Department of Pharmacy, Lahey Hospital and Medical Center, Burlington, MA, USA.
Neurocritical Care, Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
Neurocrit Care. 2017 Oct;27(2):287-296. doi: 10.1007/s12028-016-0369-0.
Drug-drug interactions (DDIs) are common and avoidable complications that are associated with poor patient outcomes. Neurocritical care patients may be at particular risk for DDIs due to alterations in pharmacokinetic profiles and exposure to medications with a high DDI risk. This review describes the principles of DDI pharmacology, common and severe DDIs in Neurocritical care, and recommendations to minimize adverse outcomes. A review of published literature was performed using PubMed by searching for 'Drug Interaction' and several high DDI risk and common neurocritical care medications. Key medication classes included anticoagulants, antimicrobials, antiepileptics, antihypertensives, sedatives, and selective serotonin reuptake inhibitors. Additional literature was also reviewed to determine the risk in neurocritical care and potential therapeutic alternatives. Clinicians should be aware of interactions in this setting, the long-term complications, and therapeutic alternatives.
药物-药物相互作用（DDI）是常见且可避免的并发症，会导致患者预后不良。神经重症监护患者由于药代动力学特征的改变以及接触高 DDI 风险的药物，可能特别容易发生 DDI。这篇综述描述了 DDI 药理学的原理、神经重症监护中常见和严重的 DDI 以及降低不良后果的建议。使用 PubMed 通过搜索“Drug Interaction”和几种高 DDI 风险和常见的神经重症监护药物对已发表的文献进行了回顾。关键的药物类别包括抗凝剂、抗生素、抗癫痫药、降压药、镇静剂和选择性 5-羟色胺再摄取抑制剂。还回顾了其他文献以确定神经重症监护中的风险和潜在的治疗替代方案。临床医生应该意识到这种情况下的相互作用、长期并发症和治疗替代方案。
