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[大学生论坛]:患者使用华法林和头孢洛林酯后国际标准化比值上升

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young 发表于 2017-12-30 19:59:55 | 显示全部楼层 |阅读模式
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Elevated International Normalized Ratio values in a patient receiving warfarin and ceftaroline.
患者使用华法林和头孢洛林酯后国际标准化比值上升
AbstractPURPOSE:
研究目标:
The case of a patient whose International Normalized Ratio (INR) became elevated due to a probable interaction between ceftaroline and warfarin is reported.
报告一患者的国际标准化比值上升的病例,原因可能是头孢洛林酯与华法林的相互作用。
SUMMARY:
概要:
A 65-year-old African-American man developed an INR of >18.0 after completing 12 days of ceftaroline therapy for the treatment of cellulitis while taking warfarin therapy. The patient was on warfarin due to his history of deep vein thrombosis of a lower extremity and pulmonary embolism, and his INR was consistently therapeutic for approximately 2 years before ceftaroline therapy. The patient reported no known drug allergies, had no history of adverse drug reactions, and had no recent changes in medications or diet. Phytonadione was administered, and the patient's INR began to decrease, returning to a therapeutic range of 2.30 after approximately 48 hours, at which time warfarin was restarted. After six days of hospitalization, the patient was discharged on his previous regimen of warfarin 7.5 mg orally once daily, with a therapeutic INR of 2.11. His cellulitis had resolved, so no further antibiotic therapy was warranted. To determine the likelihood of the drug interaction between warfarin and ceftaroline in this patient, the Drug Interaction Probability Scale of Horn and colleagues was applied and yielded a score of 6, indicating a probable likelihood of an interaction. Rechallenge was not attempted, as the patient's cellulitis had resolved and there were no evident signs or symptoms of infection.
一位非裔美国人,男性,65岁,使用头孢洛林酯治疗蜂窝组织炎,期间同时服用华法林,12天治疗结束后,该男子INR大于18.0。患者因为下肢深静脉血栓与肺栓塞史服用华法林,在使用头孢洛林酯之前的约两年时间里,INR一直维持在治疗范围内。该患者称无已知的药物过敏,无不良药物反应史,近期也未曾改变药物和饮食。注射维生素K1后,INR开始下降,约48小时后,INR降到治疗范围内,为2.3,于是再次使用华法林。住院六天后,患者出院并沿用之前的华法林使用方案,每日一次,口服7.5mg,其INR 为2.11。蜂窝组织炎消除,所以不再需要抗生素治疗。为检测该患者体内华法林与头孢洛林酯相互作用的可能性,该研究采用了Horn及其同事们的药物相互作用可能性量表,得分为6分,表明可能存在药物相互作用。因为患者蜂窝组织炎已经消除,且没有明显的感染的体征和症状,所以没有再次质疑。
CONCLUSION:
结论:
A 65-year-old man experienced an increase in INR values after the addition of ceftaroline to his medication regimen.
一名65岁男性在服用药物期间增加服用头孢洛林酯,随后其INR上升。

2014级医学英语 杨晓雅 3141201051
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