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氯氮平相关的功能性肠梗阻:一种罕见的不良反应揭示了喹硫平和苯海索的相互作用,增加了肠道监测的必要性。

Clozapine-Related Functional Bowel Obstruction: A Rare Adverse Effect Unmasking Quetiapine and Benztropine Interaction Raising Need for Bowel Surveillance.

作者信息

Tiwari Apoorv, Kambhatla Swathi, George Nathan, Anumolu Prathyusha, Malik Nikhale, Kambhatla Sujata

机构信息

Department of Internal Medicine, Michigan State University, Garden City Hospital, Garden City, MI.

Michigan State University, MI.

出版信息

ACG Case Rep J. 2024 May 17;11(5):e01351. doi: 10.14309/crj.0000000000001351. eCollection 2024 May.

Abstract

Randomized controlled trials demonstrate a significant decline in hospital admissions and length of stay following the initiation of clozapine in individuals with bipolar disorder and schizophrenia, along with an increase in quality-adjusted life years. The morbidity and mortality associated with clozapine-induced gastrointestinal hypomotility (CIGH) is greater than agranulocytosis. Despite this, we only have clozapine risk evaluation and mitigation strategies by the US Food and Drug Administration for white cell count monitoring, but none exists for CIGH. Our case highlights CIGH due to multiple factors and recommendations to prevent it and enhance clozapine compliance by conducting a thorough literature review.

摘要

随机对照试验表明,在双相情感障碍和精神分裂症患者中开始使用氯氮平后,住院人数和住院时间显著下降,同时质量调整生命年增加。与氯氮平引起的胃肠道动力不足(CIGH)相关的发病率和死亡率高于粒细胞缺乏症。尽管如此,美国食品药品监督管理局仅制定了氯氮平风险评估和缓解策略用于监测白细胞计数,而针对CIGH却没有相关策略。我们的病例突出了由多种因素导致的CIGH,并通过全面的文献综述提出了预防CIGH以及提高氯氮平依从性的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/feb9/11101216/7aedc8facd2d/ac9-11-e01351-g001.jpg

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