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病例报告：药物遗传学评估提示的危及生命的氟西汀相关性术后出血

Case Report: Life-Threatening Fluoxetine-Linked Postoperative Bleeding Informed by Pharmacogenetic Evaluation.

作者信息

Rogers Sara, Silva Patrick J, Udeani George, Deleon Monica, Mutyala Sriarchala, Panahi Ladan, Abu-Baker Asim, Neal Gabriel, Ramos Kenneth S

机构信息

Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, 78363, USA.

Department of Translational Medical Sciences, School of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA.

出版信息

Drugs R D. 2024 Mar;24(1):117-121. doi: 10.1007/s40268-023-00451-5. Epub 2024 Feb 28.

DOI:10.1007/s40268-023-00451-5
PMID:38413481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11035520/
Abstract

BACKGROUND

Selective serotonin reuptake inhibitors (SSRI) are commonly used for the treatment of depression and anxiety. Inhibition of serotonin reuptake in platelets increases bleeding risk in patients taking SSRIs.

CASE

Here, we present the case of a 52-year-old patient who developed severe postsurgical bleeding requiring blood transfusion following panniculectomy.

CONCLUSION

SSRI-induced bleeding is dose-related and strongly influenced by individual variations in drug metabolizing enzymes and transporters. Supplementary file1 (MP4 8441 KB).

摘要

背景

选择性5-羟色胺再摄取抑制剂（SSRI）常用于治疗抑郁症和焦虑症。服用SSRI的患者，血小板中5-羟色胺再摄取受抑制会增加出血风险。

病例

在此，我们报告一例52岁患者，其在腹部去脂术后发生严重术后出血，需要输血。

结论

SSRI引起的出血与剂量相关，且受药物代谢酶和转运体个体差异的强烈影响。补充文件1（MP4格式，8441KB）。

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本文引用的文献

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J Psychiatr Pract. 2021 Sep 16;27(5):372-379. doi: 10.1097/PRA.0000000000000568.
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Assessing the Mechanism of Fluoxetine-Mediated CYP2D6 Inhibition.评估氟西汀介导的CYP2D6抑制机制。
Pharmaceutics. 2021 Jan 23;13(2):148. doi: 10.3390/pharmaceutics13020148.
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Association of CYP2C19 and CYP2D6 Poor and Intermediate Metabolizer Status With Antidepressant and Antipsychotic Exposure: A Systematic Review and Meta-analysis.CYP2C19 和 CYP2D6 弱代谢和中间代谢状态与抗抑郁药和抗精神病药暴露的关联：系统评价和荟萃分析。
JAMA Psychiatry. 2021 Mar 1;78(3):270-280. doi: 10.1001/jamapsychiatry.2020.3643.
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Demonstration of an action pathway in mouse platelets leading to prolongation of bleeding time by fluoxetine.展示了氟西汀导致小鼠血小板作用途径延长出血时间的机制。
Eur J Pharmacol. 2020 Sep 15;883:173385. doi: 10.1016/j.ejphar.2020.173385. Epub 2020 Jul 23.
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Fluoxetine and Risk of Bleeding in Patients Aged 60 Years and Older Using the Korea Adverse Event Reporting System Database: A Case/Noncase Study.氟西汀与 60 岁及以上使用韩国不良事件报告系统数据库患者出血风险：病例/非病例研究。
J Clin Psychopharmacol. 2019 Jul/Aug;39(4):362-366. doi: 10.1097/JCP.0000000000001059.
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Nat Rev Cardiol. 2019 Mar;16(3):166-179. doi: 10.1038/s41569-018-0110-0.
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