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題 名 | Drug Induced Breast Abnormality=藥品誘發乳房異常症狀 |
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作 者 | 陳培瑛; 劉育伶; 賴淑惠; 羅振旭; | 書刊名 | 藥學雜誌 |
卷 期 | 30:4=121 2014.12[民103.12] |
頁 次 | 頁108-115 |
分類號 | 418.1 |
關鍵詞 | 藥品; 乳房異常; Drug adverse reaction; Gynecomastia; Galactorrhea; |
語 文 | 英文(English) |
中文摘要 | 男性女乳症和乳漏症是兩種獨特發生在乳房的不良反應。許多藥物會導致不良反應發生。我們分別敘述藥物在男性與女性引起乳房異常的案例。 案例一是一位34歲的婦女,因胃食道逆流就醫,醫師給予 mosapride、lansoprazole and sulpiride 50毫克治療3個月,病人因乳漏、月經週期不規律等症狀到乳房外科就診,經血清檢查結果顯示泌乳素 (prolactin)上升至84.0 ng/mL (正常範圍:5.8-26.53)。病人從未有任何內分泌學異常病史,因此主治醫師高度懷疑乳漏症與其服用藥品有關,建議停用 mosapride 和 lansoprazole 兩種藥品,並於一個月後複查患者的泌乳素,此時數值已在正常範圍內 (12.02 ng/mL)。 案例二是位男性病人在服用 captopril 兩年後主訴雙側乳腺腫大、乳頭觸痛 (captopril的用藥紀錄是12.5毫克,一天兩次,使用2年後單次劑量增加為25毫克。此劑量只使用1個月)。血清檢查報告顯示肝、睪丸激素和雌二醇數值都在正常範圍內。因此停用captopril,症狀大約一週後消失。一年後,乳房症狀又出現,經檢視病人服用藥物紀錄發現,病人因胃腸不適曾使用 sulpiride 50毫克每日兩次所導致的,停藥後症狀也逐漸消退。 以上兩例乳房之不良反應顯示相關症狀部分是屬於可逆的,目前最佳治療選擇是停用相關藥品並改使用其他替代藥品,詳細審查個案用藥史亦有助於確認是否是藥物不良反應。 |
英文摘要 | Gynecomastia and galactorrhea are two unique adverse effects on breast. Many drugs have been implicated in their cause. We report one case of each condition. The first case is a 34-year-old woman who reported milk-like discharge from the nipples and irregular menstrual cycle after she had taken mosapride, lansoprazole and sulpiride for 3 months because of gastro-esophageal reflux disorder. She visited our breast-surgery clinic where laboratory tests showed elevated prolactin level 84.00 ng/mL (normal range (NR) level: 5.8-26.53 ng/dL). However, she denied any endocrinology history but drugrelated galactorrhea was highly suspected. Sulpiride and lansoprazole were discontinued immediately. The patient's prolactin level was rechecked a month later and showed 12.02 ng/ mL within normal range. The second case is a 61-year-old male who reported bilateral breast enlargement with nipple tenderness following treatment with captopril (12.5 mg twice daily for 2 years and titrated to 25 mg twice daily for 1 month). Laboratory tests of liver transaminases, testosterone and estradiol were within normal limits. Captopril was then discontinued and the symptom disappeared in about one week. One year later, the symptom reoccurred after the patient had taken sulpiride 50 mg twice daily for treatment of abdominal discomfort for 2 months. The symptom also subsided after the patient has discontinued sulpiride. These two adverse reactions are reversible and these two cases clearly demonstrate that the side effects have disappeared after the patient has discontinued the causative agents. Switching to other alternative agents is the best choice to quit the side effect. Furthermore, a thorough review of medication history will also be helpful to identify the drug adverse reactions. |
本系統中英文摘要資訊取自各篇刊載內容。