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題 名 | 疑似Sulfasalazine所致之血液異常藥物不良反應案例=A Suspected Hematologic Adverse Event Induced by Sulfasalazine |
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作 者 | 黃美鈴; 林華美; | 書刊名 | 藥學雜誌 |
卷 期 | 26:1=102 2010.03[民99.03] |
頁 次 | 頁94-100 |
分類號 | 418.2133 |
關鍵詞 | 類風濕性關節炎; 藥物不良反應; 巨紅血球性貧血症; Rheumatoid arthritis; Sulfasalazine; Macrocytic anemia; |
語 文 | 中文(Chinese) |
中文摘要 | 這是一篇疑似 sulfasalazine所致之巨紅血球性貧血症 (macrocytic anemia)藥物不良反應通報案例報導,本案例除了追溯病患完整用藥史以及整個病程進展之外,亦對藥物不良反應緩解之後續作持續性之追蹤。就類風濕性關節炎的治療而言, sulfasalazine被認為是出色的抗風濕用藥 (DMARDs,disease-modifying antirheumatic drugs),其臨床療效優異,一直廣泛應用於治療類風濕性關節炎之初期。但與 sulfasalazine相關的血液異常報告,讓一部分病患對於此類藥物的使用受到了限制。 Sulfasalazine會抑制葉酸吸收並干擾葉酸代謝、引起紅血球溶血,這是 sulfasalazine引發血液異常之主因。對於這一類的藥物不良反應則通常皆以停藥、輸血或補充葉酸來處置。這樣的藥物不良反應雖然屬於嚴重藥物不良反應,但並非為使用禁忌,故與藥物不良反應相關的血液異常應密切地作定期監測,以防止此類不良反應之發生。 |
英文摘要 | In order to report a suspected macrocytic anemia adverse event induced by sulfasalazine , We not only reviewed the patient drug profile and disease progression note retrospectively but also follow up the improvement of macrocytic anemia adverse effect after sulfasalazine discontined . Sulfasalazine is considered to be a useful disease-modifying antirheumatic drug (DMARD) in the treatment of rheumatoid arthritis. Studies have found a beneficial clinical effect of sulfasalazine, compared with placebo, on tender and swollen joints, pain, and erythrocyte sedimentation rate. A review of sulfasalazine use in the management of rheumatoid arthritis concluded that combination therapy may be of benefit in patients with early or advanced rheumatoid arthritis but that there is still a need for studies to determine the efficacy and tolerability of various combinations. Blood disorders constitute 19% of all reactions reported with sulfasalazine.Sulfasalazine inhibits folic acid absorption, interferes with its metabolism, and can increase folic acid requirements through haemolysis of red blood cells. Macrocytic anaemia associated with sulfasalazine may occur more commonly in patients with rheumatoid arthritis; it was found in 7 of 50 patients within 3 to 4 months of starting treatment with sulfasalazine. The effects of sulfasalazine on folic acid metabolism appear to be dose-related and respond to withdrawal or dosage reduction, and folic acid supplements. Although the effects may be potentially serious, they are not a contra-indication to continuing sulfasalazine treatment. |
本系統中英文摘要資訊取自各篇刊載內容。