丙戊酸钠联用碳青霉烯类药物血药浓度变化特点探讨  

Change characteristics of blood drug concentrations of valproic acid combined with carbapenems

作　　者：蒋正立[1,2] 胡小铭[2] 崔可[2] 许成新[2] 林忠[2] 许东航[1,3] 

机构地区：[1]浙江大学,浙江杭州310058 [2]浙江省台州医院药剂科,浙江临海317000 [3]浙江大学医学院附属第二医院药剂科,浙江杭州310009

出　　处：《中国医院药学杂志》2017年第21期2179-2182,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨丙戊酸钠联用碳青霉烯类药物后引起丙戊酸钠血药浓度变化特点,为临床合理用药提供参考。方法:采用化学发光免疫分析法检测丙戊酸钠联用碳青霉烯类药物前、期间以及停用碳青霉烯类药物后的血药浓度,总结变化特点,并研究给药剂量调整与血药浓度变化情况。结果:丙戊酸钠联用碳青霉烯类药物后,美罗培南使其血药浓度下降(83.2±7.8)%,亚胺培南使其血药浓度下降(71.7±5.3)%,停用碳青霉烯类药物后,血药浓度逐渐恢复,但增加丙戊酸钠给药剂量对血药浓度变化影响不明显。结论:碳青霉烯类药物可致丙戊酸钠血药浓度显著降低,两者不宜联用,以确保临床用药安全、有效。OBJECTIVE To discuss the change characteristics of blood drug concentrations of valproic acid combined with carbapenems, and provide a reference for rational clinical use of drugs. METHODS Chemiluminescence analysis was used to test the blood drug concentrations of valproic acid before, during and after carbapenems were combined. The change characteristics were summarized, and the change situation between adjusting dose and blood drug concentration of valproic acid was studied. RESULTS When valproic acid was combined with carbapenems, the blood drug concentration of valproic acid was decreased by （83.2±7.8%） by meropenem, by （71.7±5.3%） by imipenem, and gradually recovered after carbapenems were withdrawn. However, the effect of dose increase of valproic acid on blood drug concentration was not obvious. CONCLUSION The blood drug concentration of valproic acid would decrease significantly due to carbapenems. The two drugs should not be used together to ensure the safety and effectiveness of clinical medication.

关 键 词：丙戊酸钠 碳青霉烯类药物 血药浓度 变化特点 

分 类 号：R969[医药卫生—药理学]