静脉输注拉唑类药物致过敏性休克1例

A case report of anaphylactic shock induced by proton pump inhibitors

目的:结合文献回顾性分析1例静脉滴注拉唑类药物致过敏性休克的原因。方法:1例男性在两次介入治疗术后分别应用注射用兰索拉唑和艾司奥美拉唑钠后出现过敏性休克,药师分析其原因并提出处理意见。结果:患者静脉滴注兰索拉唑和艾司奥美拉唑钠后分别于约15、5 min时出现全身出冷汗、心慌、血压下降等休克表现,该患者休克的发生与质子泵抑制剂(PPIs)有因果关系。药师建议立即停药,并积极按过敏性休克治疗原则进行抢救,若病情需要可选用H_(2)受体拮抗剂。结论:医护人员和药师应详细询问患者过敏史,严格掌握PPIs适应证、用法、用量及疗程,合理使用PPIs,加强用药监护,警惕过敏性休克的发生。

Objective:To retrospectively analyze the causes of anaphylactic shock caused by intravenous infusion of proton pump inhibitors(PPIs).Methods:A male patient developed anaphylactic shock after two interventional treatments with lansoprazole and esomeprazole sodium,respectively.The pharmacist analyzed its causes and proposed treatment suggestions.Results:The patient developed shock manifestations such as systemic cold sweat,palpitation,and blood pressure drop at about 15 and 5 minutes after intravenous infusion of lansoprazole and esomeprazole sodium,respectively.The occurrence of shock in this patient was causally correlated to PPIs.The pharmacist suggested that the drugs should be immediately stopped.Meanwhile,the rescue should be carried out according to the principle of anaphylactic shock treatment.H2 receptor antagonists can be considered if the condition requires.Conclusion:Medical staff and pharmacists should inquire about the allergy history of patients in detail and not only need to strictly master the indications,usage,dosage and course of treatment of PPIs,but also use PPIs reasonably,strengthen medication monitoring and be alert to the occurrence of anaphylactic shock.