丙戊酸钠与拉莫三嗪合用致严重皮肤不良反应15例文献分析

陈芝; 汪海仙; 邹炜芳

doi:10.13748/j.cnki.issn1007-7693.20223900

丙戊酸钠与拉莫三嗪合用致严重皮肤不良反应15例文献分析

Literature Analysis of 15 Cases of Severe Cutaneous Adverse Reactions Caused by Lamotrigine and Sodium Valproate

摘要

摘要:
目的分析丙戊酸钠与拉莫三嗪合用致严重皮肤不良反应的发生规律及特点，为临床安全用药提供参考。
方法在中国知网(CNKI)、维普(VIP)、万方及 PubMed、Medline、Elsevier 数据库中检索“丙戊酸钠”“拉莫三嗪”“Lamotrigine” 和“Valproic acid”，收集联合用药导致严重皮肤不良反应的个案报道并进行文献分析。
结果丙戊酸钠与拉莫三嗪相互作用致不良反应的文献报道共19例，其中15例为严重皮肤不良反应。其中，男 12 例，女 3 例，不良反应的发生时间主要集中在药物联合使用后2个月内。患者经治疗后，13例好转，2例死亡。
结论丙戊酸钠与拉莫三嗪联合使用可能更易导致严重皮肤不良反应，临床医师使用时避免联合使用，通过监测血药浓度可能有一定帮助。

Abstract:
OBJECTIVE To analyze the clinical characteristics and occurrence of severe cutaneous adverse reactions caused by lamotrigine and sodium valproate, in order to provide reference for clinical safe drug use.
METHODS The case reports of severe cutaneous adverse reactions induced by the interaction of lamotrigine and sodium valproate were collected from the databases of CNKI, VIP, Wanfang, PubMed, Medline and Elsevier, and conduct literature analysis.
RESULTS A total of 19 cases of adverse reactions caused by the interaction of sodium valproate and lamotrigine were reported. A total of 15 cases were serious skin adverse reactions, including 12 males and 3 females. The occurrence time of adverse reactions was mainly concentrated within 2 months after the combined use of drugs. After the treatment, 13 cases was improved and 2 cases failed.
CONCLUSION The combination of lamotrigine and sodium valproate may be more likely to cause severe cutaneous adverse reactions. Thus, clinicians should avoid using lamotrigine and sodium valproate in combination. To monitor the blood concentration of the lamotrigine may be helpful for the patients.

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