注射用伏立康唑致自杀倾向与感觉异常1例分析  

Suicidal tendency and paresthesia induced by voriconazole:a case report

作　　者：胡碧原 汪静 郑微旗 胡宏平 陈泳伍[2] HU Biyuan;WANG Jing;ZHENG Weiqi;HU Hongping;CHEN Yongwu(Department of Pharmacy of Shexian Branch,the Second Affiliated Hospital of Medical College of Zhejiang University,Shexian Anhui 245200,China;Department of Pharmacy,the First Affiliated Hospital of University of Science and Technology of China,Hefei Anhui 230001,China)

机构地区：[1]浙江大学医学院附属第二医院歙县分院药剂科,安徽歙县245200 [2]国科技大学附属第一医院安徽省立医院药剂科,安徽合肥230001

出　　处：《中国药物警戒》2023年第4期469-472,479,共5页Chinese Journal of Pharmacovigilance

基　　金：安徽省教育厅高等学校省级质量工程项目(2020jyxm2327)。

摘　　要：目的分析伏立康唑致自杀倾向与感觉异常不良反应的原因及相关文献复习,为其安全使用提供参考。方法分析1例肺部感染患者使用注射用伏立康唑治疗后出现自杀倾向同时伴有痛觉消失与味觉异常的病例,通过查阅国内外相关文献,结合监测患者伏立康唑的谷浓度和CYP2C19基因型及相关指标,分析发生不良反应的原因。结果患者CYP2C19基因型为快代谢型,伏立康唑谷浓度为5.12 mg·L^(-1)。伏立康唑致自杀倾向与感觉异常不良反应的原因与肝功能、炎性指标及白蛋白情况等因素相关。结论高龄患者使用伏立康唑时应尽早监测血清药浓度和测定代谢酶基因类型,密切监测肝功能、炎性指标及营养情况,及时制定个体化给药方案,以避免伏立康唑导致的精神-神经系统不良反应。Objective To analyze the causes of suicidal tendency and paresthesia induced by voriconazole and review the related literature so as to provide reference for safe use of this drug.Methods The clinical data on one patient with both pulmonary infection and suicidal tendency accompanied by nociception and abnormal taste who was treated with voriconazole for injection was analyzed.By reviewing relevant literature at home and abroad,and based on the trough concentration of voriconazole,CYP2C19 genotype and related indicators,the causes of adverse reactions were analyzed.Results CYP2C19 genotype was of the fast metabolic type,and the trough concentration of voriconazole was 5.12 mg·L^(-1).The causes of suicidal tendency and paresthesia induced by voriconazole were related to liver function,inflammatory indicators and albumin status.Conclusion Serum concentrations and metabolic enzyme gene types should be detected as soon as possible in elderly patients using voriconazole.Liver function,inflammatory indicators and nutritional status should be closely monitored.Individualized administration regimens should be formulated immediately to prevent psychonervous system adverse reactions caused by voriconazole.

关 键 词：伏立康唑 自杀倾向 痛觉消失 味觉异常 药品不良反应 肝功能 炎性指标 白蛋白情况 

分 类 号：R978[医药卫生—药品] R994.11[医药卫生—药学]