利奈唑胺与帕罗西汀合用引起5-羟色胺综合征1例分析

Analysis of a case of serotonin syndrome caused by the combination of linezolid and paroxetine

目的探讨帕罗西汀与利奈唑胺合用致5-羟色胺综合征的临床特点及临床药师在药源性疾病的鉴别及处置方面发挥的作用。方法临床药师对一例因焦虑症长期口服帕罗西汀的病人,在使用利奈唑胺600 mg,每12小时1次,静脉滴注治疗人葡萄球菌心内膜炎2 d后突发高热、瞻望、震颤及血压飙升等症状进行分析。结果5-羟色胺再摄取抑制剂帕罗西汀与单胺氧化酶抑制剂利奈唑胺合用可导致内源性升压物质拟交感胺类破坏减少,引起5-羟色胺综合征,与病人症状相符。后立即停用两药,同时在监护下进行镇静、降压等对症治疗,最终病人症状纠正。结论在制定临床给药方案时,临床医生应警惕利奈唑胺与5-羟色胺再摄取抑制剂的相互作用,同时重视临床药师在保障用药安全方面发挥的积极作用。

Objective To explore the clinicalfeatures of serotonin syndrome caused by paroxetine andtheroleof clinical pharmacists in identificationand treatment of drug-induced diseases.Methods Clinical pharmacist analyzed the etiology of a series of sudden symptoms such as fever,vision,tremor,and soaring blood pressure ofapatientwhohad been taking orally paroxetine for anxiety neurosis for a long time and received 600 mg of linezolid once every 12 hours,intravenous drip to treat Staphylococcal endocarditis after 2 days.Results The combination of paroxetine asa SSRIs,and linazolamide asa MAOI can lead to a decrease in the destruction of endogenous boost substances,causing serotonin syndrome whichbeingconsistent with the patient’s symptoms.Conclusion In the course of clinical drug therapy,attention should be paid to the adverse drug reactions caused by the interaction of liniazolidomide and SSIRs,and the positive role of clinical pharmacists in ensuring the safety of drug use.