格列美脲加重光敏性皮炎1例分析  

One Case of Photosensitive Dermatitis Aggravated by Glimepiride Reported

作　　者：陈芳 马云鹏 鲁郡 CHEN Fang;MA Yunpeng;LU Jun(Pingan Community Health Service Center of Fengxian District in Shanghai,Shanghai 201400,China;Fengxian Central Hospital in Shanghai,Shanghai 201400,China)

机构地区：[1]上海市奉贤区平安社区卫生服务中心,上海201400 [2]上海市奉贤区中心医院,上海201400

出　　处：《药品评价》2021年第6期349-352,共4页Drug Evaluation

摘　　要：一例63岁男性糖尿病患者,以血糖控制不佳收住入院。既往因光敏性皮炎需长期服用糖皮质激素,但激素的使用严重影响了其血糖的调控。临床药师经深入探究既往史和用药史,发现该患者的光敏性皮炎与其磺胺过敏之间可能存在因果关系(曾服用过含氢氯噻嗪的珍菊降压片治疗高血压,后出现过敏反应,但未重视且未停用该药)。其次,该患者此次治疗中,同属磺胺类药物的格列美脲加重了其光敏性皮炎症状(脸部褪皮严重)且伴有血压升高。临床药师经过与医患沟通,停用了格列美脲,并建议以后避免使用所有磺胺类药物。患者最后经个体化治疗后血糖控制良好出院。A 63-year-old male patient with diabetes was hospitalized for poor glucose control.His long-term usage of glucocorticoid for photosensitive dermatitis seriously impacted the glucose control.Through carefully patient's history taking and thoroughly analyzing,the clinical pharmacist speculated a possible causal relationship between photosensitive dermatitis and allergy to sulfonamides.In addition,glimepiride which also belongs to sulfonamides aggravated his photosensitive dermatitis and elevated the blood pressure during the treatment.After communicated with the patient and clinical pharmacist,the clinical pharmacist withdrawn the glimepiride,and recommended to avoid any sulfonamides.The patient's blood glucose was well controlled after personalized therapy before discharged.

关 键 词：皮炎 光变态反应 磺胺类药物交叉过敏 格列美脲 珍菊降压片 氢氯噻嗪 糖皮质激素 

分 类 号：R969[医药卫生—药理学]