洛哌丁胺心脏毒性的研究进展

中国药物警戒 ›› 2016, Vol. 13 ›› Issue (12): 740-744.

洛哌丁胺心脏毒性的研究进展

聂志广¹, 丁长玲², 田月洁^{3*, *}

1 济南市第三人民医院,山东济南250101;
2 滨州医学院附属医院,山东滨州256603;
3 山东省药品不良反应监测中心,山东济南250014

收稿日期:2017-01-13 修回日期:2017-01-13 出版日期:2016-12-20 发布日期:2017-01-13
通讯作者: 田月洁,男,硕士,主任药师,药械安全性监测。E-mail：tianyuejie@sdfda.gov.cn
作者简介:聂志广,男,副主任药师,药学。
基金资助:
山东省医药卫生科技发展计划项目（2014WS0488）：案例追踪分析法在药品不良反应监测中的应用研究

Research Progress of Cardiac Toxicity of Loperamide

NIE Zhi-guang¹, DING Chang-ling², TIAN Yue-jie^{3, *}

1 Third People's Hospital of Jinan, Shandong Jinan 250101, China;
2 Binzhou Medical University affiliated Hospital, Shandong Binzhou 256603, China;
3 Shandong Center for ADR Monitoring, Shandong Jinan 250014, China

Received:2017-01-13 Revised:2017-01-13 Online:2016-12-20 Published:2017-01-13

摘要/Abstract

摘要： 目的分析洛哌丁胺的心脏毒性及其影响因素,为合理用药提供参考。方法检索国内外文献,对洛哌丁胺引起心脏毒性的报道进行统计与分析。结果我国尚无洛哌丁胺引起心脏毒性的报道。国外文献研究表明,大剂量服用洛哌丁胺引起严重的心脏毒性,表现为晕厥、心脏骤停、QT间期延长、尖端扭转性室性心动过速等,甚至引起死亡。结论超剂量滥用、合并使用CYP3A4/CYP2C8和/或 P-糖蛋白抑制剂、低龄是洛哌丁胺心脏毒性的危险因素。应严格按照说明书规定和医生处方的剂量用药,2岁以下儿童不应服用洛哌丁胺,应注意合并用药的风险。

关键词: 洛哌丁胺, 心脏毒性, 滥用, 不良反应

Abstract: Objective To provide references for rational drug use through analyzing the cardiac toxicity of loperamide and the influencing factors. Methods References at home and abroad about the cardiac toxicity of loperamide were summarized and analyzed. Results The cardiac toxicity caused by loperamide hasn’t been reported in China. However, foreign literatures shows that higher than recommended doses of loperamide can cause serious cardiac events, including syncope, cardiac arrest, QT prolongation, torsades de pointes ventricular tachycardia and even death. Conclusion The main risk factors for cardiac toxicity of loperamide are the high dose abuse, combined with inhibitors of CYP3A4/CYP2C8 and/or P-glycoprotein, and the low age. Patients should only take loperamide in the dose prescribed by doctors or according to the label. Loperamide is not recommended for use in children under 2 years. More attentions should be paid to the risk of the combined medication.

Key words: loperamide, cardiac toxicity, abuse, adverse reaction

中图分类号:

R965

聂志广, 丁长玲, 田月洁. 洛哌丁胺心脏毒性的研究进展[J]. 中国药物警戒, 2016, 13(12): 740-744.

NIE Zhi-guang, DING Chang-ling, TIAN Yue-jie. Research Progress of Cardiac Toxicity of Loperamide[J]. Chinese Journal of Pharmacovigilance, 2016, 13(12): 740-744.

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