华法林与心血管疾病常用药物相互作用研究进展  

Research progress of warfarin interactions with commonly used drugs for cardiovascular disease

作　　者：朱长友 ZHU Chang-you(Pharmacy Department,Tianjin Jizhou District People's Hospital,Tianjin 301900,China)

机构地区：[1]天津市蓟州区人民医院药剂科,天津301900

出　　处：《中国城乡企业卫生》2024年第11期35-37,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：华法林在药物的非遗传因素中药物相互作用最为明显,因此临床上应用华法林时需了解药物的特点及其影响。华法林药物相互作用包括药效动力学与药代动力学方面,药效动力学方面:通过对维生素K合成、代谢、利用产生影响,从而产生抗凝作用;药代动力学方面:(1)通过结合消化道黏膜,影响华法林吸收;(2)通过对CYPs产生干扰作用可减少华法林代谢,增加患者体内华法林的浓度;(3)对华法林分布产生影响,增加华法林与非蛋白的结合作用,增强其抗凝作用。相互作用药物包括常用强心药物(地高辛)、抗心律失常药物(胺碘酮)、降脂药物(普伐他汀、氟伐他汀等)、抗血小板药物(氯吡格雷、阿司匹林等)、降尿酸药物(苯溴马隆)、质子泵抑制剂及降糖药物(二甲双胍)。华法林与其他药物的相互作用会影响华法林的抗凝效果。因此,本文综述了华法林与心血管疾病常用药物相互作用的研究进展,以期为华法林的临床应用提供指导。Warfarin have the most obvious drug interaction among non-genetic factors of drugs,so it is necessary to understand the characteristics and effects of warfarin in clinical application.The warfarin drug interactions include pharmacodynamics and pharmacokinetics.Pharmacodynamic aspets:through the influence of vitamin K synthesis,metabolism and utilization,the anticoagulation effect is produced.Pharmacokinetic aspets:(1)through binding to digestive tract mucosa,it affects the absorption of warfarin;(2)warfarin metabolism can be reduced and the concentration of warfarin in patients can be increased by interfering CYPs;(3)warfarin distribution is affected,the binding effect of warfarin with non-protein is increased,and its anticoagulant effect is enhanced.Interaction drugs include commonly used cardiotonic drugs(digoxin),anti-arrhythmia drugs(amiodarone),lipid-lowering drugs(pravastatin,fluvastatin,etc.),antiplatelet drugs(clopidogrel,aspirin,etc.),uric acid lowering drugs s(benbromarone),proton pump inhibitors and hypoglycemic drugs(metformin).Warfarin's anticoagulant effect can be affected by its interactions with other drugs.Therefore,the research progress of warfarin interaction with commonly used drugs for cardiovascular diseases was reviewed,in order to provide guidance for the clinical application of warfarin.

关 键 词：华法林 心血管疾病 常用药物 药物相互作用 降脂药物 抗心律失常药物 

分 类 号：R969.2[医药卫生—药理学]