醋硝香豆素可作为华法林相关性肾病患者的替代抗凝剂。
Acenocoumarol as an alternative anticoagulant in a patient with warfarin-related nephropathy.
机构信息
Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Department of Cardiothoracic & Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
出版信息
Br J Clin Pharmacol. 2018 May;84(5):1068-1071. doi: 10.1111/bcp.13541. Epub 2018 Feb 28.
Abstract
ADVERSE EVENT
Warfarin-related nephropathy.
DRUG IMPLICATED
Warfarin.
THE PATIENT
A 31-year-old female, managed with warfarin for rheumatic heart disease with atrial fibrillation.
EVIDENCE THAT LINKS THE DRUG TO THE EVENT
There were no alternative causes of nephropathy that could have caused the adverse event in this patient.
MANAGEMENT
Shifting the drug from warfarin to acenocoumarol.
MECHANISM
Difference in renal elimination between warfarin and acenocoumarol.
IMPLICATION FOR THERAPY
Clinicians should be aware of this rare adverse effect of warfarin, and acenocoumarol can be considered as an alternative therapy for this condition.
HYPOTHESES TO BE TESTED
Further prospectively designed studies are needed to consider acenocoumarol as an alternative therapy in warfarin-related nephropathy.
摘要
不良反应
华法林相关性肾病。
涉及药物
华法林。
患者
一名 31 岁女性，因风湿性心脏病伴心房颤动接受华法林治疗。
药物与事件关联的证据
无其他可能导致该患者发生不良反应的肾脏疾病病因。
处理方法
将药物从华法林转换为醋硝香豆素。
作用机制
华法林和醋硝香豆素在肾脏清除方面的差异。
治疗意义
临床医生应注意华法林这种罕见的不良反应，醋硝香豆素可作为这种情况下的替代治疗方法。
待检验假设
需要进一步前瞻性设计研究，以考虑在华法林相关性肾病中用醋硝香豆素替代治疗。
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