伏立康唑片引起幻视和幻觉不良反应2例及相关文献回顾

Adverse Reactions of Visual Disturbances and Hallucinations Induced by Voriconazole Tablets in Two Cases and Related Literature Review

目的对伏立康唑引起的幻视和幻觉不良反应的发生规律进行总结,为医务人员安全合理用药提供参考。方法通过分析我院发生的2例伏立康唑引起幻视和幻觉不良反应,查阅国内外相关文献,对伏立康唑引起的幻视和幻觉不良反应的发生概率、发生时间、发生机制、与血药浓度的关联性及转归等方面进行文献回顾。结果伏立康唑引起的视觉毒性和神经系统毒性不良反应的发生概率较其他抗真菌药大;发生不良反应的时间主要在给药的前5 d;神经系统毒性与浓度相关,视觉毒性与浓度没有显著相关性;发生不良反应后及时停药预后较良好。结论伏立康唑发生不良反应的时间主要在给药的前5 d,及时停药预后较良好。

Objective To summarize the regularity of such adverse reactions as visual disturbances and hallucination caused by voriconazole,and to provide reference for the safe and rational use of medicine by health care givers.Methods Two cases of visual disturbances and hallucinations caused by voriconazole in our hospital were reviewed.The chance,onset time,mechanism,correlations with blood concentration and outcomes of adverse reactions caused by voriconazole were studied.Results Voriconazole was more likely to cause visual toxicity and neurotoxic side effects than other antifungal drugs.Adverse reactions occurred mainly within the first five days of administration.There was a significant correlation between neurotoxicity and concentrations,but there was no significant correlation between visual toxicity and concentrations.Immediate discontinuation of the drug after the occurrence of adverse reactions could lead to good prognosis.Conclusion The adverse reactions to voriconazole mostly occur in the first five days of administration,and the prognosis is better if the drug is discontinued quickly.