BACKGROUND Pregabalin is widely used to treat neuropathic pain associated with postherpetic neuralgia.To our knowledge,this is the first report on simultaneously occurring dose-related adverse drug reactions(ADRs)of b...BACKGROUND Pregabalin is widely used to treat neuropathic pain associated with postherpetic neuralgia.To our knowledge,this is the first report on simultaneously occurring dose-related adverse drug reactions(ADRs)of balance disorder,asthenia,peripheral edema,and constipation in an elderly patient after pregabalin.CASE SUMMARY A 76-year-old female with a history of postherpetic neuralgia was prescribed pregabalin(300 mg daily).After taking pregabalin for 7 d,the patient developed balance disorder,weakness,peripheral pitting edema(2+),and constipation.On days 8-14,the pregabalin dose was reduced to 150 mg/d based on creatinine clearance.The patient’s peripheral edema improved significantly with the disappearance of all other adverse symptoms.On day 15,the pregabalin dose was increased to 225 mg/d to relieve pain.Unfortunately,the symptoms mentioned earlier gradually reappeared after 1 wk of pregabalin treatment.However,the complaints were not as severe as when taking 300 mg/d pregabalin.The patient consulted her pharmacist by telephone and was advised to reduce the dose of pregabalin to 150 mg/d and add acetaminophen(0.5 g,q6h)to relieve pain.The patient’s ADRs gradually improved over the following week.CONCLUSION Older patients should be prescribed a lower initial dose of pregabalin.The dose should be titrated to the maximum tolerable dose to avoid dose-limiting ADR.Dose reduction and the addition of acetaminophen may help limit ADR and improve pain control.展开更多
目的比较普瑞巴林与加巴喷丁治疗带状疱疹后神经痛(PHN)的效果与安全性。方法选择72例PHN患者为研究对象,随机分为普瑞巴林组与加巴喷丁组,每组36例。普瑞巴林组在常规治疗的基础上加用普瑞巴林,加巴喷丁组在常规治疗的基础上加用加巴...目的比较普瑞巴林与加巴喷丁治疗带状疱疹后神经痛(PHN)的效果与安全性。方法选择72例PHN患者为研究对象,随机分为普瑞巴林组与加巴喷丁组,每组36例。普瑞巴林组在常规治疗的基础上加用普瑞巴林,加巴喷丁组在常规治疗的基础上加用加巴喷丁。比较两组基线及治疗后不同时间点视觉模拟评分法(VAS)评分、睡眠障碍指数(SPI)与不良反应发生情况、临床疗效。结果两组组基线、治疗后3 d VAS评分无统计学差异(P>0.05)。两组患者VAS评分均随着时间推移呈下降趋势,普瑞巴林组治疗后7、14、28及56 d VAS评分分别为(4.0±0.8)、(2.8±0.7)、(2.2±0.6)、(1.6±0.5)分,均显著低于加巴喷丁组的(4.6±1.3)、(3.5±1.1)、(2.8±1.2)、(2.1±0.8)分,差异有统计学意义(P<0.05)。两组基线SPI无统计学差异(P>0.05);两组患者SPI均随着时间推移呈下降趋势,普瑞巴林组治疗后28、56 d SPI分别为(23.3±5.6)、(16.2±4.1)分,均低于加巴喷丁组的(29.4±6.0)、(21.6±5.7)分,差异有统计学意义(P<0.05)。普瑞巴林组与加巴喷丁组有效率分别为94.4%与86.1%,组间比较无统计学差异(P>0.05);普瑞巴林组优良率86.1%显著高于加巴喷丁组的63.9%,差异有统计学意义(P<0.05)。两组头晕、头痛、视物模糊、嗜睡、口干、外周水肿发生率比较无统计学差异(P>0.05)。结论普瑞巴林与加巴喷丁治疗PHN效果显著,但普瑞巴林治疗效果更佳,二者安全性相当。展开更多
文摘BACKGROUND Pregabalin is widely used to treat neuropathic pain associated with postherpetic neuralgia.To our knowledge,this is the first report on simultaneously occurring dose-related adverse drug reactions(ADRs)of balance disorder,asthenia,peripheral edema,and constipation in an elderly patient after pregabalin.CASE SUMMARY A 76-year-old female with a history of postherpetic neuralgia was prescribed pregabalin(300 mg daily).After taking pregabalin for 7 d,the patient developed balance disorder,weakness,peripheral pitting edema(2+),and constipation.On days 8-14,the pregabalin dose was reduced to 150 mg/d based on creatinine clearance.The patient’s peripheral edema improved significantly with the disappearance of all other adverse symptoms.On day 15,the pregabalin dose was increased to 225 mg/d to relieve pain.Unfortunately,the symptoms mentioned earlier gradually reappeared after 1 wk of pregabalin treatment.However,the complaints were not as severe as when taking 300 mg/d pregabalin.The patient consulted her pharmacist by telephone and was advised to reduce the dose of pregabalin to 150 mg/d and add acetaminophen(0.5 g,q6h)to relieve pain.The patient’s ADRs gradually improved over the following week.CONCLUSION Older patients should be prescribed a lower initial dose of pregabalin.The dose should be titrated to the maximum tolerable dose to avoid dose-limiting ADR.Dose reduction and the addition of acetaminophen may help limit ADR and improve pain control.
文摘目的比较普瑞巴林与加巴喷丁治疗带状疱疹后神经痛(PHN)的效果与安全性。方法选择72例PHN患者为研究对象,随机分为普瑞巴林组与加巴喷丁组,每组36例。普瑞巴林组在常规治疗的基础上加用普瑞巴林,加巴喷丁组在常规治疗的基础上加用加巴喷丁。比较两组基线及治疗后不同时间点视觉模拟评分法(VAS)评分、睡眠障碍指数(SPI)与不良反应发生情况、临床疗效。结果两组组基线、治疗后3 d VAS评分无统计学差异(P>0.05)。两组患者VAS评分均随着时间推移呈下降趋势,普瑞巴林组治疗后7、14、28及56 d VAS评分分别为(4.0±0.8)、(2.8±0.7)、(2.2±0.6)、(1.6±0.5)分,均显著低于加巴喷丁组的(4.6±1.3)、(3.5±1.1)、(2.8±1.2)、(2.1±0.8)分,差异有统计学意义(P<0.05)。两组基线SPI无统计学差异(P>0.05);两组患者SPI均随着时间推移呈下降趋势,普瑞巴林组治疗后28、56 d SPI分别为(23.3±5.6)、(16.2±4.1)分,均低于加巴喷丁组的(29.4±6.0)、(21.6±5.7)分,差异有统计学意义(P<0.05)。普瑞巴林组与加巴喷丁组有效率分别为94.4%与86.1%,组间比较无统计学差异(P>0.05);普瑞巴林组优良率86.1%显著高于加巴喷丁组的63.9%,差异有统计学意义(P<0.05)。两组头晕、头痛、视物模糊、嗜睡、口干、外周水肿发生率比较无统计学差异(P>0.05)。结论普瑞巴林与加巴喷丁治疗PHN效果显著,但普瑞巴林治疗效果更佳,二者安全性相当。
