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决奈达隆的药物不良反应文献分析
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| 篇名： | 决奈达隆的药物不良反应文献分析 |
| TITLE： | Literature analysis of adverse drug reactions induced by dronedarone |
| 摘要： | 目的 分析决奈达隆药物不良反应（ADR）的临床表现及特点，为临床安全用药提供参考。方法计算机检索PubMed数据库、万方数据、中国知网、维普网自建库起至2022年8月31日收录的决奈达隆ADR的案例报道，对案例中患者年龄、性别、国籍，决奈达隆的用法用量，ADR发生的时间分布、临床表现、治疗措施及转归情况等进行回顾性分析。结果共纳入案例报道26篇，合计27例患者。患者年龄41～86岁，平均年龄为68.8岁，其中60～79岁年龄段发生ADR较多（20例，74.1％）。男性（14例）与女性（13例）数量相差不大。患者来源于6个国家，美国最多（16例，59.3％）。14例患者用法用量为400mg，bid；1例为200mg，bid；12例患者未明确用法用量。用药1个月内ADR发生率较高（16例，59.3%），其中11例发生于1周内（40.7%），无用药12个月以上的ADR报道。ADR累及系统器官以肝胆疾病（7例次，23.3％），皮肤和皮下组织疾病（6例次，20.0%），呼吸道、胸膈和纵隔疾病（5例次，16.7%）为主，此外还包括心脏疾病、肾脏和泌尿系统疾病、血管病、医学检查、眼部疾病。27例患者中，3例发生死亡，其不良反应分别为闭塞性细支气管炎伴机化性肺炎、中毒性表皮坏死松解症、肝功能衰竭；1例进行了肝移植。结论决奈达隆存在多器官系统的ADR，用药前需完善包括心电图、肝功能、肺功能等检查；用药1个月内应加强用药监测，尤其是肝胆、皮肤、呼吸道系统的ADR。其严重ADR的发生与用药时间长短无明显关系，需要持续进行药学监护和随访，以确保患者临床用药安全。 |
| ABSTRACT： | OBJECTIVE To analyze the clinical manifestations and characteristics of adverse drug reactions （ADR） induced by dronedarone，and to provide reference for clinically safe drug use. METHODS Retrieved from PubMed database， Wanfang database，CNKI and VIP （up to August 31st， 2022），ADR cases of dronedarone were analyzed retrospectively in respect of patient’s age，gender，nationality，usage and dosage of dronedarone，and occurrence time，clinical manifestations，treatment measures and outcome of ADR，etc. RESULTS A total of 26 case reports were included，with a total of 27 patients. The age of the patients was 41-86 years old，with an average age of 68.8 years. The proportion of patients aged 60-79 was the largest （20 cases，74.1%）. There was no significant difference in the number of males （14 cases） and females （13 cases）. The patients came from 6 countries， of which the United States was the largest （16 cases，59.3%）. The dosage of 14 patients was 400 mg bid；one patient was 200 mg bid；the dosage for 12 patients was not specified. The most ADR cases （16 cases，59.3%） occurred within 1 month，of which 11 cases（40.7%） occurred within 1 week，and there were no ADR reports with medication more than 12 months. Organs/systems involved in ADRs were mainly liver and biliary diseases （7 case times，23.3%），skin and subcutaneous tissue diseases （6 case times， 20.0%），respiratory tract，thoracic and mediastinal diseases （5 case times，16.7%）. In addition，ADR also occurred in heart diseases， kidney and urinary system diseases，vascular diseases，medical examinations and eye diseases. Among 27 patients，there were 3 cases of death，the ADR were bronchiolitis obliterans with organizing pneumonia，toxic epidermal necrolysis and hepatic failure， respectively. One patient underwent liver transplantation. CONCLUSIONS Dronedarone can cause multiple organ system ADR. Before use，it is necessary to improve the examination including ECG，liver function，lung function，etc. and strengthen drug use monitoring within one month after the start of use，especially the ADR of hepatobiliary，skin and respiratory system. The occurrence of severe ADR has no obvious relationship with the duration of medication； even if it is taken safely for a long time，it still needs continuous pharmaceutical monitoring and follow-up to ensure the clinical medication safety of patients. |
| 期刊： | 2023年第34卷第07期 |
| 作者： | 上官可可；曹曼卿；王荣环 |
| AUTHORS： | SHANGGUAN Keke，CAO Manqing，WANG Ronghuan |
| 关键字： | 决奈达隆；不良反应；文献分析；闭塞性细支气管炎伴机化性肺炎；中毒性表皮坏死松解症；肝功能衰竭 |
| KEYWORDS： | dronedarone； adverse drug reaction； literature |
| 阅读数： | 188 次 |
| 本月下载数： | 11 次 |
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