丙二醇、苯甲醇和乙醇合用药物会影响危重新生儿静脉注射对乙酰氨基酚后的临床结果吗?

K. Sridharan, Muna Al Jufairi
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引用次数: 0

摘要

丙二醇(PG)和苯甲醇(BA)已被证明能抑制肝脏中对乙酰氨基酚的代谢酶。乙醇对对对乙酰氨基酚的代谢有着不可预测的影响。危重新生儿通常接受含有PG、BA和乙醇作为赋形剂的药物制剂。到目前为止,还没有关于BA、PG和乙醇作为赋形剂对同时接受对乙酰氨基酚治疗的患者的影响的报告。我们设计了本研究,以评估接受含有赋形剂药物的新生儿与不接受赋形剂的新生儿之间,血浆对乙酰氨基酚浓度、肝功能测试和血清肌酐是否存在任何显著差异。我们纳入了静脉注射对乙酰氨基酚和至少一种含有BA、PG或乙醇作为赋形剂的伴随药物的新生儿。使用测试评估血浆对乙酰氨基酚浓度和肝功能水平。丙氨酸氨基转移酶水平加倍被认为是肝毒性的标志。血清肌酐升高高于基线值>1.5倍被认为是急性肾损伤的指示。研究招募了57名新生儿。两组之间在血清对乙酰氨基酚浓度、肝肾功能测试以及动脉导管成功闭合率方面没有观察到显著差异。由于辅料BA、PG或乙醇的存在,未观察到血清对乙酰氨基酚水平和临床结果的显著变化。含有这些辅料的药物可能是安全的,甚至含有这些辅料和对乙酰氨基酚的制剂也可能对危重新生儿是安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Do Propylene Glycol, Benzyl Alcohol, and Ethanol in Concomitant Drugs Influence Clinical Outcomes Following Intravenous Acetaminophen in Critically Ill Neonates?
Propylene glycol (PG) and benzyl alcohol (BA) have been shown to inhibit the metabolizing enzyme for acetaminophen in the liver. Ethanol has unpredictable effects on acetaminophen metabolism. Critically ill neonates commonly receive drug formulations containing PG, BA, and ethanol as excipients. Until now, there have been no reports on the influence of BA, PG, and ethanol as excipients in patients undergoing concomitant acetaminophen therapy. We devised the present study to evaluate whether any significant differences in plasma acetaminophen concentrations, liver function tests, and serum creatinine exist between neonates receiving excipients containing drugs compared to those without. We included neonates that were administered intravenous acetaminophen with at least one concomitant drug containing either BA, PG, or ethanol as excipients. Plasma acetaminophen concentrations and levels of liver function were evaluated using tests. The doubling of alanine aminotransferase levels was considered to be a marker of hepatotoxicity. Elevation of serum creatinine >1.5 times higher than the baseline value was considered to be indicative of an acute kidney injury. Fifty-seven neonates were recruited in the study. No significant differences in the serum acetaminophen concentrations, liver and renal function tests, and rates of successful closure of ductus arteriosus were observed between the groups. No significant changes in the serum acetaminophen levels and the clinical outcomes were observed due to the presence of BA, PG, or ethanol in concomitant drugs as excipients. Probably, drugs containing these excipients can be safely administered, and even formulations containing these excipients with acetaminophen are likely to be safe for critically ill neonates.
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