3例克林霉素磷酸酯致严重药物不良反应病例的临床特征分析  

Analysis of Clinical Characteristics of Three Patients with Serious Adverse Drug Reactions Caused By Clindamycin Phosphate

作　　者：吴静 徐璐 WU Jing;XU Lu(Department of Pharmacy,the Third People's Hospital of Zhenjiang,Zhenjiang Jiangsu 212000,China)

机构地区：[1]镇江市第三人民医院药剂科,江苏镇江212000

出　　处：《抗感染药学》2023年第12期1250-1252,共3页Anti-infection Pharmacy

基　　金：镇江市社会发展指导性科技计划项目(编号:FZ2022104)。

摘　　要：目的:分析克林霉素磷酸酯所致严重药物不良反应(adverse drug reactions,ADRs)的临床特点,为临床克林霉素磷酸酯的用药安全提供参考。方法:3例患者住院期间,因中耳炎或支气管炎而使用了克林霉素磷酸酯;3例患者在滴注克林霉素磷酸酯过程中或滴注完不久,突然出现了畏寒、全身颤抖麻木、心率快速上升、血压快速下降等过敏性休克症状,病例-1和病例-3甚至还出现意识丧失。结果:发生ADRs后,临床快速给予地塞米松、异丙嗪、葡萄糖酸钙注射液等药物对症治疗,之后患者症状得到了缓解;后续,采用诺氏评估量表法评估克林霉素磷酸酯与ADRs之间的关联性,病例-1的结果为“肯定”,病例-2和病例-3的结果为“很可能”。结论:克林霉素磷酸酯在使用中存在发生严重ADRs的风险,临床在用药过程中应做好ADRs监测,以确保患者的用药安全。Objective:To analyze the clinical characteristics of serious adverse drug reactions(ADRs) caused by clindamycin phosphate,and provide reference for the clinically safe medication of clindamycin phosphate.Methods:Three patients were administered clindamycin phosphate during hospitalization due to otitis media or bronchitis;during or shortly after the infusion of clindamycin phosphate,they developed symptoms of anaphylactic shock such as chills,systemic trembling and numbness,rapid increase in heart rate,rapid decrease in blood pressure,and the patients 1 and3 even experienced loss of consciousness.Results:After the occurrence of ADRs,the patients clinically received symptomatic treatment with dexamethasone,promethazine,calcium gluconate injection,etc.in a rapid manner and their symptoms were relieved.Subsequently,the Naranjo's assessment scale was used to evaluate the correlation between clindamycin phosphate and ADRs,and the results for the patient 1 were "definitely related",for the patients 2 and 3were "probably related".Conclusion:There is a risk of serious ADRs during the use of clindamycin phosphate,and ADRs monitoring shall be performed during clinical medication to ensure the medication safety for patients.

关 键 词：克林霉素磷酸酯 药物不良反应 过敏性休克 临床特点 

分 类 号：R978.19[医药卫生—药品] R181.35[医药卫生—药学]