氟替美维吸入粉雾剂致过敏性休克1例分析

One case of anaphylactic shock induced by fluticasone furoate

目的探讨氟替美维吸入粉雾剂致过敏性休克发生的特点,为临床安全合理用药提供参考。方法分析某院1例使用氟替美维吸入粉雾剂导致过敏性休克的案例,结合诺氏不良反应评分,评价本次过敏性休克与怀疑药物的相关性。并通过文献回顾氟替美维吸入粉雾剂导致过敏性休克的原因及机制。结果根据患者的病史,氟替美维诺氏不良反应相关性评分得5分(可能相关),考虑氟替美维致过敏性休克可能性大。患者发生过敏性休克可能主要由氟替美维吸入粉雾剂中辅料乳蛋白所致,但不完全排除主成分乌美溴铵相关。患者经对症治疗后好转。结论应常规询问过敏史,避免使用含有乳蛋白的吸入粉雾剂或其他药物,以免引起严重过敏反应。

Objective To investigate the characteristics of anaphylactic shock induced by fluticasone furoate in order to provide reference for clinical safe and rational drug use.Methods One case of anaphylactic shock caused by the use of fluticasone furoate and treated in our hospital was analyzed.The correlations between anaphylactic shock and the suspected drug were studied using the Knoop’s adverse reaction score.The causes and mechanisms of anaphylactic shock caused by fluticasone furoate were studied by reviewing literature.Results According to the patient’s medical history,the correlation score of adverse reactions of fluticasone furoate was 5 points(possibly related).It was likely that allergic shock was caused by fluticasone furoate,or rather,by the adjuvant milk protein contained,but it was also possible that the main ingredient-umeclidinium bromide-was also involved.Conclusion Patients with a history of milk protein allergy should be routinely inquired about their allergy history,and the use of inhaled powder or other drugs containing milk protein as excipients should be avoided so as to prevent serious allergic reactions.