吲哚美辛栓致迟发型过敏性休克和药疹  

Delayed anaphylactic shock and rash due to indomethacin suppository

作　　者：李月阳[1] 王妍[2] 赵宏伟[1] 张四喜[1] 

机构地区：[1]吉林大学第一医院药学部,长春130021 [2]吉林大学第一医院干部病房,长春130021

出　　处：《药物不良反应杂志》2017年第3期237-238,共2页Adverse Drug Reactions Journal

摘　　要：1例81岁女性患者因发热在30h内3次应用吲哚美辛栓（第1次经医师同意，第2、3次为自行使用），每次1枚，每枚100mg。首次使用吲哚美辛栓后40h、末次使用该栓剂后10h，患者出现大汗淋漓、呼吸困难、恶心、口唇发绀、抽搐、意识丧失、呼之不应、血压降低等休克症状，全身出现大小不等红斑及斑丘疹伴瘙痒。考虑为吲哚美辛栓致迟发型过敏性休克和药疹。立即给予吸氧、5％葡萄糖注射液250ml静脉滴注、葡糖糖酸钙1．0g＋维生素C注射液2．0g入葡萄糖氯化钠注射液500ml静脉滴注，约1h后休克症状缓解。停用吲哚美辛栓并继续给予抗过敏治疗，6d后患者皮肤红斑及斑丘疹基本消失。An 81-year-old female patient received indomethacin suppository 3 times within 30 hours because of fever （the first time use was permitted by physician, the other 2 times of use were decided by herself）, one piece （100 mg） at each time.Forty hours after the first use of indomethacin suppository and 10 hours after the last use of the medicine, the patient developed symptoms of shock like sweating, dyspnea, nausea, cyanosis of lips, convulsions, loss of consciousness, no response to sound and lower blood pressure together with erythema and maculopapule with pruritus over the whole body.It was considered that indomethacin suppository induced the delayed anaphylactic shock and rashes.Oxygen inhalation, IV infusion of 5% glucose solution 250 ml, 1.0 g calcium gluconate＋2.0 g vitamin C＋glucose and sodium chloride for injection 500 ml were given immediately.About 1 hour later, her symptoms of shock relieved.Indomethacin suppository was withdrawn and anti-allergy therapy was continued.Six days later, her erythema and papular rashes disappeared.

关 键 词：吲哚美辛 超敏反应 迟发型 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]