从1例肾移植术后肺部感染患者探讨伏立康唑与他克莫司的药物相互作用.pdfVIP

中国药物应用与监测 2014 年10月第11卷第5 期 Chinese Journal of Drug Application and Monitoring, Vol.11, No.5, October 2014 从1 例肾移植术后肺部感染患者探讨伏立康唑与他克莫司的药物相互作用 1 1 1 1 2（1.解放军总医院药品保障中心，北京100853 ；2. 山东省千佛山医院药学部，山东济南250014 ） 黄翠丽 ，郭代红 ，朱　曼 ，王东晓 ，牟　燕 [摘要]　1例肾移植术后女性患者，因肺部感染入院，入院后合并使用伏立康唑与他克莫司（FK506 ）。临床药师重点关注 伏立康唑与 FK506 的药物相互作用，密切监测FK506 血药浓度，发现合并使用伏立康唑后，患者 FK506 血药浓度显著升高。 根据血药浓度调整 FK506 的剂量为原来剂量的 1/4，达到良好的治疗效果，并避免药物不良事件的发生。鉴于伏立康唑与 FK506 有显著的药物相互作用，建议在用药过程中应密切监测 FK506 血药浓度，并根据血药浓度调整给药剂量。 [关键词]　伏立康唑；他克莫司；药物相互作用；血药浓度 [ 中图分类号]　R969.2　　 [ 文献标识码]　A　 [ 文章编号]　1672 – 8157(2014)05 – 0291 – 03 Investigation of the drug interaction between voriconazole and tacrolimus through a renal transplant recipient with pulmonary infection 1 1 1 1 2 HUANG Cui-li , GUO Dai-hong , ZHU Man , WANG Dong-xiao , MU Yan (1. Department of Pharmaceutical Care, PLA General Hospital, Beijing 100853, China; 2. Department of Pharmacy, Qianfoshan Hospital of Shandong Province, Jinan 250014, China) [ABSTRACT]　One female patient with renal transplant was admitted into hospital for pulmonary infection. After admission, the patient received the concomitant administration of voriconazole and tacrolimus (FK506). Clinical pharmacists paid more attention to the drug interaction between voriconazole and FK506, and monitored closely the blood drug concentration of FK506. During the combination use of voriconazole and FK506, the concentration of FK506 markedly increased. In order to obtain good therapeutic effect and avoid adverse drug reactions, the dose of FK506 was adjusted to 1/4 of the initial dose with the participation of the clinical pharmacists through the monitoring of blood drug concentration. Therefore, the blood drug concentration of FK506 should be monitored closely, the dose of FK506 should be adjusted in consideration of the drug interaction between voriconazole and