口服苯妥英钠片致剥脱性皮炎1例分析  

Analysis of a Case of Exfoliative Dermatitis Caused by Oral Phenytoin Tablets

作　　者：骆碧云 王鹏 汪滢 LUO Bi-yun;WANG Peng;WANG Ying(Department of Pharmacy,the Fifth Affiliated Hospital of Southern Medical University,Guangzhou,Guangdong Province,510900 China)

机构地区：[1]南方医科大学第五附属医院药学部,广东广州510900

出　　处：《系统医学》2020年第13期112-114,共3页Systems Medicine

摘　　要：目的总结1例口服苯妥英钠片致剥脱性皮炎的临床特点,为临床合理用药及处理提供参考。方法回顾性分析2019年7月神经外科收治的1例30岁患者的临床资料:患者重型颅脑损伤,予口服苯妥英钠片预防癫痫,用药第14天出现发热,第16天出现了严重的剥脱性皮炎,停用苯妥英钠片,予注射用甲泼尼龙琥珀酸钠冲击治疗,注射用免疫球蛋白营养支持,注射用阿奇霉素、左氧氟沙星氯化钠注射液抗感染治疗后好转。结果治疗有效,患者转院。结论临床用药需严格掌握用药指征,合理用药;在用药前,务必详细询问患者的过敏史,用药后密切观察患者。一旦出现药源性剥脱性皮炎,应首先及时停用可疑药物,及时使用激素及抗组胺药物等抗过敏治疗,并提供足够热量及保持水电解质平衡。Objective To summarize the clinical characteristics of exfoliative dermatitis caused by oral phenytoin tablets in order to provide a reference for rational clinical medication and treatment.Methods The clinical data of a 30-year-old patient admitted to neurosurgery in July 2019 were retrospectively analyzed.The patient had severe head injury and received oral phenytoin tablets to prevent epilepsy,the patient caught fever on the 14th day and severe exfoliation on the 16th day for dermatitis,phenytoin sodium tablets were discontinued,injection therapy with methylprednisolone sodium succinate for injection,immunoglobulin nutritional support for injection,azithromycin and levofloxacin sodium chloride injection for injection improved after anti-infective treatment.Results The treatment was effective and the patient was transfer.Conclusion The clinical medication needs to be strictly controlled and rationally used.Before the medication,the patient's allergy history must be asked in detail,and the patient should be closely observed after the medication.Once drug-induced exfoliative dermatitis occurs,suspicious drugs should be stopped in time,anti-allergic treatment such as hormones and antihistamines should be used in a timely manner,and sufficient heat should be provided to maintain water and electrolyte balance.

关 键 词：苯妥英钠片 不良反应 剥脱性皮炎 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]