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| Analysis of medical advice of potential metabolic drug interactions in psychiatric inpatients |
| WANG Jing LIU Yan WANG Jianxin |
| Department of Pharmacy, the First Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050031, China |
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Abstract Objective To understand the situation of combined drug use in the medical advice of psychiatric inpatients, analyze the potential drug interaction, and provide reference for clinical drug use. Methods A total of 1658 operational medical records were selected from psychiatric inpatients in the First Hospital of Hebei Medical University (hereinafter referred to as “our hospital”) from July to December 2018 were selected, the medical orders of two or more drugs were screened and counted, and the potential drug interactions were analyzed from the perspective of cytochrome P450 enzyme (CYP450). Results The subtypes of CYP enzymes involved mainly include CYP3A4, CYP2D6, CYP2C9 and CYP2C19, among which CYP2D6 has the most cases, mainly CYP2D6 substrate combined with inhibitors; CYP3A4 was involved in the most medical orders, mainly CYP3A4 substrate combined with substrate. A total of 156 times of 3 or more drugs acting by the same metabolic enzyme, a total of 80 times of 2 or more drugs undergoing 2 metabolic actions. Conclusion There are many potential metabolic drug interactions among psychiatric inpatients in our hospital. The combination of multiple drugs increases the risk of medical treatment, and it is necessary to strengthen the monitoring of therapeutic drugs in clinical application, so as to improve the safety and efficacy of drugs.
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[1] 李珍，杨巧玲，刘晓东.甘南州2014-2018年严重精神障碍患者现状分析[J].中国公共卫生管理，2019，35（3）：416-418，425.
[2] Lambert TJ，Reavley NJ，Jorm AF，et al. Royal Australian and New Zealand College of Psychiatrists expert consensus statement for the treatment，management and monitoring of the physical health of people with an enduring psychotic illness [J]. Aust N Z J Psychiatry，2017，51（4）：322-337.
[3] Monteith S，Glenn T. A comparison of potential psychiatric drug interactions from six drug interaction database programs [J]. Psychiatry Res，2019，275：366-372.
[4] 王毅，何雪梅，林萍.388例精神障碍住院患者时点用药药物相互作用分析[J].中国药物滥用防治杂志，2016，22（2）：68-70，100.
[5] 沙碧君，周素凤，王璐，等.药物相互作用临床研究方法及进展[J].中国临床药理学与治疗学，2019，24（9）：1037-1045.
[6] 姚多祥，修琪昆，陈依军，等.药物相互作用的研究进展[J].药物生物学术，2018，25（6）：546-550.
[7] Munro AW，McLeanKJ，Grant JL，et al. Structure and function of the cytochrome P450 peroxygenase enzymes [J]. Biochem Soc Trans，2018，46（1）：183-196.
[8] Guengerich FP，Waterman MR，Eqli M，et al. Recent Structural Insights into Cytochrome P450 Function [J]. Trends pharmacol Sci，2016，37（8）：625-640.
[9] 魏春燕，吴逢波，徐珽.CYP450与药物相互作用[J].中国药业，2014，23（6）：17-20.
[10] 王传跃.P450酶与精神药物的氧化代谢及相互作用[J].国外医学精神病学分册，1999，26（3）：129-133.
[11] 陈颖，吴晓燕，瞿发林.非典型抗精神病药物的代谢及其引起的药物相互作用[J].实用药物与临床，2010，13（5）：374-376.
[12] Chen X，Liang C，Cui L，et al. A rapid LC-MS/MS method for simultaneous determination of quetiapine and duloxetine in rat plasma and its application to pharmacokinetic interaction study [J]. J Food Drug Anal，2019，27（1）：323-331.
[13] 朱双燕，张清盛，王玮.联合用药致癫痫发作1例病例分析[J].中国药师，2016，19（11）：2099-2101.
[14] 王素云，麦家铭，王占璋，等.118例喹硫平药物不良反应/事件及其发生时间的相关性因素分析[J].中国临床药学杂志，2018，27（6）：413-416.
[15] Schoretsanitis G，Haen E，Gründer G，et al. Pharmacokinetics of venlafaxine in treatment responders and non-responders：a retrospective analysis of a large naturalistic database [J]. Eur J Clin Pharmacol，2019，75（8）：1109-1116.
[16] Paulzen M，Schoretsanitis G，Hiemke C，et al. Reduced clearance of venlafaxine in a combined treatment with quetiapine [J]. Prog Neuropsychopharmacol Biol Psychiatry，2018，85：116-121.
[17] 徐晓晨，刘跃辉，塔娜，等.CYP2C19基因多态性及与其代谢相关药物的研究[J].中国现代医生，2018，56（1）：165-168.
[18] 李晓芳.艾司西酞普兰合并阿立哌唑治疗精神病性症状抑郁症疗效观察[J].世界最新医学信息文摘，2018， 18（87）：103-104.
[19] 李继，王建军，李烨，等.草酸艾司西酞普兰对脑卒中后抑郁、认知及神经功能的影响[J].河北医科大学学报，2017，38（5）：589-592.
[20] 王胜鹏，郗昊，姚蕾.38例西酞普兰及相关制剂致不良反应文献分析[J].中国药物滥用防治杂志，2018，24（4）：211-214.
[21] 刘得水，李丽波，荣华，等.艾司西酞普兰联合黛力新治疗卒中后抑郁患者临床疗效分析[J].中国医药科学，2018， 8（20）：7-10.
[22] 周青.首发重症抑郁伴失眠患者应用艾司西酞普兰治疗的临床效果[J].中外医学研究，2018，16（31）：126-127.
[23] 周朝雄.艾司西酞普兰与帕罗西汀治疗单项抑郁症的临床疗效及不良反应观察[J].当代医学，2018，24（22）：152-153. |
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