病例报告：地尔硫䓬-芬太尼 CYP3A4 药物相互作用导致的谵妄。
Case report: delirium due to a diltiazem-fentanyl CYP3A4 drug interaction.
机构信息
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
出版信息
Gen Hosp Psychiatry. 2010 Nov-Dec;32(6):648.e9-648.e10. doi: 10.1016/j.genhosppsych.2010.08.003. Epub 2010 Sep 22.
INTRODUCTION
Fentanyl and diltiazem are frequently used medications. Diltiazem inhibits cytochrome P450 3A4 isoenzymes. This can suppress fentanyl metabolism.
METHOD
We present a case of delirium after coadministration of fentanyl and diltiazem.
DISCUSSION
Cautious use is warranted while concomitantly administering fentanyl and diltiazem as this can potentiate fentanyl toxicity. Other 3A4 inhibitors include ketoconazole, erythromycin, nefazodone, ritonavir, delavirdine, aprepitant and imatinib. Psychosomatic medicine psychiatrists, pain and palliative care physicians and cardiologists in particular should be aware of this interaction.
简介
芬太尼和地尔硫䓬是常用药物。地尔硫䓬抑制细胞色素 P450 3A4 同工酶。这可能会抑制芬太尼的代谢。
方法
我们报告了一例芬太尼和地尔硫䓬同时使用后出现谵妄的病例。
讨论
同时使用芬太尼和地尔硫䓬时需要谨慎，因为这可能会增强芬太尼的毒性。其他 3A4 抑制剂包括酮康唑、红霉素、奈法唑酮、利托那韦、地拉韦啶、阿瑞匹坦和伊马替尼。精神科医生、疼痛和姑息治疗医生以及心脏病专家应特别注意这种相互作用。
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