摘要
近年来多种广泛应用的药物可能导致或加剧心律失常已成为药品风险管理的重点。胺碘酮和左氧氟沙星均为目前临床普遍使用且已知可延长QT间期的药物,但二者联合使用却是诱发尖端扭转型室性心动过速(TdP)的主要危险因素。本例患者心律失常合并泌尿道感染使用胺碘酮联合左氧氟沙星治疗后发生TdP,临床药师综合药物关联性评价、药物作用机制和国内外相关文献资料分析判断TdP主要由胺碘酮和左氧氟沙星联合作用所致,建议停药,给予硫酸镁、利多卡因和氯化钾等药物处理,最终患者病情平稳后行植入型心律转复除颤器(ICD)治疗好转出院。
The possibility that several widely used drugs can cause or exacerbate arrhythmia has become a focus of drug risk management in recent years.Amiodarone and Levofloxacin are widely used drugs that are known to prolong the QT interval,while their combined use is a major risk factor for inducing torsade de pointes(TdP).TdP occurred after Amiodarone combined with Levofloxacin treatment in patients with arrhythmia complicated with urinary tract infection.Clinical pharmacists'comprehensive drug correlation evaluation,drug mechanism of action and analysis of relevant literature at home and abroad determined that TdP was mainly caused by the combined effect of Amiodarone and Levofloxacin.It was recommended to stop the drug and give Magnesium Sulfate,Lidocaine,Potassium Chloride and other drugs.Finally,the patient was treated with implantable cardioverter defibrillator(ICD)and discharged.
作者
冯佳媛
FENG Jiayuan(Department of Pharmacy,the Fourth Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia Autonomous Region,Baotou 014030,China)
出处
《中国当代医药》
CAS
2024年第13期118-122,共5页
China Modern Medicine
