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Arzneimittelinteraktionen mit oralen Antikoagulantien vom Cumarintyp

Drugs interacting with coumarine oral anticoagulants

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Summary

Many drugs are known to modify the pharmacological action of coumarin anticoagulants when administered simultaneously. Mechanisms of interaction may consist in inhibition of absorption, displacement from protein binding sites, inhibition or induction of drug metabolizing enzymes in liver microsomes, and effect on synthesis and metabolization of the vitamin K-dependent clotting factors. Coumarins also may inhibit the metabolic degradation of other drugs. It is therefore necessary to test new compounds for a possible interaction with coumarin agents. Patients treated with coumarin anticoagulants should be controled carefully for changes in the hypoprothrombinaemic action when additional drugs are given or when these are discontinued.

Zusammenfassung

Eine große Zahl von Medikamenten tritt bei gleichzeitiger Gabe in Interaktion mit Cumarinderivaten. Wesentliche Mechanismen sind dabei Resorptionshemmung, Verdrängung aus der Plasmaeiweißbindung, Hemmung oder Induktion des metabolisierenden Enzymsystems sowie Beeinflussung von Synthese oder Abbau der Vitamin Kabhängigen Gerinnungsfaktoren. Auch die Cumarine selbst sind in der Lage, die Metabolisierung anderer Pharmaka hemmend zu beeinflussen. Es ergibt sich die Notwendigkeit, neu einzuführende Medikamente auf die Interaktion mit Cumarinen zu testen. Eine sorgfältige Überwachung des Patienten ist bei Beginn oder Beendigung jeder Therapie mit einem in Kombination mit Cumarinen eingesetzten Pharmakon angezeigt.

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  1. Medizinische Universitätsklinik Bonn, Germany

    R. Gugler & H. J. Dengler

  2. Clinical Pharmacology-Toxicology Center, University of Kansas Medical Center, 66103, Kansas City, Kansas, U.S.A.

    R. Gugler

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Gugler, R., Dengler, H.J. Arzneimittelinteraktionen mit oralen Antikoagulantien vom Cumarintyp. Klin Wochenschr 51, 1081–1090 (1973). https://doi.org/10.1007/BF01468301

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