阿托伐他汀钙片致全身严重皮疹1例分析  

One case of severe systemic rash caused by atorvastatin calcium tablets

作　　者：李芳 龙秀英[2] 柏娜 魏京霞[1] LI Fang;LONG Xiuying;BAI Na;WEI Jingxia(Department of Pharmacy,Chengdu Sixth People's Hospital,Chengdu Sichuan 610051,China;Department of Neurology,Chengdu Sixth People,s Hospital,Chengdu Sichuan 610051,China)

机构地区：[1]成都市第六人民医院药剂科,四川成都610051 [2]成都市第六人民医院神经内科,四川成都610051

出　　处：《中国药物警戒》2024年第8期939-942,共4页Chinese Journal of Pharmacovigilance

摘　　要：目的分析阿托伐他汀引起全身严重皮疹的临床特点及可能致敏机制,为慢病患者多重用药提供警示,并为其早期临床处置提供参考。方法通过1例老年脑梗死患者多重用药(氨氯地平、阿司匹林、阿托伐他汀、尤瑞克林、依达拉奉右崁醇)后出现全身皮疹,停用尤瑞克林、依达拉奉右崁醇,调整阿司匹林为氯吡格雷后患者皮疹仍加重,停用全部药物(只保留抗过敏药物)后皮疹逐渐消退,后恢复氯吡格雷、氨氯地平后患者皮疹未复发的全病程,采用Naranjo评分及结合文献资料,分析可能致敏的药物。结果根据患者皮疹的临床表现以及皮疹消退的时间与临床用药的关系,结合阿托伐他汀Naranjo评分5分,考虑其很有可能是引起患者皮疹的药物。结论慢病患者多重用药过程中,临床需注意阿托伐他汀钙片可在用药数天后引起全身严重皮疹。Objective To analyze the clinical characteristics and potential allergenic mechanisms of atorvastatin induced severe generalized rash in patients with chronic diseases,providing a warning for future polypharmacy and reference for early clinical management.Methods A retrospective study was conducted on a patient with cerebral infarction who developed a generalized rash after polypharmacy(amlodipine,aspirin,atorvastatin,urinary kallidinogenase and edaravone dexborneol)was conducted.The rash worsened even after discontinuing urinary kallidinogenase and edaravone dexborneol and switching aspirin to clopidogrel.The rash subsided only after discontinuing all medications except for antiallergic drugs.When clopidogrel and amlodipine were reintroduced,the rash did not recur.The Naranjo score and literature review were used to analyze the potential allergenic drug.Results Based on the clinical presentation of the rash and its relationship with the timing of medication,combined with the Naranjo score of 5 for atorvastatin,it is very likely that atorvastatin is the drug causing the patient’s rash.Conclusions Clinicians should be aware that atorvastatin can cause severe generalized rash in chronic diseases patients a few days after administration during polypharmacy.

关 键 词：阿托伐他汀钙片 严重皮疹 脑梗死 不良反应 多重用药 慢病管理 

分 类 号：R972[医药卫生—药品] R994.11[医药卫生—药学]