|
|
1例头孢哌酮/舒巴坦钠致凝血功能障碍的病例分析
|
Abstract:
临床药师参与1例使用头孢哌酮/舒巴坦钠后引起凝血功能障碍的治疗过程。该患者为84岁男性，既往诊断为高血压、糖尿病。因“黑便、呕咖啡样物质”入院，入院后CT检查提示双肺肺炎，予头孢哌酮钠舒巴坦钠静脉滴注后出现鼻衄，临床药师分析患者既往疾病史以及用药史，考虑出现凝血功能障碍为头孢哌酮钠/舒巴坦钠所致。立即停用头孢哌酮/舒巴坦，并予维生素K1肌肉注射，输注新鲜冰冻血浆200 ml等治疗后凝血功能无异常。临床药师结合患者的病情和用药情况，分析药物使用与药品不良反应之间的关系，为临床合理用药提供参考，保障患者用药安全。
Clinical pharmacists participated in the treatment of 1 case of coagulation dysfunction caused by cefoperazone/sulbactam sodium. The patient was an 84-year-old male who was previously diag-nosed with hypertension and diabetes. The patient was admitted to hospital due to “melena and vomiting coffee-like substance”. After admission, CT examination showed bilateral pulmonary pneu- monia. After intravenous infusion of cefoperazone sodium and sulbactam sodium, epistaxis oc-curred. Clinical pharmacists analyzed the patient’s past medical history and medication history, and considered that the coagulation dysfunction was caused by cefoperazone sodium/sulbactam sodi-um. Cefoperazone/sulbactam was immediately discontinued, and vitamin K1 was intramuscularly injected, and 200 ml of fresh frozen plasma was infused. After treatment, there was no abnormal coagulation function. Based on the patient’s condition and medication, clinical pharmacists ana-lyzed the relationship between drug use and adverse drug reactions, so as to provide reference for clinical rational drug use and ensure the safety of drug use.
| [1] | Wang, W., Liu, Y.M., Yu, C., et al. (2020) Cefoperazone-Sulbactam and Risk of Coagulation Disorders or Bleeding: A Retrospective Cohort Study. Expert Opinion on Drug Safety, 19, 339-347.
https://doi.org/10.1080/14740338.2020.1713090 |
| [2] | Hu, H.R. (2019) Fatal Vitamin K-Dependent Coagulopathy Associated with Cefoperazone/Sulbactam: A Case Report. Drug Safety-Case Reports, 6, Article Number 6. https://doi.org/10.1007/s40800-019-0100-0 |
| [3] | 陈志文, 等. 头孢哌酮钠舒巴坦钠的临床价值与不良反应分析[J]. 深圳中西医结合杂志, 2021, 31(17): 120-122. |
| [4] | 韦玲云, 等. 头孢哌酮/舒巴坦致凝血功能障碍的相关因素研究进展[J]. 吉林医药学院学报, 2022, 43(2): 124-126. |
| [5] | 斯日古楞, 等. 头孢哌酮钠/舒巴坦钠静脉输注致凝血功能障碍1例[J]. 中国药物应用与监测, 2019, 16(6): 380-382. |
| [6] | Shao, X.P., Ren, Y.Y., Xie, N., et al. (2023) Effect of Cefoperazone/Sulbactam on Blood Coagulation Function in Infected Emergency Department Patients and the Necessity of Vitamin K1 (VK1) Preventive Intervention: A Single- Center, Retrospective Analysis. Medical Science Monitor, 29, e939203. https://doi.org/10.12659/MSM.939203 |
| [7] | 王艳宁, 钟慧. 头孢哌酮舒巴坦钠致凝血功能障碍临床分析[J]. 中国药物应用与监测, 2005(5): 57-58. |
| [8] | Wu, S., Wu, G. and Wu, H. (2021) A Comparison of Coagulation Function in Patients Receiving Aspirin and Cefoperazone-Sulbactam with and without Vitamin K(1): A Retrospective, Observational Study. Clinical Therapeutics, 43, e335-e345. https://doi.org/10.1016/j.clinthera.2021.10.005 |
| [9] | Wang, Y.Y., Yu, J.H. and Duan, J.L. (2020) Analysis of In-fluencing Factors of Coagulation Caused by Cefoperazone Sulbactam. Chinese General Practice, 23, 138-140. |
| [10] | 梁小刚. 第三代头孢菌素类药物临床不良反应原因分析及风险预防机制探索[J]. 人人健康, 2020, 7(7): 274. |
| [11] | Chen, L.J., Hsiao, F.Y., Shen, L.J., et al. (2016) Use of Hypoprothrombinemia-Inducing Cephalosporins and the Risk of Hemorrhagic Events: A Nationwide Nested Case-Control Study. PLOS ONE, 11, e0158407.
https://doi.org/10.1371/journal.pone.0158407 |
| [12] | Schentag, J.J., Welage, L.S., Grasela, T.H., et al. (1987) Deter-minants of Antibiotic-Associated Hypoprothrombinemia. Pharmacotherapy, 7, 80-86. https://doi.org/10.1002/j.1875-9114.1987.tb03522.x |
| [13] | 彭怡倩, 朱玉萍. 头孢哌酮钠舒巴坦钠致3例凝血功能异常的病例分析[J]. 中国处方药, 2022, 20(12): 94-95. |
| [14] | 蒋红, 等. 头孢哌酮钠/舒巴坦钠对凝血功能的影响及处理[J]. 药学服务与研究, 2016, 16(4): 300-303. |
| [15] | 庞立峰. 注射用头孢哌酮钠舒巴坦钠致凝血功能异常1例[J]. 中国药物警戒, 2018, 15(5): 312-313. |
| [16] | 中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版) [J]. 中华结核和呼吸杂志, 2016(4): 253-279. |
