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[住院患者药物引起的皮肤不良反应:一年监测]

[Adverse cutaneous reactions to drugs among hospitalized patients: a one year surveillance].

作者信息

Danza Alvaro, López Maynés, Vola Magdalena, Alvarez-Rocha Alfredo

机构信息

Departamento Clínico de Medicina, Hospital de Clínicas, Montevideo, Uruguay.

出版信息

Rev Med Chil. 2010 Nov;138(11):1403-9. Epub 2011 Jan 27.

Abstract

BACKGROUND

Adverse cutaneous reactions to Drugs (CDRs) are of particular interest among all adverse Drug reactions (ADR) due to their frequency, potential severity and because of the importance of an early diagnosis. Antimicrobial agents, anticonvulsants and non-steroidal anti-inflammatory Drugs are the Drugs associated to the highest risk of CDRs.

AIM

To assess CDRs in hospitalized patients and identify the Drugs involved.

MATERIAL AND METHODS

All patients hospitalized in the Hospital de Clínicas in Montevideo, Uruguay, with suspected CDRs, detected during one year, were included in this prospective study. The imputability was established using the Karch and Lasagna algorithm modified by Naranjo. We analyzed age, gender, Drugs involved, causal disease, severity, latency and evolution.

RESULTS

Seventeen patients, aged 17 to 85 years (15 females) with CDRs were identifed. Twelve had morbilliform exanthemas, four had reactions with eosinophilia and systemic symptoms and one had a Stevens Johnson syndrome. The Drugs involved were antimicrobials in nine cases, hypouricemic agents in four cases, anticonvulsants in three cases and aspartic insulin in one. Twelve patients had a life threatening reaction and one required admission to the intensive care unit. No deaths occurred.

CONCLUSIONS

CDRs were more common in women and most of them were caused by antimicrobial agents.

摘要

背景

药物引起的皮肤不良反应(CDR)在所有药物不良反应(ADR)中备受关注,因其发生频率、潜在严重性以及早期诊断的重要性。抗菌药物、抗惊厥药物和非甾体抗炎药是与CDR风险最高相关的药物。

目的

评估住院患者中的CDR并确定所涉及的药物。

材料与方法

本前瞻性研究纳入了乌拉圭蒙得维的亚临床医院一年内检测出疑似CDR的所有住院患者。使用经纳兰霍修改的卡尔奇和拉萨尼亚算法确定因果关系。我们分析了年龄、性别、所涉药物、病因疾病、严重程度、潜伏期和病程。

结果

确定了17例年龄在17至85岁之间(15名女性)患有CDR的患者。12例有麻疹样皮疹,4例有嗜酸性粒细胞增多和全身症状反应,1例有史蒂文斯 - 约翰逊综合征。所涉药物中,9例为抗菌药物,4例为降尿酸药物,3例为抗惊厥药物,1例为门冬胰岛素。12例患者有危及生命的反应,1例需要入住重症监护病房。无死亡病例。

结论

CDR在女性中更为常见,且大多数由抗菌药物引起。

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