摘要
1例37岁肺部毛霉菌感染患者使用艾沙康唑治疗引起癫痫样发作。该患者合并低蛋白血症、肝功能不全,肾功能不全等多种疾病,治疗前精神正常,使用艾沙康唑27 d后突发呼之不应、失神、身体僵直,艾沙康唑血药谷浓度为6.4 mg·L^(-1),考虑癫痫样发作可能由于艾沙康唑血药浓度过高所致的神经毒性引起,立即停药,之后患者未出现癫痫。采用Naranjo's评估量表对不良反应与艾沙康唑的关联性进行评价,结果为“很可能有关”。该病例提示临床使用艾沙康唑时应警惕癫痫不良反应,做好药学监护,发生不良反应后应及时进行用药分析和对症处理。
A 37-year-old patient with pulmonary mucormycosis who developed epilepticlike seizures during treatment with isavuconazole.The patient had multiple comorbidities,including hypoalbuminemia,hepatic dysfunction,and renal insufficiency and displayed normal mental status before treatment.However,after 27 days of isavuconazole therapy,the patient experienced a sudden onset of unresponsiveness,absence seizures,and body rigidity.Therapeutic drug monitoring revealed a plasma trough concentration of isavuconazole at 6.4 mg·L^(-1),the epileptic-like seizures were suspected to be caused by neurotoxicity due to elevated isavuconazole plasma levels.The drug was immediately discontinued,and no further seizures occurred.The Naranjo’s Assessment Scale was used to evaluate the association between adverse reactions and isavuconazole,and the result was"probably relevant".This case highlights the need for caution regarding the potential adverse reaction of seizures when using isavuconazole in clinical practice.This case suggests that clinical use of isavuconazole should be auompanied by vigilance epileptic-like adverse events.Pharmaceutical care and timely analysis of medication use should be carried out,and appropriate symptomatic management should be provided promptly in case of any adverse events.
作者
郭巧
梁培
GUO Qiao;LIANG Pei(Department of Pharmacy,Nanjing Jiangning Hospital,Nanjing 211100,China;Department of Pharmacy,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)
出处
《药物流行病学杂志》
2025年第1期116-120,共5页
Chinese Journal of Pharmacoepidemiology
关键词
艾沙康唑
癫痫样发作
血药浓度
药品不良反应
Isavuconazole
Epileptic-like seizures
Blood drug concentration
Adverse drug reaction
