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抗癫痫药物与合并症治疗药物在儿童癫痫患者中的药代动力学药物相互作用。

Pharmacokinetic drug interactions between antiseizure medications and drugs for comorbid diseases in children with epilepsy.

机构信息

Regional Health Agency of Tuscany, Firenze, Italy.

Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.

出版信息

Expert Opin Drug Metab Toxicol. 2021 May;17(5):595-610. doi: 10.1080/17425255.2021.1903429. Epub 2021 Mar 30.

Abstract

: Nearly 80% of children with epilepsy have one or more chronic comorbidities that require specific drug treatments in several cases. Drug-drug interactions (DDIs) between antiseizure medications (ASMs) and all other drugs (NON-ASMs) used to treat comorbid diseases may have serious consequences.: All potential DDIs between 27 ASMs and all NON-ASMs used for oral chronic treatment of those disorders most often comorbid with epilepsy in children were searched for drug compendia. Clinical evidence of the identified DDIs was also searched in the literature. Forty-eight drugs have been identified as potential DDIs with at least one ASM. Most important DDIs are between some ASMs and omeprazole and pantoprazole (drugs for gastrointestinal disorders), ibuprofen and cyclobenzaprine (drugs for musculoskeletal disorders), loratidine, lumacaftor/ivacaftor, montelukast, and theophylline (drugs for respiratory system), levothyroxine, liothyronine and several corticosteroids (systemic hormonal preparations), almotriptan, dihydroergotamine, ergotamine, and several antipsychotics, antidepressants and anxiolytics (drugs for nervous diseases). Clinical evidence of the predicted DDIs was found in a minority of cases.: Treatment of children with epilepsy should be decided considering treatment of both seizures and comorbid diseases and aimed at minimizing the risk of DDIs between ASMs and NON-ASMs.

摘要

近 80%的癫痫患儿存在一种或多种需要在某些情况下进行特定药物治疗的慢性共病。抗癫痫药物 (ASM) 与用于治疗共病的所有其他药物 (NON-ASM) 之间的药物-药物相互作用 (DDI) 可能会产生严重后果。

从药物学手册中搜索了 27 种 ASM 与所有用于治疗儿童最常见共病的慢性口服疾病的 NON-ASM 之间所有潜在的 DDI。还在文献中搜索了已确定的 DDI 的临床证据。已确定 48 种药物与至少一种 ASM 存在潜在 DDI。最重要的 DDI 是一些 ASM 与奥美拉唑和泮托拉唑(用于胃肠道疾病的药物)、布洛芬和环苯扎林(用于肌肉骨骼疾病的药物)、氯雷他定、拉莫三嗪、芦芦卡帕/依伐卡帕、孟鲁司特和茶碱(用于呼吸系统的药物)、左甲状腺素、左甲状腺素钠和几种皮质类固醇(全身激素类制剂)、阿莫曲坦、二氢麦角胺、麦角胺和几种抗精神病药、抗抑郁药和抗焦虑药(用于治疗神经系统疾病的药物)之间的 DDI。在少数情况下发现了预测 DDI 的临床证据。

治疗癫痫患儿时,应考虑到治疗癫痫发作和共病的治疗,并旨在最大限度地减少 ASM 和 NON-ASM 之间 DDI 的风险。

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