TDM和基因检测指导1例抑郁患者文拉法辛个体化用药  

Individualized Drug Administration of Venlafaxine for One Patient with Depression under the Guidance of Therapeutic Drug Monitoring and Genetic Detection

作　　者：杨欣[1] 林晓秋 莫煊 赵子洲 郑银佳 江惠珍 黎行山[1] 李咏梅[1] YANG Xin;LIN Xiaoqiu;MO Xuan;ZHAO Zizhou;ZHENG Yinjia;JIANG Huizhen;LI Hangshan;LI Yongmei(Department of Pharmacy,The Fifth Affiliated Hospital Of Guangzhou Medical University,Guangzhou,Guangdong 510070,China;Department of Psychologic,The Fifth Affiliated Hospital Of Guangzhou Medical University,Guangzhou,Guangdong 510070,China;The College of Pharmacy,Guangzhou Medical University,Guangzhou,Guangdong 511436,China)

机构地区：[1]广州医科大学附属第五医院药学部,广东广州510070 [2]广州医科大学附属第五医院心理科,广东广州510070 [3]广州医科大学药学院,广东广州511436

出　　处：《今日药学》2019年第12期816-819,共4页Pharmacy Today

基　　金：广东省药学会科学研究基金(2018JZ16)

摘　　要：目的利用TDM和基因检测技术指导1例抑郁患者文拉法辛个体化用药。方法选取某院心理科门诊收治的1名抑郁患者,采静脉血2 mL提取核酸,荧光检测仪检测CYP2D6基因,结合血药浓度监测对患者进行用药调整评估疗效。结果患者CYP2D6的基因型为快代谢型,用药方案调整后,患者的病情稳定,生活质量明显改善,无不良反应发生。结论药师通过TDM和基因检测协助医师个体化精准用药,促进合理用药,降低不良反应风险,值得临床推广。OBJECTIVE Therapeutic drug monitoring(TDM) and genetic testing were used to guide the individualized administration of venlafaxine in one patient of depression. METHODS A severely depressed patient admitted to the department of psychology of our hospital was selected as the target. Extraction of the 2 mL venous blood DNA,fluorescence detection method of analysis of patients with CYP2D6 genotype,and have been carried out with blood concentration monitoring,providing a suitable dosing regimen and evaluating the therapeutic effects. RESULTS After the adjustment of medication plan according to the patient fast metabolizing genotype,the patient condition was stable,and the quality of the patient’s life improved significantly without any adverse reactions occurred. CONCLUSION Pharmacists assist doctor to individualize precision medication by TDM and genetic testing,which could promot rational drug use and reduce the risk of adverse reactions,and be worthy to clinical recommendation.

关 键 词：文拉法辛 CYP2D6 基因检测 个体化用药 

分 类 号：R971.43[医药卫生—药品]