction between erythromycin, clarithromycin and azithromycin (Azithromycin), an antimicrobial drug of macrolides, in order to provide reference for rational drug use in clinic. Clinical trial literature on clarithromycin and azithromycin mediated drug interaction, and collection of drug instructions, Statistical analysis was carried out using the drug interaction standard recommended by the Food and Drug Administration (FDAA). Results: clinical trials showed that 20 drugs had the possibility of interacting with Erythromycin. The medium and weak interactions of 22 drugs with clarithromycin and 2111,9 drugs with strong, moderate or weak interactions with azithromycin, respectively, showed that there was a drug interaction possibility with clarithromycin, and 5 drugs with azithromycin had the possibility of drug interaction with azithromycin. Midazolam was used as CYP3A4 substrate to evaluate the intensity of drug interaction mediated by these three factors. Clarithromycin, erythromycin and azithromycin were found to cause strong drug interactions. Conclusion: the possibility of drug interaction between erythromycin and clarithromycin is higher than that of azithromycin, which may be due to the fact that erythromycin and clarithromycin inhibit CYP3A4 more strongly than azithromycin.
【作者单位】：乐山市人民医院内分泌科;乐山市人民医院药学部;
【分类号】：R969.4

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