...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Canadian journal of hospital pharmacy. >Pharmacokinetic Interactions between Valproic Acid and Lorazepam (PIVOtAL Study): A Review of Site-Specific Practices
【24h】

Pharmacokinetic Interactions between Valproic Acid and Lorazepam (PIVOtAL Study): A Review of Site-Specific Practices

机译：丙戊酸和洛拉齐泮之间的药代动力学相互作用（关键研究）：对网站特定实践的综述

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Coadministration of lorazepam and valproic acid is identified by tertiary references as causing a major drug interaction that requires therapy modification and dosage adjustments. The proposed mechanism involves inhibition of lorazepam glucuronidation via direct inhibition of uridine 5'-diphosphate-glucuronosyltransferase enzymes by valproic acid. However, the clinical significance of this interaction is unclear. Objectives: To identify site-specific practices and assess clinical responses to the interaction between valproic acid and lorazepam. Methods: A chart review was conducted for patients over 18 years of age who were admitted, from September 2008 to September 2014 inclusive, to the psychiatry or neurology service at Vancouver General Hospital, Vancouver, British Columbia, and who received concomitant valproic acid and lorazepam therapy. Results: Of the 30 patients included in the chart review, 12 (40%) received an intervention. A total of 8 (27%) patients experienced an adverse drug reaction (ADR), such as drowsiness and dizziness. Seven of these 8 patients were among those who received an intervention. The mean dosage (± standard deviation) of lorazepam was 4.2 ±1.2 mg per day among patients who experienced an ADR and less than 2 mg per day among those who did not experience an ADR. Conclusions: The current recommendation from tertiary drug references is to reduce the dose of lorazepam by 50% when this drug is coadminis-tered with valproic acid. However, this recommendation could not be validated through an analysis of patients exposed to this interaction in the clinical setting or through a review of the literature. Further clinical and pharmacokinetic studies are required to determine whether concurrent treatment with lorazepam and valproic acid should be considered as causing a major drug interaction. Until more data are available, clinicians should remain cognizant of the potential for a drug-drug interaction and should use the lowest effective dose of lorazepam when this drug is administered concomitantly with valproic acid.
机译：背景：三级参考文献确定，劳拉西泮和丙戊酸钠合用会引起主要的药物相互作用，需要进行治疗调整和剂量调整。所提出的机制涉及丙戊酸通过直接抑制尿苷5'-二磷酸葡萄糖醛酸转移酶抑制劳拉西泮葡萄糖醛酸化。然而，这种相互作用的临床意义尚不清楚。目的：确定特定场所的实践，并评估丙戊酸钠和劳拉西泮相互作用的临床反应。方法：对2008年9月至2014年9月期间在不列颠哥伦比亚省温哥华市温哥华总医院接受精神病学或神经病学服务并同时接受丙戊酸和劳拉西泮治疗的18岁以上患者进行图表回顾。结果：在纳入图表审查的30名患者中，12名（40%）接受了干预。共有8名（27%）患者出现药物不良反应（ADR），如嗜睡和头晕。这8名患者中有7人接受了干预。在发生ADR的患者中，劳拉西泮的平均剂量（±标准偏差）为4.2±1.2 mg/d，而在未发生ADR的患者中，劳拉西泮的平均剂量小于2 mg/d。结论：目前来自三级药物参考文献的建议是，当该药物与丙戊酸合用时，将劳拉西泮的剂量减少50%。然而，这项建议无法通过对临床环境中暴露于这种相互作用的患者进行分析或通过文献回顾来验证。需要进行进一步的临床和药代动力学研究，以确定劳拉西泮和丙戊酸同时治疗是否应被视为引起主要药物相互作用。在获得更多数据之前，临床医生应继续认识到药物相互作用的可能性，并在与丙戊酸同时服用该药物时，应使用最低有效剂量的劳拉西泮。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号