注射用美罗培南与丙戊酸钠的药物相互作用分析

目的探究注射用美罗培南对丙戊酸钠血药浓度的影响及机制。方法通过收集我院相关病例资料及查阅美罗培南与丙戊酸钠药物相互作用的相关文献报道,归纳总结美罗培南对丙戊酸钠血药浓度的影响及机制。结果本组共收集到23例注射用美罗培南与丙戊酸钠联合使用的病例,美罗培南使用后引起丙戊酸钠血药浓度明显降低(P<0.05),丙戊酸的血药浓度从(35.74±2.3)mg/L下降到(2.97±1.3)mg/L。其作用机制为合用美罗培南抑制丙戊酸钠的吸收,使丙戊酸钠向红细胞转运加强,抑制葡萄糖醛酸丙戊酸分解为游离型丙戊酸。结论在临床上要尽量避免美罗培南与丙戊酸钠联合使用,这两种药物的相互作用是不能通过改变丙戊酸钠的剂量而缓解的,临床上在使用丙戊酸钠时必须要用美罗培南时可改用卡马西平或苯妥英钠等药物替代。

The Analysis of Injection of Meropenem and Sodium Valproate Drug Interaction

Objective Explore the injection of sodium valproate plasma concentration of meropenem and mechanisms.Methods Access to meropenem sodium valproate drug interactions reported in the literature,summarized the impact and mechanisms of sodium valproate plasma concentration of meropenem.Clinical data collected in our hospital and access to meropenem and sodium valproate drug interactions reported in the literature,summarized the impact and mechanisms of sodium valproate plasma concentration of meropenem.Results Were collected from 23 cases of injection used in conjunction with meropenem and sodium valproate cases,caused by sodium valproate serum concentrations were significantly lower（P 0.05） after use of meropenem and valproic acid plasma concentration（35.74 ± 2.3） mg / L down to（2.97 ± 1.3） mg / L.Its mechanism of action of the combination of meropenem inhibited the absorption of valproate sodium valproate to the erythrocyte transporter to enhance,inhibit the glucuronide of valproic acid decomposition as a free type of valproic acid.Conclusion In clinical practice to avoid the joint use of meropenem and sodium valproate,the interaction of these two drugs can not change the dose of sodium valproate alleviate the clinical use of sodium valproate have to use the United Statesmeropenem when you can switch to alternative drugs such as carbamazepine or phenytoin.