奥司他韦致神经精神不良事件国内外文献系统回顾性分析  

A systematic retrospective study and review of neuropsychiatric adverse events induced by oseltamivir

作　　者：李菁[1] 房德敏[1] 张金红[1] LI Jing;FANG De-min;ZHANG Jin-hong(Department of Pharmacy,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院药学部,天津300211

出　　处：《现代药物与临床》2021年第12期2687-2694,共8页Drugs & Clinic

摘　　要：目的系统分析奥司他韦致精神异常的临床特点,为临床实践提供证据和建议。方法计算机检索PubMed、Embase、中国生物医学文献数据库、中国知网、维普数据库和万方数据库,时间截止到2021年1月,纳入奥司他韦致神经精神不良事件的中英文病例报道,对文献进行筛选、数据归纳及统计。结果最终纳入中英文文献19篇,22例患者(男10例,女12例)。中位年龄17岁,其中50%为18岁以下儿童。多数患者无基础疾病,68.2%的患者为联合用药,所有患者均无精神相关疾病史。不良反应表现为失眠、情绪异常、行为异常、幻觉、谵妄,严重者可出现自杀现象。68.2%的患者在服药2 d内出现不良反应症状,时间最长在服药4 d后出现症状。主要的治疗措施是立即停药,7例不良反应严重者使用抗精神病药物(主要为苯二氮䓬类),多数患者在停药2 d内症状均有所改善或消失,其中3例患者不良反应改善时间超过10 d,中位累积药量450 mg,最大累积药量750 mg,最小累积药量60 mg。不良反应关联性评价为肯定1例,很可能18例,可能3例。结论神经精神事件是奥司他韦少见的不良反应,多表现为情绪异常、行为异常、幻觉、谵妄等,一般在用药2 d内发生,临床医生和药师应当主动告知患者及家属,发现精神异常现象应立即停药,及时就医,避免导致严重后果。Objective Systematic review and analysis the clinical characteristics of oseltamivir induced mental disorders to provide evidence and suggestions for clinical practice. Methods The PubMed, Embase, CBM, CNKI, VIP and WANFANG as databases were searched by computer. Until December 2020, both Chinese and English case reports of oseltamivir neuropsychiatric adverse events were included. Two researchers independently screened the literatures, summarized and statistically analyzed the data. Results A total of 19 literatures in Chinese and English were searched, including 22 patients(10 males and 12 females). The median age was 17, and 50% of them were children under 18 years of age. Most of the patients had no underlying diseases, 68.2% of the patients were given combined medication, and all the patients had no history of mental diseases. Adverse drug reaction performance is insomnia, abnormal mood, abnormal behavior, hallucination, delirium, serious person can appear suicide phenomenon. 68.2% of the patients developed adverse drug reaction symptoms within 2 days after taking the drug, and the longest time was 4 days after taking the drug. The main treatment was immediate discontinuation of drugs. Seven patients with severe adverse drug reaction were treated with antipsychotic drugs(mainly benzodiazepines). The symptoms of most patients improved or disappeared within 2 days after discontinuation of drugs,among which the adverse drug reaction improvement time of 3 patients was over 10 days. The median cumulative dose was 450 mg,the maximum cumulative dose was 750 mg, and the minimum cumulative dose was 60 mg. Adverse drug reaction correlation evaluation was positive in 1 case, big probable in 18 cases, and probable in 3 cases. Conclusion Neuropsychiatric events are rare adverse reactions of oseltamivir, mainly manifested as emotional abnormalities, behavioral abnormalities, hallucinations, delirium, etc., which generally occur within 2 days after administration of oseltamivir. Clinicians and pharmacists should take the i

关 键 词：奥司他韦 精神异常 不良反应 系统回顾性分析 苯二氮䓬类 

分 类 号：R969.3[医药卫生—药理学]