21.有關
之敘述,下列何者正確?
(A)ticagrelor的活化基因具有基因多型性,用藥前應先進行基因檢測
(B)服用clopidogrel的病人,應避免併用omeprazole,以防交互作用
(C)cangrelor主要經由CYP2C19代謝
(D)併用CYP3A4 inhibitor會影響prasugrel的藥效
答案:登入後查看
統計: A(185), B(3245), C(214), D(220), E(0) #2623946
統計: A(185), B(3245), C(214), D(220), E(0) #2623946
詳解 (共 10 筆)
#5546893
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抑制ADP Recepter (P2Y12) |
CABG停藥 |
其他 |
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不可逆 |
Ticlopidine |
Pro- drug |
肝代活化(3A4) 罕見致命血小板低下、血小板低下紫斑症 |
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|
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Clopidogrel |
肝代活化(2C19) 血液病變毒性小、血小板低下紫斑症 |
停5天 |
同時開立了omeprazole,可改ticagrelor,非得用PPI可用pantoprazole |
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|
Prasugrel |
水解活化 |
停7天
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避免使用 1. >75y or<60kg 2.曾經中風、TIA (∵出血風險高) |
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可逆 (can) |
Cangrelor |
唯一IV |
停1小時 |
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|
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Ticagrelor |
3A4受質 |
停3天 (有看到停5天 |
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51
0
#4927983
是不影響活化 但代謝需要3A4呀 ಠ_ಠ
Clopidogrel is a pro-drug which is converted to its active drug moiety by CYP450 2C19 isoenzyme
prasugrel is also a pro-drug, but it undergoes conversion to its active metabolite via hydrolysis in the intestine and then oxidation by CYP450 2B6 and 3A4 isoenzymes
ㅤㅤ
https://www.acc.org/latest-in-cardiology/articles/2017/06/22/06/24/comparison-of-clopidogrel-and-prasugrel-for-prevention-of-ischemic-events-in-acs
42
0
#5535372
補充
Ticagrelor 是
1)3A4 受質
2)P-gp 受質 跟 inhibitor
Ticagrelor 是
1)3A4 受質
2)P-gp 受質 跟 inhibitor
26
0