115例伏立康唑致幻觉不良反应分析  

Analysis of 115 cases of voriconazole induced hallucination adverse reactions

作　　者：张斌[1] 任晓蕾[1] 张晓[2] 张海英[1] ZHANG Bin;REN Xiao-lei;ZHANG Xiao;ZHANG Hai-ying(Department of Pharmacy,People's Hospital,Peking University,Bejing 100044,China;Beijing Centerfor Adverse Drug Reaction Monitoring,Beijing 100024,China)

机构地区：[1]北京大学人民医院药剂科,北京100044 [2]北京市药品不良反应监测中心,北京100024

出　　处：《中国临床药理学杂志》2023年第1期115-117,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的以北京地区伏立康唑药物不良反应(ADR)报告为依据,了解伏立康唑致幻觉的发生特点和规律,为临床安全使用伏立康唑及出现精神异常的识别处置提供指导。方法对2011-01-01——2021-06-30北京市药品不良反应监测中心收集的医疗机构报告的115例伏立康唑导致幻觉的ADR报告进行回顾性分析。结果115例幻觉ADR报告中男性64例,女性51例,年龄最小2岁,最大93岁,平均年龄(65.76±18.46)岁,16例患者有过敏史。其中静脉滴注给药61例,口服给药54例。给药剂量每次0.02~0.5 g。给药频次12例每天1次,103例每天2次。3例患者有治疗药物监测(TDM)结果,其中2例患者伏立康唑血药浓度>5.0μg·mL^(-1)。61例患者出现幻视,11例患者出现幻听,其余54例患者幻觉表现未详述。有42例患者合并出现其他精神异常症状,如胡言乱语、烦躁、失眠等。115例患者中89例患者(77.39%)幻觉发生在初始用药3天内,患者幻觉平均发生时间(3.11±3.09)天。结论医护人员要密切关注伏立康唑致幻觉的危险因素,在TDM引导下实施个体化给药,降低ADR的发生率。Objective Based on the adverse drug reaction(ADR)reports of voriconazole in Beijing area,the characteristics and regularity of voriconazole induced hallucinations were investigated to provide guidance for the safe clinical use of voriconazole and the treatment of mental abnormalities.Methods A retrospective analysis was performed on 115 ADR reports of hallucination caused by voriconazole collected from medical institutions in Beijing Adverse Drug Reaction Monitoring Center from January 1,2011 to June 30,2021.Results Among the 115 ADR cases with hallucination,64 were male and 51 were female,with the minimum age of 2 years and the maximum age of 93 years,with an average age of(65.76±18.46)years,and 16 patients with allergic history,61 cases were given by intravenous drip and 54 cases by oral administration.The dose varied from 0.02 g to 0.5 g each time.The frequency of administration was once a day in 12 cases and twice a day in 103 cases.Three patients had therapeutic drug monitoring(TDM)monitoring results,of which two patients had voriconazole blood concentration>5.0μg·mL^(-1).Vision hallucinations occurred in 61 patients,auditory hallucinations occurred in 11 patients,and hallucinations were not described in detail in the remaining 54 patients.At the same time,42 patients showed other abnormal mental symptoms such as gibberish,irritability,insomnia,etc.Among 115 patients,89 patients(77.39%)had hallucinations within 3days of initial medication.The mean duration of hallucinations was(3.11±3.09)days.Conclusion Medical staff should pay close attention to the risk factors of voriconazole induced hallucinations,and implement individualized administration under the guidance of TDM to reduce the occurrence of ADR.

关 键 词：伏立康唑 幻觉 精神异常 北京市 

分 类 号：R978.1[医药卫生—药品]