Andersen W K, Feingold D S
Department of Dermatology, Boston University Medical Center, Mass., USA.
Arch Dermatol. 1995 Apr;131(4):468-73.
All physicians, including dermatologists, are at risk for prescribing drugs that interact in a harmful way. Although prescribing a harmful drug combination may have serious consequences, no review has examined the drug-drug combinations that are of greatest concern for dermatologists. Our goal is to review the pharmacologic mechanisms of adverse drug interactions, the risky drugs, and the patients who are most vulnerable. In so doing, we hope to provide guidance through a potential minefield of adverse interactions.
Although there are only sparse epidemiologic data regarding the prevalence or cost of adverse drug interactions in dermatology, the consequences may range from a minor loss of therapeutic effect of an administered agent to a life-threatening toxic reaction. We will review methotrexate, cyclosporin A, antifungal agents, antibiotics, retinoids, and antihistamine interactions with each other and with other systemic medications.
An organized reporting system needs to be developed so that statistically meaningful epidemiologic data can be obtained for adverse drug interactions, such as the Medwatch program recently proposed by the Food and Drug Administration. Such a system will provide valuable data regarding drug combinations that may be dangerous and determine the scope of the problem as a public health issue.
包括皮肤科医生在内的所有医生都有开具有害相互作用药物的风险。尽管开具有害药物组合可能会产生严重后果，但尚无综述研究皮肤科医生最应关注的药物-药物组合。我们的目标是综述药物不良相互作用的药理机制、高风险药物以及最易受影响的患者。通过这样做，我们希望在潜在的不良相互作用雷区中提供指导。
尽管关于皮肤科药物不良相互作用的患病率或成本仅有稀少的流行病学数据，但其后果可能从所使用药物治疗效果的轻微丧失到危及生命的毒性反应不等。我们将综述甲氨蝶呤、环孢素A、抗真菌药、抗生素、维甲酸类药物以及抗组胺药彼此之间以及与其他全身性药物的相互作用。
需要建立一个有组织的报告系统，以便能够获得关于药物不良相互作用的具有统计学意义的流行病学数据，例如美国食品药品监督管理局最近提议的Medwatch计划。这样一个系统将提供有关可能危险的药物组合的有价值数据，并确定作为公共卫生问题的该问题的范围。
