專技 - 調劑學與臨床藥學題庫下載題庫

兩個機轉：
1. macrolide 抑制p-gp，使digoxin 無法排除而累積

2. macrolide 清除可以代謝digoxin 的細菌，使更多的digoxin 被吸收

Macrolide inhibition of P-glycoprotein (P-gp) mediated transport of cardiac glycosides could theoretically lead to increases in glycoside bioavailability and/or decreases in renal clearance. Several macrolides inhibit P-glycoprotein (P-gp) mediated transport of digoxin and digitoxin to some extent in vitro with telithromycin showing the greatest inhibitory potency, followed by clarithromycin, followed by azithromycin and erythromycin.

A second theory, which has not been the su...

兩個機轉：
1. macrolide 抑制p-gp，使digoxin 無法排除而累積

2. macrolide 清除可以代謝digoxin 的細菌，使更多的digoxin 被吸收

Macrolide inhibition of P-glycoprotein (P-gp) mediated transport of cardiac glycosides could theoretically lead to increases in glycoside bioavailability and/or decreases in renal clearance. Several macrolides inhibit P-glycoprotein (P-gp) mediated transport of digoxin and digitoxin to some extent in vitro with telithromycin showing the greatest inhibitory potency, followed by clarithromycin, followed by azithromycin and erythromycin.

A second theory, which has not been the subject of future study with macrolides since its original proposal, is that antibiotics including erythromycin could eradicate gut bacteria capable of metabolizing digoxin, such as Eubacterium lentum, thus leaving greater quantities of unmetabolized drug available for absorption.

UpToDate Lexicomp Cardiac Glycosides / Macrolide Antibiotics