With the increasing use of nirmatrelvir-ritonavir in older COVID-19 patients,adverse drug reactions due to drug-drug interactions have become more frequent.This report describes a patient who experienced severe bradyc...With the increasing use of nirmatrelvir-ritonavir in older COVID-19 patients,adverse drug reactions due to drug-drug interactions have become more frequent.This report describes a patient who experienced severe bradycardia and hypotension following the concurrent use of heart rate-control medications and nirmatrelvir-ritonavir during an active COVID-19 infection.This suggests that clinicians should be cautious when dealing with nirmatrelvir-ritonavir and try their best to avoid serious adverse reactions.展开更多
Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omi...Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omicron variant.Methods:Ninety-three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated.Informa-tion was collected on general health status,medication,and adverse drug reactions(ADRs)according to whether nirmatrelvir-ritonavir and azvudine were administered sequentially or concomitantly.Data on times of onset,clinical manifestations,and outcomes of ADRs and on conversion to a nega-tive nucleic acid test were also recorded.Results:Possible ADRs were recorded in 41 patients(44.1%).There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir-ritonavir and azvudine.Liver enzyme levels increased in nine cases and creatinine clearance decreased in two.Cases of atrial fibrillation(n=1),sleep disorder(n=2),rash(n=2),dizziness(n=1),and weakness(n=5)were also documented.Only vomiting,poor appetite,diarrhea,xerostomia,bitter taste,and rash were considered probable ADRs;others were thought to be possible ADRs.In all cases,the nucleic acid test did not turn negative after the first antiviral was applied.The nucleic acid test of 28 patients did not turn negative before discharge.The remaining 65 patients(69.9%)returned a negative nucleic acid test after receiving the second antiviral agent.Conclusions:Treatment with nirmatrelvir-ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID-19 caused by the Omicron variant.展开更多
目的:分析奈玛特韦/利托那韦相关药物不良反应(adverse drug reaction, ADR)的特点,为临床合理用药提供参考。方法:检索建库起至2023年1月中国知网、万方数据库、维普网、PubMed、Web of Science数据库,收集奈玛特韦/利托那韦相关ADR个...目的:分析奈玛特韦/利托那韦相关药物不良反应(adverse drug reaction, ADR)的特点,为临床合理用药提供参考。方法:检索建库起至2023年1月中国知网、万方数据库、维普网、PubMed、Web of Science数据库,收集奈玛特韦/利托那韦相关ADR个案报道,提取文献资料进行统计分析。结果:共纳入文献17篇,共计18例患者。其中男性6例,女性12例,患者年龄为14~80岁,其中71~80岁年龄段比例最高。2例怀疑为奈玛特韦/利托那韦导致的ADR,累及神经系统和心脏器官;16例为与其他药物相互作用导致的ADR,相互作用药物为免疫抑制剂11例,钙通道阻滞剂2例,抗肿瘤药物、抗精神病药、血脂调节剂各1例。经停药或对症支持治疗均治愈。结论:奈玛特韦/利托那韦的安全性仍需要进一步监测与研究,临床使用中需重点关注可能的药物相互作用,减少ADR的发生。展开更多
目的建立高效液相色谱质谱联用(HPLC-MS/MS)法测定人血浆奈玛特韦和利托那韦的血药浓度,并应用于治疗药物监测。方法血浆样品经蛋白沉淀后测定,流动相为0.1%甲酸水溶液(A相)、乙腈(B相),采用等度洗脱,流速为0.3 m L·min^(-1),柱温...目的建立高效液相色谱质谱联用(HPLC-MS/MS)法测定人血浆奈玛特韦和利托那韦的血药浓度,并应用于治疗药物监测。方法血浆样品经蛋白沉淀后测定,流动相为0.1%甲酸水溶液(A相)、乙腈(B相),采用等度洗脱,流速为0.3 m L·min^(-1),柱温为40℃,使用EC-C18色谱柱,正离子模式下进行多反应监测。结果用于定量分析的离子通道分别为m/z 500→110(奈玛特韦),m/z721.2→296.3(利托那韦),m/z 614.4→421(内标瑞德西韦)。人血浆中奈玛特韦在0.01~10μg·mL^(-1)、利托那韦在0.01~2.0μg·mL^(-1)浓度范围内线性关系良好,提取回收率分别为79.56%~89.91%、82.03%~89.56%,日间及日内的RSD均小于15%,并且稳定性良好。采用该方法检测了34例新型冠状病毒肺炎(COVID-19)患者口服Paxlovid后的血药浓度,血药浓度范围在1.04~18.0μg·mL^(-1)之间。结论本研究建立的HPLC-MS/MS方法检测快速,灵敏度高,准确性好,能应用于COVID-19患者服用Paxlovid后的血药浓度监测。展开更多
文摘With the increasing use of nirmatrelvir-ritonavir in older COVID-19 patients,adverse drug reactions due to drug-drug interactions have become more frequent.This report describes a patient who experienced severe bradycardia and hypotension following the concurrent use of heart rate-control medications and nirmatrelvir-ritonavir during an active COVID-19 infection.This suggests that clinicians should be cautious when dealing with nirmatrelvir-ritonavir and try their best to avoid serious adverse reactions.
