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安非他酮治疗引起的血管性水肿。

Angioedema caused by bupropion treatment.

作者信息

Bhella R, Southgate J

机构信息

BM BSc FRCP (Corresponding author) Consultant Acute Physician Norfolk and Norwich University Foundation Trust Colney Lan, Norwich, NR4 7UY.

出版信息

Acute Med. 2010;9(2):70-2.

Abstract

Reports of urticaria and rash with bupropion are common, with an estimated incidence of 1-4%. Serious adverse reactions, including seizures and angioedema occur less commonly, but may be dose related. Rarely patients present with fever, arthralgia and myalgia resembling a serumsickness reaction. A case of a 30 year-old man presenting with a rash, angioedema, and arthralgia 19 days after commencing bupropion treatment to aid smoking cessation is described. Treatment with antihistamines and steroids, resulted in improvement within 3 hours, and complete resolution after 3 days. Management also included identifying and discontinuing the causative agent. Recent concerns over neuropsychiatric side effects of bupropion are highlighted. The literature is reviewed and recommendations for safer prescribing discussed.

摘要

关于安非他酮引起荨麻疹和皮疹的报告很常见,估计发生率为1%-4%。严重不良反应,包括癫痫发作和血管性水肿较少见,但可能与剂量有关。极少数患者会出现类似血清病反应的发热、关节痛和肌痛。本文描述了一名30岁男性患者,在开始使用安非他酮辅助戒烟治疗19天后出现皮疹、血管性水肿和关节痛的病例。使用抗组胺药和类固醇治疗后,3小时内症状改善,3天后完全消退。治疗还包括识别并停用致病药物。文中强调了近期对安非他酮神经精神副作用的关注。对相关文献进行了综述,并讨论了更安全用药的建议。

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