氟比洛芬酯注射液致急性肝肾功能衰竭1例分析

doi:10.19803/j.1672-8629.2022.02.26

摘要/Abstract

摘要： 目的为预防临床应用氟比洛芬酯注射液致肝肾功能损伤提供依据。方法分析1例双膝单髁置换术后患者使用氟比洛芬酯注射液致急性肝肾衰竭的诊治经过,根据国家药品不良反应监测中心制定的药品不良反应（ADR）判定标准进行该例严重ADR的关联性评价。结果停药并给予床旁血液净化联合血液灌流、保肝、抗感染治疗后,患者肝肾功能基本恢复正常。结论临床应用氟比洛芬酯注射液时,除关注患者胃肠道与皮肤过敏等不良发应外,还需密切关注其肝肾功能的变化,同时警惕预示肝肾毒性反应的症状和体征,以确保临床用药在获取疗效的同时兼具安全性。

关键词: 氟比洛芬酯, 药品不良反应, 肝功能衰竭, 肾功能衰竭

Abstract: Objective To provide evidence for clinical use of flurbiprofen axetil injection and to prevent liver and kidney damage. Methods A retrospective view of the process of diagnosis and treatment of one patient was analyzed, who was cured with flurbiprofen axetil injection after unicompartmental knee arthroplasty and then appeared acute hepatic and renal failure. The relevance evaluation of severe adverse reaction was carried according to the ADR criteria established by National ADR Monitoring Center. Results The liver and kidney functions of the patient were restored to normal after the patient was stopped the flurbiprofen axetil injection and treated with blood purification combined with hemoperfusion and some liver protection and anti-infection medicines. Conclusion This case reminds us that in the clinical application of flurbiprofen axetil injection, in addition to paying attention to adverse reactions such as gastrointestinal tract and skin allergies, we also need to pay close attention to changes in liver and kidney function. At the same time, be vigilant for the symptoms and signs that predict liver and kidney toxicity, so as to ensure that clinical medications are effective and safe.

Key words: flurbiprofen axetil, adverse drug reaction, liver failure, renal failure

中图分类号:

R994.11

原小陇, 陶东红, 万齐华. 氟比洛芬酯注射液致急性肝肾功能衰竭1例分析[J]. 中国药物警戒, 2022, 19(2): 224-227.

YUAN Xiaolong, TAO Donghong, WAN Qihua. One case of acute hepatic and renal failure induced by flurbiprofen axetil injection[J]. Chinese Journal of Pharmacovigilance, 2022, 19(2): 224-227.

参考文献

[1] LIU H, GUO DH, SONG YD, et al.Case report and literature evaluation of liver injury caused by flurbiprofen (ester)[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2018, 15(5): 291-295.
[2] National Institutes of Health. Liver tox: clinical and research information on drug-induced liver injury [EB/OL].(2018-01-25)[2020-03-27]. https://www.ncbi.nlm.nih.gov/books/NBK547852/.
[3] DE LOOZE F, SHEPHARD A, SMITH AB.Locally delivered flurbiprofen 8.75mg for treatment and prevention of sore throat: a narrative review of clinical studies[J]. Journal of Pain Research, 2019, 12: 3477-3509.
[4] AMINU N, CHAN SY, YAM MF, et al.A dual-action chitosan-based nanogel system of triclosan and flurbiprofen for localised treatment of periodontitis[J]. International Journal of Pharmaceutics, 2019, 570: 118659.
[5] TIOZZO FL, MANNIELLO MD, BORTOLOTTI F, et al.Anti-inflammatory flurbiprofen nasal powders for nose-to-brain delivery in Alzheimer’s disease[J]. Journal of Drug Targeting, 2019, 27(9): 984-994.
[6] WANG YH.Advances in pharmacology and clinical application of flurbiprofen axetil[J]. Tianjin Pharmacy(天津药学), 2018, 30(2): 58-60, 71.
[7] ZENG QL, HANG JW, HANG SA.A case of dyspnea caused by flurbiprofen axetil injection[J]. Evaluation and Analysis of Drug-Use in Hospitals of China(中国医院用药评价与分析), 2018, 18(10): 1440.
[8] NI XJ, ZHONG H, LIU XY.A case of epilepsy caused by flurbiprofen axetil injection[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2012, 9(7): 443.
[9] XI N, ZHAO GR.A case of acute liver injury caused by flurbiprofen axetil[J]. Pharmaceutical Journal of Chinese People's Liberation Army(解放军药学学报), 2017, 33(3): 297.
[10] Chinese Pharmaceutical Association.The 16th China Pharmacist Pharmacy Week Proceedings China Conference of 2016(2016年中国药学大会暨第十六届中国药师周论文集)[C]. Chinese Pharmaceutical Association: Chinese Pharmaceutical Association, 2016.
[11] LIU H, SONG YD, ZHAO SY.Study on automatic monitoring and risk factors of flurbiprofen axetil-related liver damage[J]. Chinese Journal of Drug Application and Monitoring(中国药物应用与监测), 2018, 15(6): 344-347.
[12] CHEN MM, LI Y. Study on the risk factors of flurbiprofen axetil related liver damage[J]. World Latest Medical Information(世界最新医学信息文摘), 2019, 19(70): 110, 118.
[13] ZHANG CY, SU SX, WU LX, et al.Effect of flurbiprofen axetil postoperative analgesia on renal function in elderly patients[J]. Chinese Journal of Clinical Research(中国临床研究), 2010, 23(8): 693-694.
[14] MA XR, FENG Y, ZHANG WD.The effect of flurbiprofen axetil on renal function in patients with hypertension[J]. Chinese Journal of Pain Medicine(中国疼痛医学杂志), 2019, 25(8): 608-613.
[15] DOGAN S, CELIKBILEK M, DEMIRKAN K, et al.Prolonged cholestatic jaundice associated with flurbiprofen[J]. Journal of Pharmacy Practice, 2014, 27(4): 396-398.
[16] OTSUKA N, YATABA I, MATSUSHITA I, et al.A minimal impact of long-term S-flurbiprofen plaster application on kidney function in osteoarthritis patients[J]. Clinical and Experimental Nephrology, 2017, 21(6): 1060-1067.
[17] SANTORO D, VITA G, ROVITO S, et al.Drug-induced TINU syndrome and genetic characterization[J]. Clinical Nephrology, 2012, 78(3): 230-236.
[18] YU YC, MAO YM, CHEN CW.Drug-induced liver injury treatment guidelines[J]. Journal of Practical Hepatology(实用肝脏病杂志), 2017, 20(2): 257-274.
[19] ZHANG YK, HANG QX.A case of liver damage caused by intravenous drip of cefuroxime sodium for injection[J]. China Pharmaceuticals(中国药业), 2014, 23(12): 61.
[20] Adverse Drug Reaction Reporting and Monitoring Management Measures [EB/OL]. (2004-03-04)[2020-03-01]. http://www.nhc.gov.cn/wjw/bmgz/200804/8fd34a2690c04eeeb266856bf364931e.shtml.
[21] JIANG J.Study on the pharmacological activity of FXR antagonists and the mechanism of NSAIDs inducing liver injury[D]. East China University of Science and Technology, 2013.
[22] YATABA I, OTSUKA N, MATSUSHITA I, et al.Plasma pharmacok-inetics and synovial concentrations of S-flurbiprofen plaster in humans[J]. European journal of clinical pharmacology, 2016, 72(1): 53-59.