头孢菌素类和氟喹诺酮类引起胃肠道或心血管不良反应报告54例分析

Analysis on 54 cases of gastrointestinal or cardiovascular adverse reactions caused by cephalosporins and fluoroquinolones

目的对湘南学院附属医院近5年头孢菌素类和氟喹诺酮类药物引起胃肠道或心血管不良反应的情况、高危因素、防治措施等进行分析,为临床安全用药提供参考。方法收集该院2016年7月1日—2021年6月30日上报到国家药品不良反应监测网的头孢菌素类和氟喹诺酮类药物引起胃肠道或心血管不良反应的病例54例,对怀疑药品、药品不良反应(ADR)临床表现、发生时间及转归进行回顾性分析。结果54例ADR患者中,男性占比较多,年龄>40岁人群居多,原患疾病情况以肺部感染居多,给药途径均为静脉滴注;头孢菌素类引起心血管和胃肠道不良反应最多的是头孢哌酮钠舒巴坦钠,而氟喹诺酮类最多的是左氧氟沙星。ADR发生时间在第1天的多见(23例),其中以给药10 min内发生ADR的最高(13例);其次是发生在给药>5 d(15例);临床表现绝大部分患者有胸闷、凝血酶原时间延长及心动过速或心率加快等;痊愈17例,好转37例。结论临床应用头孢菌素类和氟喹诺酮类药物治疗时,药师应重视其引起的胃肠道或心血管不良反应,积极预防和减少ADR,充分保障患者的用药安全、有效。

Objective To analyze the situation,high risk factors,prevention measures of gastrointestinal or cardiovascular adverse reactions caused by cephalosporins and fluoroquinolones in the Affiliated Hospital of Xiangnan University in recent five years,in order to provide reference for security of drug usage in clinical practice.Methods 54 cases of gastrointestinal or cardiovascular adverse reactions caused by cephalosporins and fluoroquinolones,which has been reported to the National Adverse Drug Reaction Monitoring Network in the hospital from July 1,2016 to June 30,2021,were collected and the suspected drugs,clinical manifestations,occurrence time and outcomes of adverse drug reactions(ADR)were retrospectively analyzed.Results Among the 54 patients with ADR,the majority were male,the majority were people aged over 40 years old,the primary disease was pulmonary infection,and the route of administration was intravenous drip;Cefoperazone sodium sulbactam was the most common cause of cardiovascular and gastrointestinal adverse reactions of cephalosporins,while levofloxacin was the most common cause of fluoroquinolones.ADR occurred more frequently on the first day(23 cases),of which the highest ADR occurred within 10 minutes of administration(13 cases),followed by ADR occurred more than 5 days after administration(15 cases);The clinical manifestations of most patients were chest tightness,prolonged prothrombin time,tachycardia or tachycardia,etc;17 cases were cured and 37 cases were improved.Conclusion When cephalosporins and fluoroquinolones have been used in clinical treatment,pharmacists should pay more attention to the gastrointestinal or cardiovascular adverse reactions of these drugs,actively prevent and reduce ADR,and fully ensure medicine safety for patients.