目的 结合实际案例,对利福平与华法林联合使用时华法林剂量的调整进行文献检索和分析,为给药方案的优化提供解决路径。方法 报道、分析1例案例,同时查阅相关文献进行综述讨论。结果 本例患者在合并使用利福平后,华法林剂量增加至84 mg·week-1时国际标准化比值达标,较黄种人的常规用量21 mg·week-1有明显增加。文献研究提示合并使用利福平时,华法林剂量增加可能达到数倍,停用利福平后,需减少华法林剂量,增加国际标准化比值监测频率。结论 华法林与利福平合并使用时,可根据患者国际标准化比值情况增加华法林剂量,基因检测有益于拟定华法林给药方案;停用利福平后,建议增加国际标准化比值监测频率,及时减低华法林剂量,以达到更佳抗凝效果,减少不良反应发生。
Abstract
OBJECTIVE To report an actual case and doing a review about the interaction of warfarin and rifampin to provide a regimen about the combination of the two drugs. METHODS Discribed a case and analyzed it,while access to relevant literature review.RESULTS With concurrent use of rifampin, the dose of warfarin increase to 84 mg穡eek-1 when targeted INR reached. The available literature suggest that when the two drug concurrent used, warfarin doses may increase for several folds, once discontinue rifampin the warfarin dose should be decreased and more INR tests were needed. CONCLUSION For patient taking rifampin at the same time, the warfarin dose would increase according to the INR, the genetic test may be helpful; when warfarin is discontinued, the warfarin dose may decrease and INR test may increase to get a efficacy and safety anticoagulation therapy.
关键词
华法林 /
利福平 /
抗凝管理 /
基因检测
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Key words
warfarin /
rifampin /
anticoagulation management /
genetic test
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中图分类号：
R969.2
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参考文献
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脚注
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基金
“十二五”国家863计划课题(2012AA02A518)
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