心律失常患者使用噻托溴铵粉吸入剂引起房颤1例

doi:10.5246/jcps.2015.03.024

中国药学(英文版) ›› 2015, Vol. 24 ›› Issue (3): 192-194.DOI: 10.5246/jcps.2015.03.024

心律失常患者使用噻托溴铵粉吸入剂引起房颤1例

魏艳红^1,2, 杨莉萍^1*, 张亚同¹, 邵宏³

1. 北京医院药学部, 北京 100730
2. 北京大学首钢医院药剂科, 北京 100144
3. 北京大学医学部药学院药事管理与临床药学系, 北京 100191

收稿日期:2014-04-17 修回日期:2014-11-28 出版日期:2015-03-29 发布日期:2014-11-28
通讯作者: Tel.: 86-10-85133637

Atrial fibrillation associated with tiotropium in patients with pre-existing arrhythmia: a case report

Yanhong Wei^1,2, Liping Yang^1*, Yatong Zhang¹, Hong Shao³

1. Department of Clinical Pharmacy, Beijing Hospital, Beijing 100730, China
2. Department of Pharmacy, Peking University Shougang Hospital, Beijing 100144, China
3. Department of Pharmacy, Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, China

Received:2014-04-17 Revised:2014-11-28 Online:2015-03-29 Published:2014-11-28
Contact: Tel.: 86-10-85133637

摘要/Abstract

摘要： 吸入性抗胆碱能药物噻托溴铵广泛用于COPD的治疗。然而噻托溴铵有促心律失常促缺血作用, 增加患者心血管事件的发生率。有心律失常疾病的患者, 其发生率会更大。1例79岁男性患者, 有心律失常病史, 使用噻托溴铵粉吸入剂18 μg, 2次/天, 2周后出现房颤, 对症治疗后痊愈。噻托溴铵的促心律失常作用很容易被忽略, 本文旨在提醒医务人员警惕噻托溴铵粉吸入剂在COPD患者中的促心律失常作用。

关键词: 噻托溴铵, 房颤, 不良反应, 患者教育

Abstract:

Inhaled anticholinergic agent tiotropium is widely used in the treatment of chronic obstructive pulmonary disease (COPD). However, it has pro-arrhythmic and pro-ischaemic effects, which can potentially increase the risk of serious cardiovascularevents, especially in patients with pre-existing arrhythmias. We presented a 79-year-old man with a medical history of arrhythmia, who developed atrial fibrillation after used tiotropium 18 μg daily for two weeks. We urge the caution of pro-arrhythmic effect of tiotropium. Healthcare professionals should be aware of the potential effect when prescribing tiotropium to patients with known cardiac rhythm disorders.

Key words: Tiotropium, Atrial fibrillation, Adverse effects, Patient education

中图分类号:

R711

Supporting:

魏艳红, 杨莉萍, 张亚同, 邵宏. 心律失常患者使用噻托溴铵粉吸入剂引起房颤1例[J]. 中国药学(英文版), 2015, 24(3): 192-194.

Yanhong Wei, Liping Yang, Yatong Zhang, Hong Shao. Atrial fibrillation associated with tiotropium in patients with pre-existing arrhythmia: a case report[J]. Journal of Chinese Pharmaceutical Sciences, 2015, 24(3): 192-194.

参考文献

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[3] Singh, S.; Loke, Y.K.; Enright, P.; Furberg, C.D. Thorax. 2013, 68, 114-116.

[4] Jara, M.; Lanes, S.F.; Wentworth III, C.; May, C.; Kesten, S. Drug Saf. 2007, 30, 1151-1160.

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[6] Gregory, M.D.; Mersfelder, T.L.; Jamieson, T. Ann. Pharmacother. 2010, 44, 391-393.

[7] Naranjo, C.A.; Busto, U.; Sellers, E.M.; Sandor, P.; Ruiz, I.; Roberts, E.A.; Janecek, E.; Domecq, C.; Greenblatt, D.J. Clin. Pharmacol. Ther. 1981, 30, 239-245.

[8] MHRA. Drug Safety Update. 2010,4,H2. This article can be found online at http://www.mhra.gov.uk/home/groups/dsu/documents/publication/con099854.pdf (accessed 2013 Sep 30).

[9] Electronic Medicines Compendium. Spiriva Respimat—Patient Information Leaflet 2013. This article can be found online at http://www.medicines.org.uk/emc/medicine/ 20547/PIL/Spiriva+Respimat+2.5+microgram%2c+solution+ for+inhalation/ (accessed 2014 Apr 15).

[10] Electronic Medicines Compendium. Spiriva Respimat—Summary of Product Characteristics 2013. This article can be found online at http://www.medicines.org.uk/emc/medicine/20134/SPC/Spiriva+Respimat+2.5+micrograms+ solution+for+inhalation/ (accessed 2014 Apr 15).

[11] Gault, M.H.; Longerich, L.L.; Harnett, J.D.; Wesolowski, C. Nephron. 1992, 62, 249-256.

心律失常患者使用噻托溴铵粉吸入剂引起房颤1例

Atrial fibrillation associated with tiotropium in patients with pre-existing arrhythmia: a case report

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