Centeno-Hoil Gregoreo, Mousavi Homa
Farmacéutico comunitario. Farmacia Zarzuelo, Benalmádena (Málaga). Farmacia España.
Farm Comunitarios. 2023 Dec 21;16(3):37-42. doi: 10.33620/FC.2173-9218.(2024).11. eCollection 2024 Apr 15.
The study presents the case of a 47-year-old woman with type 2 diabetes (T2D), hypertension and anemia, treated with metformin, glyburide, metoprolol, and iron/folic acid. A drug interaction was identified between glyburide and metoprolol, causing symptoms of hypoglycemia in the afternoon. Evaluation using Horn's Drug Interaction Probability Scale (DIPS) suggested a probable interaction. Pharmacokinetic analysis revealed that the time at which the maximum concentrations of both drugs were reached coincided with the onset of symptoms. A new medication schedule was implemented which resolved the symptoms. The drug interaction was attributed to the blockade of adrenergic effects by metoprolol, compromising the ability to counteract the action of insulin released by glybenclamide. The importance of surveillance, informed decision-making and the implementation of preventive strategies is highlighted to ensure the safety and effectiveness of pharmacological treatment in patients with specific clinical conditions, such as T2D and concomitant cardiovascular diseases.
该研究报告了一名47岁患有2型糖尿病（T2D）、高血压和贫血的女性病例，她正在接受二甲双胍、格列本脲、美托洛尔以及铁/叶酸治疗。研究发现格列本脲和美托洛尔之间存在药物相互作用，导致患者在下午出现低血糖症状。使用霍恩药物相互作用概率量表（DIPS）进行评估表明这可能是一种相互作用。药代动力学分析显示，两种药物达到最大浓度的时间与症状发作时间一致。实施了新的用药方案后症状得到缓解。这种药物相互作用归因于美托洛尔对肾上腺素能效应的阻断，损害了机体对抗格列本脲释放胰岛素作用的能力。强调了监测、明智决策以及实施预防策略对于确保患有特定临床病症（如T2D和伴发心血管疾病）患者药物治疗的安全性和有效性的重要性。
