新型冠状病毒肺炎治疗药物与精神科药物的相互作用

目的 探讨新型冠状病毒肺炎(COVID-19)治疗药物与精神科药物的相互作用,为临床合理用药提供参考。方法 通过查阅文献及美国Medscape网站药物相互作用查询功能,从新型冠状病毒肺炎主要治疗药物代谢动力学入手,分析其与精神科药物的相互作用。结果 CYP3A4强效抑制剂利托那韦、克拉霉素、伊曲康唑等会抑制主要经CYP3A代谢的精神科药物清除而升高其血药浓度,从而引起严重或致命的不良反应;喹诺酮类抗菌药物特别是环丙沙星是CYP1A2的强抑制剂,可抑制氯氮平的代谢,导致氯氮平中毒致死;中药中的某些成分同样会影响精神科药物的疗效。结论 新型冠状病毒肺炎治疗药物与精神科药物的相互作用普遍存在,临床用药时应高度重视,避免严重不良反应的发生。

Drug Interactions Between Psychiatric Drugs and Drugs for the Coronavirus Disease 2019

Objective To investigate the drug interactions between psychotropic drugs and drugs for the coronavirus disease 2019(COVID-19),so as to provide reference for the rational application of clinical drugs.Methods The pharmacokinetics of main treatment drugs for the COVID-19 were searched through literature review and the Medscape’s inquiry function of drug interactions,to analyze the drug interactions between them and psychiatric drugs.Results Ritonavir,clarithromycin and itraconazole,the potent inhibitors of CYP3 A4,could inhibit the clearance of psychiatric drugs mainly metabolized by CYP3 A and increase their plasma concentration,thus causing serious or fatal adverse reactions.Quinolones,especially ciprofloxacin,as a strong inhibitor of CYP1 A2,could inhibit the metabolism of clozapine and lead to the death induced by clozapine poisoning.Some ingredients of Chinese herb medicine could also affect the efficacy of psychiatric drugs.Conclusion The drug interactions between psychotropic drugs and drugs for the COVID-19 are common,we should pay great attention to drug interactions in the clinical use to avoid the occurrence of serious adverse reactions.