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常见抗真菌药物相互作用治疗浅部真菌感染。

Common drug-drug interactions in antifungal treatments for superficial fungal infections.

机构信息

a Department of Medicine , University of Toronto School of Medicine , Toronto , Canada.

b Mediprobe Research Inc ., London , Canada.

出版信息

Expert Opin Drug Metab Toxicol. 2018 Apr;14(4):387-398. doi: 10.1080/17425255.2018.1461834. Epub 2018 Apr 26.

Abstract

Antifungal agents can be co-administered alongside several other medications for a variety of reasons such as the presence of comorbidities. Pharmacodynamic interactions such as synergistic and antagonistic interactions could be the result of co-administered medications. Pharmacokinetic interactions could also transpire through the inhibition of metabolizing enzymes and drug transport systems, altering the absorption, metabolism and excretion of co-administered medications. Both pharmacodynamic and pharmacokinetic interactions can result in hospitalization due to serious adverse effects associated with antifungal agents, lower therapeutic doses required to achieve desired antifungal activity, and prevent antifungal resistance. Areas covered: The objective of this review is to summarize pharmacodynamic and pharmacokinetic interactions associated with common antifungal agents used to treat superficial fungal infections. Pharmacodynamic and pharmacokinetic interactions that impact the therapeutic effects of antifungal agents and drugs that are influenced by the presence of antifungal agents was the context to which these antifungal agents were addressed. Expert opinion: The potential for drug-drug interactions is minimal for topical antifungals as opposed to oral antifungals as they have minimal exposure to other co-administered medications. Developing non-lipophilic antifungals that have unique metabolizing pathways and are topical applied are suggested properties that could help limit drug-drug interactions associated with future treatments.

摘要

抗真菌药物可以与其他几种药物联合使用,原因有多种,例如存在合并症。药效学相互作用,如协同和拮抗相互作用,可能是联合用药的结果。药代动力学相互作用也可能通过抑制代谢酶和药物转运系统发生,改变联合用药的吸收、代谢和排泄。由于与抗真菌药物相关的严重不良反应、实现所需抗真菌活性所需的治疗剂量降低以及预防抗真菌耐药性,药效学和药代动力学相互作用都可能导致住院治疗。

涵盖领域

本综述的目的是总结与治疗浅表真菌感染常用的常见抗真菌药物相关的药效学和药代动力学相互作用。抗真菌药物和受抗真菌药物存在影响的药物的治疗效果受到影响的药效学和药代动力学相互作用是讨论这些抗真菌药物的背景。

专家意见

与口服抗真菌药物相比,局部用抗真菌药物发生药物-药物相互作用的可能性较小,因为它们与其他联合使用的药物接触较少。开发具有独特代谢途径且局部应用的非亲脂性抗真菌药物是一种可能有助于限制与未来治疗相关的药物-药物相互作用的建议特性。

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