氟喹喏酮类与茶碱类联用致药物不良事件的文献分析

Systematic Review of Adverse Drug Events of Fluoroquinolones Combined with Theophylline

目的分析氟喹诺酮类与茶碱类联用致不良事件的特点,为临床合理用药提供参考。方法检索Pub Med、CNKI、VIP、CMB和万方数据有关氟喹诺酮类与茶碱类联用致不良事件的文献进行统计学分析。结果各种氟喹诺酮类与茶碱类联用均可致不良事件,其中左氧氟沙星联用氨茶碱最多;老年患者较易发生,平均年龄(64.5±19.4)岁;发生不良事件的平均时间为(3.35±1.45)d,多为迟发性,临床以心律失常和精神异常最为常见,一旦出现不良事件立即停药,大部分不适症状即刻缓解。结论不良事件可能是因为氟喹喏酮类与茶碱类相互影响其体内代谢动力学参数,使体内血药浓度增加所致。因此老年患者应适当减少用药剂量或延长给药间隔,同时对有心脑血管病史和精神病史的患者慎用。

Objective To investigate the characteristics of adverse drug events( ADEs) associated with fluoroquinolones combined with theophylline,so as to provid reference for clinical medication. Methods ADEs of fluoroquinolones combined with theophylline,reported in Pub Med,CNKI,VIP,CMB and Wanfang database,were collected and analyzed statistically. Results All fluoroquinolones combined with theophylline could induce ADEs,and levofloxacin combined with aminophylline was the most fatal. Elderly patients were more vulneraule and the mean age was( 64. 5 ± 19. 4) years. ADEs mostly occurred in( 3. 35 ± 1. 45) d,mainly in the form of delayed allergy.Arrhythmia and mental abnormality were the most common soymptoms. Once ADEs occurred,most of the discomfort was relieved immediately after medication was suspended. Conclusion ADE may be due to the interactions between fluoroquinolones and theophylline that increase make the drug concentration in vivo. Therefore,elderly patients should reduce the dosage or extend intervals. Patients with a history of cardiovascular and cerebrovascular disease or mental illness should use these drugs with caution.