新的抗抑郁药物和细胞色素P450系统:关注文拉法辛、奈法唑酮、米氮平。
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新的抗抑郁药物和细胞色素P450系统:关注文拉法辛、奈法唑酮、米氮平。
抑制焦虑。1998;7增刊1:24-32。
- PubMed ID
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9597349 (在PubMed]
- 文摘
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目的:综述批判性评估最近的细胞色素P450的信息系统,重点是药物的相互作用包括抗抑郁药物,尤其是文拉法辛、奈法唑酮、米氮平。方法:国际文学细胞色素P450系统和相关药物的相互作用从1995 - 1997年被严格检查。结果:文拉法辛、奈法唑酮和米氮平对细胞色素P450系统有不同的影响。体外,文拉法辛是一种弱CYP2D6抑制剂比大多数的选择性5 -羟色胺再摄取抑制剂(SSRIs) 1 - 3倍的数量级。体内药物相互作用研究体外一般确认结果。然而,一些例外存在。这种相互作用的临床意义仍然是未知的。文拉法辛极少或没有论证抑制CYP1A2, CYP3A4,或者CYP2C。奈法唑酮是一种CYP3A4的有效抑制剂,因此与并发管理terfenadine绝对禁忌,阿司咪唑、cisapride。这是一个弱抑制CYP1A2, 3 a4, 2 d6。 A metabolite of nefazodone, mCPP, is a weak and probably clinically insignificant inhibitor of CYP2D6. Mirtazapine has minimal inhibitory effects on CYP1A2, CYP3A4, and CYP2D6 in vitro. Little is known about its interactions with other drugs. CONCLUSIONS: With the addition of the latest antidepressant medications, the clinician may now choose antidepressants with little liability for drug-drug interactions. Venlafaxine and mirtazapine are associated with a lower risk of clinically significant drug interactions than SSRIs. Nefazodone is a potent inhibitor of CYP3A4 and therefore may not be suitable for all patient populations. It is, however, a much weaker CYP2D6 inhibitor than the SSRIs. More studies are needed to assess more accurately and precisely the risk of such untoward drug-drug interactions with these novel antidepressants, particularly in more diverse ethnic patient populations.
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- 药物酶
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药物 酶 类 生物 药理作用 行动 米氮平 细胞色素P450 1 a2 蛋白质 人类 未知的底物细节 米氮平 细胞色素P450 3 a4 蛋白质 人类 未知的底物抑制剂细节 - 药物的相互作用Learn More" title="" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
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药物 交互 整合药物之间
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