Shovick V A, Rihn T L
Department of Pharmacy, South Side Hospital, Pittsburgh, PA 15203.
DICP. 1991 Jun;25(6):598-600. doi: 10.1177/106002809102500605.
Patients who are receiving multiple medications must be screened for significant drug interactions. The specific mechanism of a drug interaction determines whether the patient may experience a subtherapeutic effect or a potentially toxic reaction. Three cases of relative warfarin resistance, possibly related to high-dose nafcillin, are described in this report. Several reports have suggested that penicillinase-resistant penicillins, such as nafcillin and dicloxacillin, exert an important enzyme-inducing effect in patients receiving warfarin. This potential interaction must be appropriately recognized and managed in order to maintain adequate anticoagulation in this patient population.
正在接受多种药物治疗的患者必须接受重大药物相互作用的筛查。药物相互作用的具体机制决定了患者是可能出现治疗效果不佳还是潜在的毒性反应。本报告描述了3例可能与高剂量萘夫西林有关的相对华法林抵抗病例。几份报告表明，耐青霉素酶的青霉素，如萘夫西林和双氯西林，在接受华法林治疗的患者中发挥重要的酶诱导作用。为了在这一患者群体中维持足够的抗凝作用，必须适当认识和处理这种潜在的相互作用。
