1例硫酸镁联合利托君诱发急性左心衰/肺水肿的病例分析

Analysis of A Case of Acute Left Heart Failure/Pulmonary Edema Induced by Magnesium Sulfate Combined with Ritodrine

目的探讨硫酸镁与利托君联合应用的安全性与合理性。方法 1例未足月胎膜早破患者保胎治疗过程中出现急性左心衰/肺水肿,临床药师通过参照临床诊治指南,结合患者病史、辅助检查、药物治疗史等情况,根据药物的理化性质,查阅相关文献资料,分析药物之间的相互作用,得出硫酸镁与利托君联合使用导致患者出现左心衰/肺水肿。结果硫酸镁用于保护胎儿脑神经时,不建议与利托君联合使用,如必须要用,需做好心电监护、用药监测,建议交替使用。结论硫酸镁和利托君均能减少钙离子内流,作用机制相似,因此两药合用的安全性越来越受到关注。

OBJECTIVE To explore the safety and rationality of the combination of magnesium sulfate and ritodrine. METHODS Acute left heart failure pulmonary edema occurred in the course of fetal preservation treatment for preterm premature rupture of membranes. Clinical pharmacists consulted the clinical diagnosis and treatment guidelines,combined with the patient’s medical histories,assistant examinations and drug treatment histories and so on,consulted the relevant literatures,analyzed the interaction between drugs according to the physicochemical properties of drugs,,and drew a conclusion that the combination of magnesium sulfate and ritodrine resulted in left heart failure/pulmonary edema. RESULTS When magnesium sulfate was used to protect fetal brain nerve,it was not recommended to use it combined with ritodrine. If it was necessary to use,ECG monitoring and medication monitoring would be done well,and alternative use would be recommended. CONCLUSION Both magnesium sulfate and ritodrine can reduce the calcium influx,and the mechanism of action are similar. Therefore,the safety of the combination of the two drugs will attracted more and more attention.