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題 名 | Terlipressin-induced Reversible Cyanosis Side Effect=疑似Terlipressin引起可逆性發紺之不良反應 |
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作 者 | 宋懿宸; 劉俊良; 徐秀娥; | 書刊名 | 藥學雜誌 |
卷 期 | 35:4=141 2019.12[民108.12] |
頁 次 | 頁67-77 |
分類號 | 418.23 |
關鍵詞 | 發紺; 肝腎症候群; 藥物不良反應; Terlipressin; Cyanosis; Hepatorenal syndrome; |
語 文 | 英文(English) |
中文摘要 | Terlipressin 併用白蛋白為目前對於逆轉第一型肝腎症候群之首選處方。本案例為一位65 歲男性入院後,因第一型肝腎症候群給予 terlipressin 治療,在施打藥物後48 小時出現四肢、肚臍疝氣以及陰囊部位有發紺的現象,且經由停止 terlipressin 之後明顯恢復。根據藥物不良反應相關性評估 (Naranjo score),強烈懷疑此不良反應為 terlipressin 所造成。此外,terlipressin 已被報導過許多不良反應,例如:心肺功能、腸胃道方面、皮膚缺血以及鈉鉀離子不平衡等。Terlipressin 引起之發紺現象可能源自於藥物本身具有的血管收縮以及增強血小板凝集之能力有關。預防此藥物不良反 應的方法為減少藥物之劑量、改變藥品給藥方式從靜脈推注改成靜脈點滴輸注以及防止給予高風險之病人。除了上述方法外,norepinephrine 亦可以當作替代藥物治療肝腎症候群。此篇案例報告旨在提供少見的 terlipressin 引起之發紺現象的探討。 |
英文摘要 | The most recommended medication to reverse type I hepatorenal syndrome (HRS) is terlipressin concomitant with albumin. However, we presented a 65-year-old male suffering from the rare side effect of skin cyanosis in his fingers, scrotal region and umbilical hernia. This phenomenon had been observed for 48 hours after the dose of terlipressin, and began to recover after drug withdrawal. Terlipressin was the most suspected causative drug according to the Naranjo score, and the presentations were consistent with previous case reports. Various adverse effects of terlipressin have been reported in terms of cardiopulmonary, gastrointestinal, skin ischemia and sodium/potassium imbalance. Furthermore, the possible mechanisms of terlipressin-induced cyanosis are the abilities of enhancing vasoconstriction and escalating coagulation. In addition to discontinuing or reducing the dose, changing the manners of administrating and avoiding high risk patients, norepinephrine might be an alternative medication depending on the clinicians' consideration. This case report aims to demonstrate an uncommon adverse effect of terlipressin, to explain possible mechanisms and to suggest a substitutable medication. |
本系統中英文摘要資訊取自各篇刊載內容。