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Pharmacogenomics J. 2016 Oct;16(5):485-90. doi: 10.1038/tpj.2016.47. Epub 2016 Jun 7.
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Management of Hypertensive Patients With Multiple Drug Intolerances: A Single-Center Experience of a Novel Treatment Algorithm.多种药物不耐受高血压患者的管理：一种新型治疗算法的单中心经验
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多种药物不良反应及基因多态性检测：1例结果为阴性的病例报告

Multiple adverse drug reactions and genetic polymorphism testing: A case report with negative result.

作者信息

Arellano Ana Lucía, Martin-Subero Marta, Monerris Mar, LLerena Adrián, Farré Magí, Montané Eva

机构信息

Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Barcelona Department of Pharmacology, Therapeutics, and Toxicology, Universitat Autònoma de Barcelona, Barcelona Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, Barcelona FIDMAG Research Foundation, Barcelona Department of Anesthesiology and Reanimation, Pain Unit, Hospital Universitari Germans Trias i Pujol, Barcelona CICAB Clinical Research Center, Extremadura University Hospital and Medical School, Badajoz, Spain.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8505. doi: 10.1097/MD.0000000000008505.

DOI:10.1097/MD.0000000000008505
PMID:29137046
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5690739/
Abstract

RATIONALE

Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6.

PATIENT CONCERNS

We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period.

INTERVENTIONS AND OUTCOMES

A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency.

LESSONS

Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.

摘要

原理

药物代谢途径的缺陷可以解释为什么一些患者有多次药物不良反应（ADR）的病史；因此，我们旨在分析一名与通过CYP2D6进行常见肝脏代谢途径的药物相关的多次ADR患者的基因多态性。

患者情况

我们报告了一名在2年内出现与阿米替林、曲马多和度洛西汀相关的精神病和高血压的患者。

干预措施与结果

进行了药物遗传学检测以评估CYP2D6酶的致病作用，但未显示代谢缺陷。

经验教训

尽管该报告病例结果为阴性；但对细胞色素P450同工酶多态性进行分型在一些有多次ADR病史的患者中可能是一种有用的诊断工具。