抗癫痫药相关低钠血症  

Hyponatremia associated wth antiepileptic drugs

作　　者：潘雯 丁晶 吕迁洲 李晓宇 Pan Wen;Ding Jing;Lyu Qianzhou;Li Xiaoyu(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Neurology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032 [2]复旦大学附属中山医院神经内科,上海200032

出　　处：《药物不良反应杂志》2021年第3期134-139,共6页Adverse Drug Reactions Journal

摘　　要：多种抗癫痫药与低钠血症有关,其中以卡马西平、奥卡西平和艾司利卡西平最为常见,涉及的其他抗癫痫药还有丙戊酸、左乙拉西坦、拉莫三嗪和拉考沙胺等。抗癫痫药相关低钠血症的大多数患者症状轻微,但是严重的急性或慢性持续性低钠血症可导致癫痫、昏迷等,甚至导致死亡。抗癫痫药物导致低钠血症的发生机制并未完全明确,目前认为可能与抗利尿激素分泌异常有关。年龄较大、基线血钠水平较低、药物高暴露量以及多种药物联用是抗癫痫药导致低钠血症的危险因素,临床应重视该类人群,进行适当监测和防治。A variety of antiepileptic drugs are associated with hyponatremia,among which carbamazepine,oxcarbazepine,and eslicarbazepine are the most common,and other antiepileptic drugs involved include valproic acid,levetiracetam,lamotrigine,and lacosamide.Most patients with antiepileptic drugrelated hyponatremia have mild symptoms,but severe acute or chronic persistent hyponatremia can lead to epilepsy,coma,and even death.The mechanism of hyponatremia induced by antiepileptic drugs is not fully clear and is currently thought to be likely related to abnormal antidiuretic hormone secretion.The risk factors of antiepileptic drug-related hyponatremia are older age,lower baseline serum sodium level,high drug exposure,and combination of multiple drugs.Attention should be paid to this kind of patients in clinic,and appropriate monitoring,prevention,and treatment should be carried out.

关 键 词：癫痫 低钠血症 ADH分泌不当综合征 药物相关副作用和不良反应 卡马西平 奥卡西平 艾司利卡西平 

分 类 号：R971.6[医药卫生—药品]