患有心内膜炎并接受抗生素治疗的患者的抗凝问题：利福平与维生素K拮抗剂的相互作用
Problems in anticoagulation of a patient with antibiotic treatment for endocarditis: interaction of rifampicin and vitamin K antagonists.
作者信息
Mizera Lars, Geisler Tobias, Mörike Klaus, Gawaz Meinrad, Steeg Martin
机构信息
Klinik für Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tuebingen, Germany.
Department fur Experimentelle und Klinische Pharmakologie und Toxikologie, Eberhard Karls Universitat Tubingen, Tübingen, Germany.
出版信息
BMJ Case Rep. 2018 Feb 12;2018:bcr-2016-215155. doi: 10.1136/bcr-2016-215155.
Abstract
The cytochrome P450 is a superfamily of isoenzymes that are responsible for the metabolism of many drugs. Significant changes in pharmacokinetics and drug interactions may be due to induction of hepatic cytochrome P450 enzymes. Rifampicin is a common inducer of CYP3A4. We report a case of a 57-year-old woman who was suspected for endocarditis and therefore treated with rifampicin. Due to previous mechanical aortic valve replacement, she also received phenprocoumon for anticoagulation. Although continuing anticoagulant therapy, antibiotic coadministration led to normal international normalised ratio (INR) level. Fifteen days after the treatment with rifampicin ended, INR returned to therapeutic level.
摘要
细胞色素P450是一个同工酶超家族，负责许多药物的代谢。药代动力学和药物相互作用的显著变化可能是由于肝细胞色素P450酶的诱导。利福平是CYP3A4的常见诱导剂。我们报告一例57岁女性患者，怀疑患有心内膜炎，因此接受利福平治疗。由于之前进行了机械主动脉瓣置换，她还接受苯丙香豆素进行抗凝治疗。尽管继续进行抗凝治疗，但抗生素联合使用导致国际标准化比值（INR）水平正常。利福平治疗结束15天后，INR恢复到治疗水平。
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