期刊
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
卷 39, 期 3, 页码 319-321出版社
WILEY
DOI: 10.1111/jcpt.12135
关键词
pharmacy practice; Japanese patient; vitamin K epoxide reductase complex, subunit 1; warfarin; cytochrome P450 2C9; therapeutic drug monitoring; pharmacogenetics; carbamazepine
资金
- Grants-in-Aid for Scientific Research [25670049] Funding Source: KAKEN
What is known and objective Carbamazepine is known to interact with warfarin. We report on a case of this interaction and on its management using the patient's genetic information. Case summary The case concerns a 74-year-old Japanese woman with a mood disorder and a central retinal vein occlusion. She was on therapy that included carbamazepine and had started to take warfarin. However, the patient's prothrombin time expressed as the international normalized ratio (PT-INR) was 1 center dot 40 despite taking a dose three times higher than the average. The patient's S-warfarin concentration was 0 center dot 15 mu g/mL and R-warfarin was 0 center dot 52 mu g/mL. Her cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase complex, subunit 1 (VKORC1), genotypes were *1/*1 and -1639GA, respectively. The VKORC1 genotype indicated that she would require an even higher dose. We proposed a further increase in dose and the patient's PT-INR rose to 1 center dot 99. What is new and conclusion The patient required a high warfarin dose because of the VKORC1 genotype, and induction of CYP2C9 by carbamazepine. We improved the patient's pharmacotherapy based on her genetic information.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据