Qureshi G D, Reinders T P, Somori G J, Evans H J
Ann Intern Med. 1984 Apr;100(4):527-9. doi: 10.7326/0003-4819-100-4-527.
Drug-induced warfarin resistance may be mediated by the direct effect of a drug on warfarin's absorption, excretion, distribution, or metabolism. A 29-year-old man on long-term stable anticoagulation therapy with warfarin sodium developed resistance to warfarin while receiving nafcillin. His prothrombin time ranged between 14 and 17 s (control, 12 s) despite an increase in his warfarin dosage to 25 mg/d. Pharmacokinetic studies showed that the decreased hypoprothrombinemic effect of warfarin was most likely due to rapid metabolism of the anticoagulant induced by nafcillin. Warfarin's half-life was 11 hours when the patient was on nafcillin therapy and 44 hours when he was off nafcillin therapy. This interaction may be clinically important in patients requiring concomitant administration of nafcillin and warfarin.
药物诱导的华法林抵抗可能是由药物对华法林吸收、排泄、分布或代谢的直接作用介导的。一名29岁长期接受华法林钠稳定抗凝治疗的男性在接受萘夫西林治疗时出现了对华法林的抵抗。尽管他的华法林剂量增加到25mg/d，但其凝血酶原时间仍在14至17秒之间（对照为12秒）。药代动力学研究表明，华法林降低凝血酶原的作用减弱很可能是由于萘夫西林诱导抗凝剂快速代谢所致。患者接受萘夫西林治疗时，华法林的半衰期为11小时，未接受萘夫西林治疗时为44小时。这种相互作用在需要同时使用萘夫西林和华法林的患者中可能具有临床重要性。
