临床药师参与美托洛尔致老年患者幻觉不良反应处理的实例分析

Metoprolol induced hallucination in elder patient-clinical apothecary thinking and literature analysis

目的:探讨美托洛尔所致不良反应(ADR)的一般规律和临床特点,为临床合理用药提供参考,体现临床药师作用。方法:通过一例老年患者服用美托洛尔出现中枢神经系统不良反应,临床药师协助医师判断、处理展开分析讨论,并检索1994年以来美托洛尔所致中枢神经系统ADR的病例报道,进行统计和分析。结果:美托洛尔致不良反应临床表现以心血管系统不良反应最常见,呼吸系统、变态反应次之,而神经系统不良反应较少见。结论:美托洛尔作为新一代高选择性的β受体阻滞剂,疗效显著,但其伴随的不良反应日益突出,临床药师在日常工作过程中需密切关注,特别是在诊断不明时应想到少见药物不良反应的可能性,减少和避免药源性损害的发生。

OBJECTIVE To study the general regularity and clinical characteristics of adverse drug reaction（ADR） caused by metoprolol,and to provide reference for rational use of drugs in the clinic. METHODS One case of hallucinations possibly linked to metoprolol in our hospital was reported. Literatures about metoprolol-induced ADR reported in domestic pharmaceutical journals after 1994 were collected and analyzed statistically. RESULTS Metoprolol-induced ADR mainly involved cardiovas cular system, followed by the damage of respiratory system, allergic reactions and nervous system. CONCLUSION The doctors and pharmacists should pay more attention to ADR of metoprolol,and work together to ensure the safe and appropriate use of metoprolol.