同时使用非典型抗精神病药物和合成大麻素导致横纹肌溶解症和需要透析的急性肾损伤
Rhabdomyolysis and Acute Kidney Injury Requiring Dialysis as a Result of Concomitant Use of Atypical Neuroleptics and Synthetic Cannabinoids.
作者信息
Zhao Aiyu, Tan Maybel, Maung Aung, Salifu Moro, Mallappallil Mary
机构信息
State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
出版信息
Case Rep Nephrol. 2015;2015:235982. doi: 10.1155/2015/235982. Epub 2015 Oct 13.
The use of synthetic cannabinoids (SCBs) is associated with many severe adverse effects that are not observed with marijuana use. We report a unique case of a patient who developed rhabdomyolysis and acute kidney injury (AKI) requiring dialysis after use of SCBs combined with quetiapine. Causes for the different adverse effects profile between SCBs and marijuana are not defined yet. Cases reported in literature with SCBs use have been associated with reversible AKI characterized by acute tubular necrosis and interstitial nephritis. Recent studies have showed the involvement of cytochromes P450s (CYPs) in biotransformation of SCBs. The use of quetiapine which is a substrate of the CYP3A4 and is excreted (73%) as urine metabolites may worsen the side effect profiles of both quetiapine and K2. SCBs use should be included in the differential diagnosis of AKI and serum Creatinine Phosphokinase (CPK) level should be monitored. Further research is needed to identify the mechanism of SCBs nephrotoxicity.
合成大麻素（SCBs）的使用与许多严重不良反应相关，而使用大麻则不会出现这些不良反应。我们报告了一例独特的病例，一名患者在使用SCBs联合喹硫平后发生横纹肌溶解和急性肾损伤（AKI），需要进行透析。SCBs和大麻之间不良反应谱不同的原因尚未明确。文献报道的使用SCBs的病例与以急性肾小管坏死和间质性肾炎为特征的可逆性AKI有关。最近的研究表明细胞色素P450（CYPs）参与了SCBs的生物转化。喹硫平是CYP3A4的底物，以尿液代谢物形式排泄（73%），使用喹硫平可能会使喹硫平和K2的副作用加剧。AKI的鉴别诊断应包括SCBs的使用情况，并且应监测血清肌酸磷酸激酶（CPK）水平。需要进一步研究以确定SCBs肾毒性的机制。
Zotero 插件