Abstract:
In cardiology, acetylsalicylic acid (ASA) and warfarin are among the most commonly used prophylactic therapies against thromboembolic events. Drug-drug interactions are generally well-known. Less known are the drug-nutrient interactions (DNIs), impeding drug absorption and altering micronutritional status. ASA and warfarin might influence the micronutritional status of patients through different mechanisms such as binding or modification of binding properties of ligands, absorption, transport, cellular use or concentration, or excretion. Our article reviews the drug-nutrient interactions that alter micronutritional status. Some of these mechanisms could be investigated with the aim to potentiate the drug effects. DNIs are seen occasionally in ASA and warfarin and could be managed through simple strategies such as risk stratification of DNIs on an individual patient basis; micronutritional status assessment as part of the medical history; extensive use of the drug-interaction probability scale to reference little-known interactions, and application of a personal, predictive, and preventive medical model using omics.
摘要:
在心脏病学中,乙酰水杨酸(ASA)和华法林是最常用的预防血栓栓塞事件的治疗方法.药物-药物相互作用通常是众所周知的。鲜为人知的是药物-营养素相互作用(DNIs),阻碍药物吸收和改变微量营养状态。ASA和华法林可能通过不同的机制影响患者的微量营养状态,如配体的结合或结合性质的修饰,吸收,运输,细胞使用或集中,或排泄。我们的文章回顾了改变微量营养素状态的药物-营养素相互作用。可以研究这些机制中的一些机制以增强药物作用。在ASA和华法林中偶尔会发现DNIs,可以通过简单的策略进行管理,例如根据个体患者对DNIs进行风险分层;将微量营养素状态评估作为病史的一部分;广泛使用药物相互作用概率量表来参考鲜为人知的相互作用,和个人的申请,预测性,和使用组学的预防医学模型。