由药物转运体介导的药物与二甲双胍相互作用的处方分析  

Analysis on drug transporters-mediated interaction between drugs and metformin

作　　者：张金桂 何梦文 王超[3] Zhang Jingui;He Mengwen;Wang Chao(Phase I Clinical Trial Ward,Hainan General Hospital,Haikou 570311,Hainan Province,China;Information Center,Hainan General Hospital,Haikou 570311,Hainan Province,China;Department of Pharmacy,Hainan General Hospital,Haikou 570311,Hainan Province,China)

机构地区：[1]海南省人民医院I期临床试验病房,海口570311 [2]海南省人民医院信息科,海口570311 [3]海南省人民医院药学部,海口570311

出　　处：《中国基层医药》2021年第12期1775-1779,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的从药物转运体的角度分析含二甲双胍门诊处方合并其他用药的潜在药物相互作用。方法收集海南省人民医院2019年7-12月门诊所有含二甲双胍处方,参照药品说明书、Drugbank、Pubmed等数据库分析处方中合并用药与二甲双胍的潜在相互作用。结果共收集含二甲双胍门诊处方15 568张,其中男性患者、女性患者处方分别为9 146、6 422张。联合用药处方14 902张,联合用药种类主要包括其他降糖药、抗血小板药、降压药、降脂药、神经保护药。药物转运体层面与二甲双胍联用具有潜在相互作用的包括阿司匹林、阿托伐他汀钙、瑞格列奈、比索洛尔、美托洛尔、氯吡格雷,共11 614次。其中通过抑制有机阳离子转运体1(OCT1)共5 938次;通过抑制OCT2共5 676次。结论该院含二甲双胍门诊处方与其常联用的慢性病治疗药不存在配伍禁忌,但门诊医生对潜在相互作用导致的剂量调整认识度不足。Objective To investigate the potential drug interactions of outpatient prescriptions containing metformin combined with other drugs from the perspective of drug transporters.Methods The prescriptions containing metformin that were used in the Outpatient Department of Hainan General Hospital,China between July and December 2019 were collected.The potential interaction between drugs and metformin used in the prescriptions was analyzed according to drug instructions,Drugbank,PubMed databases.Results A total of 15568 outpatient prescriptions containing metformin were collected,including 9146 prescriptions for male patients and 6422 prescriptions for female patients.A total of 14902 prescriptions contained combined medication.The drugs used in combination included other hypoglycemic drugs,antiplatelet drugs,antihypertensive drugs,lipid-lowering drugs,and neuroprotective drugs.The drug transporters including aspirin,atorvastatin calcium,repaglinide,bisoprolol,metoprolol and clopidogrel had a potential interaction with metformin.There were 11614 prescriptions containing drug transporters and metformin,including 5938 prescriptions inhibiting organic cation transporter 1 and 5676 prescriptions inhibiting organic cation transporter 2.Conclusion There is no incompatibility between the outpatient prescriptions containing metformin and the commonly used drugs for chronic diseases,but the outpatient doctors do not have enough knowledge about dose adjustment caused by potential interaction.

关 键 词：载体蛋白质类 有机阴离子转运子 有机阳离子转运蛋白质类 降血糖药 二甲双胍 药物相互作用 门诊医疗 药物处方 

分 类 号：R969.2[医药卫生—药理学]