伏立康唑谷浓度指导人群临床用药研究进展

Voriconazole trough concentration in population′s clinical medication guidance:research advances

伏立康唑是新一代三唑类抗真菌药物。由于其非线性药代动力学特征,且浓度时间曲线下面积和谷浓度之间有良好的相关性,谷浓度被用来指导不同人群个体化的临床用药。谷浓度低于治疗阈值可导致药效减弱,高于治疗阈值可增加药物诱导毒性反应的风险,如神经毒性、视幻觉和肝毒性等。合理临床用药可提高药效并增加药物安全性。本文对不同人种、肥胖患者、炎症及移植患者的伏立康唑谷浓度特点进行综述,以期为临床用药提供指导。

Voriconazole is a new generation of triazoles antifungal drugs. The trough concentration of voriconazole is used to guide individualized clinical medication of different population because of its nonlinear pharmacokinetic characteristics and close correlation between AUC. Lower trough concentration than treatment thresholds can lead to diminished efficacy,whereas higher concentration than treatment threshold can increase the risk of drug induced toxicity,such as neurotoxicity,visual hallucination,hepatotoxicity. Rational clinical medication can improve efficacy and increase safety. This review summerizes the characteristics of voriconazole trough concentration in different races,obese patients,inflammation and transplantation people,with the hope of providing guidance for clinical medical use.