基金Analysis of Omicron Variant Mutation Patterns and Research on Prevention and Control,Grant/Award Number:2023YFC3041500。
文摘Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omicron variant.Methods:Ninety-three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated.Informa-tion was collected on general health status,medication,and adverse drug reactions(ADRs)according to whether nirmatrelvir-ritonavir and azvudine were administered sequentially or concomitantly.Data on times of onset,clinical manifestations,and outcomes of ADRs and on conversion to a nega-tive nucleic acid test were also recorded.Results:Possible ADRs were recorded in 41 patients(44.1%).There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir-ritonavir and azvudine.Liver enzyme levels increased in nine cases and creatinine clearance decreased in two.Cases of atrial fibrillation(n=1),sleep disorder(n=2),rash(n=2),dizziness(n=1),and weakness(n=5)were also documented.Only vomiting,poor appetite,diarrhea,xerostomia,bitter taste,and rash were considered probable ADRs;others were thought to be possible ADRs.In all cases,the nucleic acid test did not turn negative after the first antiviral was applied.The nucleic acid test of 28 patients did not turn negative before discharge.The remaining 65 patients(69.9%)returned a negative nucleic acid test after receiving the second antiviral agent.Conclusions:Treatment with nirmatrelvir-ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID-19 caused by the Omicron variant.
文摘目的:分析奈玛特韦/利托那韦相关药物不良反应(adverse drug reaction, ADR)的特点,为临床合理用药提供参考。方法:检索建库起至2023年1月中国知网、万方数据库、维普网、PubMed、Web of Science数据库,收集奈玛特韦/利托那韦相关ADR个案报道,提取文献资料进行统计分析。结果:共纳入文献17篇,共计18例患者。其中男性6例,女性12例,患者年龄为14~80岁,其中71~80岁年龄段比例最高。2例怀疑为奈玛特韦/利托那韦导致的ADR,累及神经系统和心脏器官;16例为与其他药物相互作用导致的ADR,相互作用药物为免疫抑制剂11例,钙通道阻滞剂2例,抗肿瘤药物、抗精神病药、血脂调节剂各1例。经停药或对症支持治疗均治愈。结论:奈玛特韦/利托那韦的安全性仍需要进一步监测与研究,临床使用中需重点关注可能的药物相互作用,减少ADR的发生。
文摘目的建立高效液相色谱质谱联用(HPLC-MS/MS)法测定人血浆奈玛特韦和利托那韦的血药浓度,并应用于治疗药物监测。方法血浆样品经蛋白沉淀后测定,流动相为0.1%甲酸水溶液(A相)、乙腈(B相),采用等度洗脱,流速为0.3 m L·min^(-1),柱温为40℃,使用EC-C18色谱柱,正离子模式下进行多反应监测。结果用于定量分析的离子通道分别为m/z 500→110(奈玛特韦),m/z721.2→296.3(利托那韦),m/z 614.4→421(内标瑞德西韦)。人血浆中奈玛特韦在0.01~10μg·mL^(-1)、利托那韦在0.01~2.0μg·mL^(-1)浓度范围内线性关系良好,提取回收率分别为79.56%~89.91%、82.03%~89.56%,日间及日内的RSD均小于15%,并且稳定性良好。采用该方法检测了34例新型冠状病毒肺炎(COVID-19)患者口服Paxlovid后的血药浓度,血药浓度范围在1.04~18.0μg·mL^(-1)之间。结论本研究建立的HPLC-MS/MS方法检测快速,灵敏度高,准确性好,能应用于COVID-19患者服用Paxlovid后的血药浓度监测。
