中国药业2024，Vol.33Issue(11)：108-112,5.DOI:10.3969/j.issn.1006-4931.2024.11.025
1例心力衰竭合并慢性肾功能不全患者重复使用左西孟旦致尖端扭转型室性心动过速用药分析与药学监护
Medication Analysis and Pharmaceutical Care of Repeated Use of Levosimendan-Induced Torsade de Pointes in a Patient with Heart Failure and Chronic Kidney Insufficiency
摘要
Abstract
Objective To promote the rational and standardized clinical application of Levosimendan.Methods The risk factors,mechanism,prevention and treatment of severe adverse drug reactions such as hypotension,torsades de pointes(TdP)and ventricular fibrillation(VF)induced by repeated use of levosimendan in a patient with heart failure and chronic renal insufficiency were analyzed and evaluated.Results Repeated use of levosimendan in a patient with chronic renal insufficiency might increase concentrations of the active metabolites of levosimendan due to impaired renal function,resulting in more obvious and lasting hemodynamics effects,repeated use in a short period might result in drug concentration stacks and increase the risk of adverse drug reactions.Malignant arrhythmias such as TdP and VF were caused by a combination of factors such as hypokalemia that lead to prolonged QT intervals.Conclusion Clinicians should fully understand the pharmacological effects and metabolic characteristics of levosimendan and strengthen the monitoring during medication,to promote rational drug use in the clinic,in order to ensure the patients'medication safety.关键词
左西孟旦/心力衰竭/肾功能不全/低血压/QT间期/尖端扭转型室性心动过速/药学监护Key words
levosimendan/heart failure/chronic renal insufficiency/hypotension/QT interval/torsades de pointes/pharmaceutical care分类
医药卫生引用本文复制引用
王艳玲,张青霞..1例心力衰竭合并慢性肾功能不全患者重复使用左西孟旦致尖端扭转型室性心动过速用药分析与药学监护[J].中国药业,2024,33(11):108-112,5.基金项目
国家重点研发计划课题[2020YFC2008305]. （）
