2例伏立康唑引起的精神症状不良反应并文献复习  

Adverse Reactions of Voriconazole:A Report of Two Cases and a Review of Literature

作　　者：刘兰兰 卢波 程国振 张京 王明星 王相村 LIU Lan-lan;LU Bo;CHENG Guo-zheng;ZHANG Jing;WANG Ming-xing;WANG Xiang-cun(Department of Pharmacy,Mengyin County People′s Hospital,Mengyin 276299,China;Department of Respiratory Medicine,Mengyin County People′s Hospital,Mengyin 276299,China;Quality Manage Office,Mengyin County People′s Hospital,Mengyin 276299,China)

机构地区：[1]蒙阴县人民医院药学部,山东蒙阴276299 [2]蒙阴县人民医院呼吸内科,山东蒙阴276299 [3]蒙阴县人民医院质管办,山东蒙阴276299

出　　处：《海峡药学》2024年第3期102-105,共4页Strait Pharmaceutical Journal

摘　　要：目的探讨伏立康唑治疗过程中发生的药物不良反应,提醒临床医师和临床药师对伏立康唑相关不良反应引起重视。方法报道1例间质性肺炎伴乙肝的老年患者,使用伏立康唑合并左氧氟沙星、奥美拉唑治疗后出现视觉障碍,停用后视觉障碍症状消失;报道1例基础病复杂的肺部感染老年患者,使用伏立康唑合并奥美拉唑过程中出现幻视伴精神症状,停用伏立康唑后幻视及精神症状消失。结果视觉障碍、幻视伴精神症状是伏立康唑所致的不良反应可能性大;药源性视觉障碍及精神症状不排除与合并使用奥美拉唑、左氧氟沙星有关。结论临床药师密切关注用药安全,注意药物之间相互作用,必要时检测血药浓度及进行基因型检测。OBJECTIVE To investigate the adverse effects of voriconazole during the course of treatment,and to remind cinicians and pharmacists to pay attention to the adverse reactions of voriconazole.METHODS It was reported that one elderly patient with interstitial pneumonia complicated with hepatitis B developed visual impairment after treatment with voriconazole,omeprazole,levofloxacin.And the visual impairment disappeared after discontinuation.One case of elderly patient complex underlying disease of pulmonary infections were reported,and we found that developerd hallucinations and psychiatric symptoms in the process of using voriconazole,and disapeared after stopping the use of voriconazole.RESULTS Hallucinations and psychiatric symptoms was probably an adverse reaction caused by voriconazole.Drug-induced visual impairment and psychiatric symptoms could not be excluded from the association with the combined use of omeprazole and levofloxacin.CONCLUSION Clinicians and pharmacists should pay close attention to the clinical drug safety,pay more attention to the drug-drug interactions,and monitor the drug concentrations in plasma and genotype when necessary.

关 键 词：伏立康唑 幻视 精神障碍 药物相互作用 药物不良反应 

分 类 号：R969.3[医药卫生—药理学]