Взаимодействие алкоголя и лекарственных средств: фокус на препараты, действующие на центральную нервную систему и анальгетики


DOI: https://dx.doi.org/10.18565/pharmateca.2021.13.9-15

А.П. Переверзев (1), О.Д. Остроумова (1, 2), Д.А. Сычев (1)

1) Российская медицинская академия непрерывного профессионального образования, Москва, Россия; 2) Первый Московский государственный медицинский университет им. И.М. Сеченова, Москва, Россия
Известно, что прием алкоголя является фактором риска развития многих социально значимых заболеваний: у лиц, регулярно употребляющих алкоголь, отмечается увеличение числа случаев ряда сердечно-сосудистых заболеваний, цирроза печени, острого панкреатита, желудочно-кишечного кровотечений, метаболических осложнений, злокачественных новообразований и психических расстройств. Однако негативный прогноз у лиц, регулярно злоупотребляющих алкоголем, обусловлен не только большим количеством патологических состояний, но и осложнениями фармакотерапии вследствие межлекарственных взаимодействий или недостаточной их эффективности на фоне взаимодействия лекарственных средств с алкоголем. Например, было выявлено усиление фармакодинамических эффектов амитриптиллина, тразодона, габапентина на фоне приема этанола. Также в работе ряда авторов было отмечено повышение на 20% AUC12 после приема карбамазепина в дозе 400 мг в первый день, чем AUC после приема карбамазепина в течение 9 дней после отмены этанола у 7 хронических потребителей этанола; увеличение Cmax и AUC эзогабина на 23 и 36% соответственно у 17 здоровых мужчин и женщин, употреблявших алкоголь в умеренном количестве; увеличение Cmax и AUC клобазама в среднем на 59 и 54% соответственно у 8 здоровых субъектов мужского пола, получавших клобазам (20 мг перорально) с этанолом (в виде комбинации пива и бренди). Таким образом, одновременное применение алкоголя и лекарственных средств потенциально может быть ассоциировано с повышенным риском развития нежелательных реакций. При назначении фармакотерапии необходимо обязательно учитывать потенциальные фармакодинамические и фармакокинетические взаимодействия алкоголя и лекарственных лекарственных средств, но все же намного лучше избегать одновременного применения алкоголя и лекарственных препаратов.

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Об авторах / Для корреспонденции


Автор для связи: Ольга Дмитриевна Остроумова, д.м.н., профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Первый МГМУ им. И.М. Сеченова, заведующая кафедрой терапии и полиморбидной патологии? Российская медицинская академия непрерывного профессионального образования, Москва, Россия; ostroumova.olga@mail.ru


ORCID / eLibrary SPIN:
А.П. Переверзев, https://orcid.org/0000-0001-7168-3636; eLibrary SPIN: 4842-3770
О.Д. Остроумова, https://orcid.org/0000-0002-0795-8225; eLibrary SPIN: 3910-6585
Д.А. Сычев, https://orcid.org/0000-0002-4496-3680; eLibrary SPIN: 4525-7556


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