华法林致发疹型药疹  

Exanthematous eruption due to warfarin

作　　者：秦琼[1] 薛领[1] 周玲[1] Qin Qiong;Xue Ling;Zhou Ling(Department of Pharmacy,the First Affiliated Hospital of Soochow University,Jiangsu Province,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院药学部,苏州215006

出　　处：《药物不良反应杂志》2020年第10期585-586,共2页Adverse Drug Reactions Journal

基　　金：国家自然科学基金(81803628);江苏省药学会奥赛康课题项目(A2017024)。

摘　　要：1例66岁女性风湿性心脏病患者全麻下行二尖瓣生物瓣置换术+冠状旁路移植术,术后给予华法林1.25 mg口服、1次/d抗凝,亚胺培南西司他丁钠和替考拉宁静脉滴注抗感染。用药9 d后,患者腹部和胸背部出现大面积皮疹伴瘙痒,诊断为发疹型药疹。停用上述药物,给予低分子肝素钠皮下注射。停药3 d后,皮疹明显好转。因病情需要患者再次口服华法林,10 d后,患者胸背部皮疹复现。再次停用华法林,换用低分子肝素钠,同时给予氯雷他定口服和复方炉甘石洗剂外用。再次停用华法林3 d后皮疹好转。换用另一厂家生产的华法林后,患者未再发生皮肤过敏反应。A 66-year-old female patient with rheumatic heart disease underwent mitral valve replacement and coronary artery bypass grafting under general anesthesia.After the operation,she received warfarin 1.25 mg once daily for anticoagulation,intravenous infusions of imipenem and cilastatin sodium and teicoplanin for anti-infection.After 9 days of treatments,the patient developed a large area of skin rash with itching on her abdomen,chest,and back.She was diagnosed as having exanthematous drug eruption.The above-mentioned drugs were stopped and low molecular weight heparin was given by subcutaneous injection.Three days after the drug withdrawal,her rash was improved markedly.She was given warfarin again due to her illness.Ten days later,the rash on her chest and back recurred.Warfarin was stopped again and replaced by low molecular weight heparin.At the same time,oral loratadine and external application of calamine lotion were given.The rash was improved 3 days after warfarin was stopped again.Skin allergic reaction did not recur after switching to warfarin produced by another manufacturer.

关 键 词：华法林 辅药 药疹 

分 类 号：R969[医药卫生—药理学]