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伊曲康唑:关于药物相互作用和生物利用度的注意事项。

Itraconazole: Precautions regarding drug interactions and bioavailability.

作者信息

Puttick M P, Phillips P

机构信息

Department of Medicine, St Paul's Hospital, and Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia.

出版信息

Can J Infect Dis. 1994 Jul;5(4):179-83. doi: 10.1155/1994/612027.

DOI:10.1155/1994/612027
PMID:22346497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3250854/
Abstract

OBJECTIVE

To describe patients with fungal infections in whom drug interactions and bioavailability problems were associated with itraconazole treatment failure.

DESIGN

Retrospective chart review.

SETTING

Two tertiary care university-affiliated teaching hospitals.

POPULATION STUDIED

Itraconazole-treated patients between 1990 and 1992.

MAIN RESULTS

Four patients treated with itraconazole were identified in whom suboptimal serum itraconazole levels were associated with relapse of disseminated histoplasmosis, treatment failure of invasive aspergillosis or development of superficial mycoses. Low serum itraconazole levels were associated with concurrent therapy with rifampin or agents inhibiting gastric acid secretion, with administration of itraconazole capsule contents through a nasogastric tube or with the presence of aids.

CONCLUSIONS

It is recommended that serum itraconazole levels be measured in patients with potentially life-threatening mycoses if coexistent factors may interfere with itraconazole therapy.

摘要

目的

描述那些因药物相互作用和生物利用度问题导致伊曲康唑治疗失败的真菌感染患者。

设计

回顾性病历审查。

地点

两家大学附属三级护理教学医院。

研究对象

1990年至1992年间接受伊曲康唑治疗的患者。

主要结果

确定了4例接受伊曲康唑治疗的患者,其血清伊曲康唑水平不理想与播散性组织胞浆菌病复发、侵袭性曲霉病治疗失败或浅表真菌病的发生有关。血清伊曲康唑水平低与同时使用利福平或抑制胃酸分泌的药物、通过鼻胃管给予伊曲康唑胶囊内容物或患有艾滋病有关。

结论

如果存在可能干扰伊曲康唑治疗的共存因素,建议对患有潜在危及生命的真菌病的患者检测血清伊曲康唑水平。

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本文引用的文献

1
Prevention of relapse of histoplasmosis with itraconazole in patients with the acquired immunodeficiency syndrome.伊曲康唑预防获得性免疫缺陷综合征患者组织胞浆菌病复发的研究。
Ann Intern Med. 1993 Apr 15;118(8):610-6. doi: 10.7326/0003-4819-118-8-199304150-00006.
2
Itraconazole-didanosine excipient interaction.
JAMA. 1993;269(12):1508.
3
Ketoconazole. Mechanism of action, spectrum of activity, pharmacokinetics, drug interactions, adverse reactions and therapeutic use.酮康唑。作用机制、活性谱、药代动力学、药物相互作用、不良反应及治疗用途。
Pharmacotherapy. 1984 Nov-Dec;4(6):343-73. doi: 10.1002/j.1875-9114.1984.tb03398.x.
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Interaction of ketoconazole with rifampin and isoniazid.
N Engl J Med. 1984 Dec 27;311(26):1681-3. doi: 10.1056/NEJM198412273112606.
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The effect of ketoconazole on amphotericin B in a model of disseminated aspergillosis.酮康唑在播散性曲霉病模型中对两性霉素B的影响。
J Infect Dis. 1985 May;151(5):902-10. doi: 10.1093/infdis/151.5.902.
6
Gastropathy and ketoconazole malabsorption in the acquired immunodeficiency syndrome (AIDS).获得性免疫缺陷综合征(艾滋病)中的胃病与酮康唑吸收不良
Ann Intern Med. 1988 Sep 15;109(6):471-3. doi: 10.7326/0003-4819-109-6-471.
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Gastric secretory failure in patients with the acquired immunodeficiency syndrome (AIDS).
Ann Intern Med. 1988 Sep 15;109(6):502-4. doi: 10.7326/0003-4819-109-6-502.
8
Adrenal response to corticotropin during therapy with itraconazole.伊曲康唑治疗期间肾上腺对促肾上腺皮质激素的反应。
Antimicrob Agents Chemother. 1987 Apr;31(4):647-9. doi: 10.1128/AAC.31.4.647.
9
Ketoconazole vs. itraconazole for antifungal prophylaxis in patients with severe granulocytopenia: preliminary results of two nonrandomized studies.
Rev Infect Dis. 1987 Jan-Feb;9 Suppl 1:S94-9. doi: 10.1093/clinids/9.supplement_1.s94.
10
Tolerance to and efficacy of itraconazole in treatment of systemic mycoses: preliminary results.
Rev Infect Dis. 1987 Jan-Feb;9 Suppl 1:S87-93. doi: 10.1093/clinids/9.supplement_1.s87.