1例肺结核合并肺栓塞治疗药物的调整及分析  

Adjustment and analysis of the treatment drugs for a case of pulmonary tuberculosis complicated with pulmonary embolism

作　　者：罗芬 金美玲[3] 李晓宇[1] 叶晓芬 LUO Fen;JIN Weiling;LI Xiaoyu;YE Xiaofen(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Pharmacy,the Second Xiangya Hospital,Central South University,Changsha 410011,China;Department of Allergy,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032 [2]中南大学湘雅二医院药学部,长沙410011 [3]复旦大学附属中山医院变态(过敏)反应科,上海200032

出　　处：《上海医药》2023年第19期111-114,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：以1例肺结核合并肺栓塞患者需同时服用利福霉素类抗结核药和口服抗凝药为切入点,发现并全面分析了利福霉素类药物和口服抗凝药之间的相互作用,并给出了药物选择的建议:若同时需用利福霉素类药物和口服抗凝药,利福霉素类药物可选择利福喷丁或利福布汀,抗凝药物可选择艾多沙班或达比加群酯;也可选利伐沙班或阿哌沙班,同时监测抗凝疗效。利福霉素类药物为CYP3A4中强效诱导剂,选用时需仔细分析用药方案有无药物相互作用,避免合用药物疗效降低,发生严重不良后果。The interaction between anti-tuberculosis rifamycin and oral anticoagulants was found and comprehensively analyzed and suggestions for drug selection were given by taking a patient with pulmonary tuberculosis complicated with pulmonary embolism who needed to take two kinds of medicines at the same time as a starting point.When there’s a need for both rifamycin and oral anticoagulant treatment,rifapentine or rifabutin can be considered for rifamycin therapy,while idoxaban or dabigatran etexilate can be selected for oral anticoagulant.Nevertheless,rivaroxaban or apixaban can be alsi selected but close monitoring of anticoagulation effectiveness is advised.Rifamycins are powerful inducers of CYP3A4,and it is necessary to carefully analyze the drug regimen for drug interactions to avoid reducing the efficacy of the combined medication and causing serious adverse consequences.

关 键 词：肺结核 肺栓塞 利福霉素 口服抗凝药 药物相互作用 

分 类 号：R969.2[医药卫生—药理学] R973.2[医药卫生—药学]