环孢素A与钙离子通道拮抗剂的相互作用及临床意义

杨静; 董艺宁; 彭婷婷; 赵春蕾; 孙淑娟<sup>*</sup>

引用本文:	杨静,董艺宁,彭婷婷,赵春蕾,孙淑娟.环孢素A与钙离子通道拮抗剂的相互作用及临床意义[J].中国现代应用药学,2015,32(7):891-895.
	YANG Jing,DONG Yining,PENG Tingting,ZHAO Chunlei,SUN Shujuan.Interaction and Clinical Significance of Cyclosporine A and Calcium Channel Blockers[J].Chin J Mod Appl Pharm(中国现代应用药学),2015,32(7):891-895.

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环孢素A与钙离子通道拮抗剂的相互作用及临床意义
杨静¹, 董艺宁², 彭婷婷³, 赵春蕾⁴, 孙淑娟⁵
1.山东省交通医院，济南 250031;2.山东黄河医院，济南 250032;3.山东省中医药大学二附院，济南 250001;4.济南市历城区人民医院，济南 250115;5.山东省千佛山医院药学部，济南 250014

摘要:

器官移植术后尤其使用环孢素A后所致高血压常选用钙离子通道拮抗剂作为一线降压药物。但由于两者都主要通过肝微粒体CYP450酶系代谢，同时又是P-糖蛋白的底物及抑制剂，因此存在较多相互作用。不同钙离子通道拮抗剂对环孢素A血药浓度的影响有较大区别，而环孢素A的免疫抑制作用强度、肝肾毒性与其血药浓度又呈量效依赖关系，因此有必要将两者的相互作用进行深入探讨。本文主要通过分析环孢素A与钙离子通道拮抗剂的药代学及药效学相互作用及相关研究进展，以期为临床联用环孢素A与钙离子通道拮抗剂提供合理使用建议。

关键词: 环孢素A 钙离子通道拮抗剂相互作用

DOI：

分类号:

基金项目:山东省自然科学基金资助项目(ZR2011HL049)；山东省科技厅资助基金(2010GWZ20217, 2013GSF11848)；山东省中医药局课题(2013-196)

Interaction and Clinical Significance of Cyclosporine A and Calcium Channel Blockers

YANG Jing¹, DONG Yining², PENG Tingting³, ZHAO Chunlei⁴, SUN Shujuan⁵

1.Shandong Traffic Hospital, Jinan 250031, China;2.Shandong Huanghe Hospital, Jinan 250032, China;3.The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250115, China;4.Licheng District People's Hospital of Jinan, Jinan 250001, China;5.Pharmacy Department of Shandong Qianfoshan Hospital, Jinan 250014, China

Abstract:

Calcium channel blockers are often chosen as a first-line hypotensor in the treatment of high blood pressure after organ transplantation, especially after using cyclosporine A. Calcium channel blockers and cyclosporine A are mainly metabolized by CYP450 enzyme system of liver microsomes, and both are P-glycoprotein substrates and inhibitors, so there are many interactions. The influence of different calcium channel blockers on the plasma concentration of cyclosporine A is very different. However, the immune inhibition strength, liver and kidney toxicity of cyclosporine A and it's plasma concentration are dose-dependent. Therefore it is necessary to explore the interaction of cyclosporine A and calcium channel blockers. In this paper, by analyzing the pharmacokinetic and pharmacodynamics interaction and related research progress, it is provided reasonable advice for clinical combination cyclosporine A and calcium channel blockers.

Key words: cyclosporine A calcium channel blockers interaction