Thomas Binny, Mohamed Mahmoud, Al Hail Moza, Awwad Fatma Alzahra Y, Wahba Ramy M, Hassan Sabir B, Omar Khalid, El Kassem Wessam, Abdul Rouf Palivalappila
Hamad Medical Corporation, Doha, Qatar; Robert Gordon University, Aberdeen, Scotland, UK; Qatar University, Doha.
Hamad Medical Corporation, Doha, Qatar; Qatar University, Doha; Weill Cornell Medical College, Ar-Rayyan, Qatar.
Clin Pharmacol. 2016 Dec 13;8:199-202. doi: 10.2147/CPAA.S106234. eCollection 2016.
We report a case of 22-year-old primigravida presented to Women's Hospital - Hamad Medical Corporation emergency with severe epigastric pain, nausea, and vomiting. On admission, she was dehydrated with remarkably worsening symptoms. Laboratory findings revealed significantly elevated liver enzymes with unknown etiology. Her past medical history showed an admission for nausea and vomiting 3 weeks previously and she was discharged on antiemetics, and esomeprazole for the first time. Due to the predominantly elevated liver enzymes, the clinical pharmacist discussed the possibility of esomeprazole-induced adverse effects and suggested to suspend esomeprazole based on the evidence from literature review. The liver enzymes showed a substantial improvement within days after the discontinuation of the drug; however, a rechallenge was not done since it could have adversely affected the mother or the fetus. Using the Naranjo Adverse Drug Reaction Probability scales, the adverse reaction due to esomeprazole was classified as "probably".
我们报告了一例22岁的初产妇，因严重上腹部疼痛、恶心和呕吐被送往哈马德医疗公司妇女医院急诊科。入院时，她脱水且症状明显加重。实验室检查结果显示肝酶显著升高，病因不明。她的既往病史显示3周前曾因恶心和呕吐入院，当时出院时首次使用了止吐药和埃索美拉唑。由于肝酶主要升高，临床药师讨论了埃索美拉唑引起不良反应的可能性，并根据文献综述的证据建议停用埃索美拉唑。停药后数天内肝酶显著改善；然而，未进行再次用药挑战，因为这可能会对母亲或胎儿产生不利影响。使用纳兰霍药物不良反应概率量表，埃索美拉唑引起的不良反应被分类为“很可能”。
