长期使用氯喹/羟氯喹不良反应/事件病例分析与药物相互作用

doi:10.19803/j.1672-8629.2020.05.02

中国药物警戒 ›› 2020, Vol. 17 ›› Issue (5): 261-266.
DOI: 10.19803/j.1672-8629.2020.05.02

• 新型冠状病毒肺炎诊疗药品安全研究专栏 • 上一篇下一篇

长期使用氯喹/羟氯喹不良反应/事件病例分析与药物相互作用

卫红涛, 沈素^*, 邸宣, 崔璨, 廖音, 宋尧

首都医科大学附属北京友谊医院,北京 100050

收稿日期:2020-02-24 修回日期:2020-06-22 出版日期:2020-05-15 发布日期:2020-05-13
通讯作者: ^*沈素,女,学士,主任药师,临床药物治疗与合理用药。E-mail: shensu11022000@163.com
作者简介:卫红涛,男,学士,副主任药师,临床合理用药。
基金资助:
北京医卫健康公益基金（B17247-046）：探索建立患者药物治疗安全性评价体系

Common Adverse Drug Events due to Long-term Medication with Chloroquine / Hydroxychloroquine and Drug Interactions

WEI Hongtao, SHEN Su^*, DI Xuan, CUI Can, LIAO Yin, SONG Yao

Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2020-02-24 Revised:2020-06-22 Online:2020-05-15 Published:2020-05-13

摘要/Abstract

摘要： 目的检索与分析长期应用氯喹/羟氯喹（CQ/HCQ）可能导致的药品不良反应/事件（ADR/AE）及相关影响因素,总结常见药物相互作用,为临床合理用药提供参考。方法通过检索PubMed、中国期刊全文数据库（CNKI）、万方数据库从建库至今CQ/HCQ引起的药物不良反应/事件的个案报道文献,设定服药3个月以上出现的ADR/AE为长期应用导致的ADR/AE,总结与CQ/HCQ可能产生严重相互作用的药物。结果共检索到文献1 280篇,最终纳入85篇,其中视觉损伤51篇,出现黄斑病变35例,视力下降15例,视网膜病变1例,色盲1例,失明2例,停药后好转15例,未恢复38例,长期用药>5年、累积剂量超过1 000 g的视觉损伤多不可恢复。心脏ADR/AE共24篇,病例31例,ADR/AE包括传导阻滞25例,心肌损伤17例,心衰15例;其中死亡4例,植入起搏器6例,心脏移植4例。皮肤ADR/AE纳入5篇,其他ADR/AE纳入5篇,主要表现为听力减退。结论临床长期使用CQ/HCQ可出现严重ADR/AE,包括心脏毒性、黄斑变性、听力减退等需注意监测;CQ/HCQ主要经CYP450酶代谢,使用过程中应注意药物相互作用的影响。

关键词: 氯喹, 羟氯喹, 不良事件, 文献分析, 药物相互作用

Abstract: ObjectiveTo investigate the possible adverse drug reactions caused by long-term use of chloroquine/hydroxychloroquine (CQ/HCQ) and related risk factors in order to provide evidence for rational clinical applications of these drugs. Methods Electronic databases including PubMed, CNKI and Wanfang were searched for possible ADR/AE caused by CQ/HCQ administration. ADR/AE that occurred more than 3 months after medication were identified as long-term ADR/AE. Results A total of 1 280 articles were retrieved, 85 of which were adopted. Among the 85 articles, 51 involved visual impairment, including 35 cases of maculopathy, 15 cases of vision decline, 1 case of retinopathy, 1 case of color blindness, and 2 cases of blindness. There were 15 cases of improvement after drug withdrawal, but 38 patients didn't recover. Most of the cases of visual impairment could not recover with a cumulative dose >1 000 g and after more than 5 years of medication. There were also 24 articles on heart related ADR/AE involving 31 patients. These ADR/AE involved 25 cases of conduction block, 17 cases of myocardial injury and 15 cases of heart failure. There were 4 cases of death, 6 cases of implantation with pacemakers and 4 cases of heart transplantation. There were 5 articles related to skin ADR/AE and another 5 ones related to other ADR/AE. Conclusion CQ/HCQ can cause serious ADR/AE, including cardiotoxicity, maculopathy, and hypoacusis. CQ/HCQ is mainly metabolized by CYP450 enzyme, so drug interactions deserve attention.

Key words: chloroquine, hydroxychloroquine, adverse drug events, literature analysis, drug interactions

中图分类号:

R994.11

卫红涛, 沈素, 邸宣, 崔璨, 廖音, 宋尧. 长期使用氯喹/羟氯喹不良反应/事件病例分析与药物相互作用[J]. 中国药物警戒, 2020, 17(5): 261-266.

WEI Hongtao, SHEN Su, DI Xuan, CUI Can, LIAO Yin, SONG Yao. Common Adverse Drug Events due to Long-term Medication with Chloroquine / Hydroxychloroquine and Drug Interactions[J]. Chinese Journal of Pharmacovigilance, 2020, 17(5): 261-266.

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长期使用氯喹/羟氯喹不良反应/事件病例分析与药物相互作用

Common Adverse Drug Events due to Long-term Medication with Chloroquine / Hydroxychloroquine and Drug Interactions

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