目的 探讨伏立康唑治疗过程中发生的药物不良反应,提醒临床医师和药师对伏立康唑相关不良反应引起重视.方法 报道2例基础疾病复杂的侵袭性肺部真菌病患者,使用伏立康唑过程中出现声音嘶哑,停用伏立康唑后声音嘶哑消失.报道1例侵袭性肺曲霉病老年患者使用伏立康唑治疗,合并使用塞来昔布治疗过程中患者出现明显乏力、肌痛,检测肌酸激酶升高,先后停用塞来昔布及伏立康唑后,肌酸激酶恢复正常.结果 声音嘶哑是伏立康唑所致不良反应的可能性大,而药物性肌病的不良反应是伏立康唑增加了塞来昔布的血药浓度,导致肌痛发生.结论 密切关注临床用药安全,注意药物之间相互作用,监测血药浓度.%Objective To investigate the adverse effects of voriconazole during the course of treatment,and to remind clinicians and pharmacists to pay attention to the adverse reactions of voriconazole.Methods Two cases of patients with complex underlying disease of invasive pulmonary fungal infections were reported,and we found that the voice hoarse appeared in the process of using voriconazole,and disappeared after stopping the use of voriconazole.One case of voriconazole-treated invasive pulmonary aspergillos is in elderly patient was reported.The patient was co-treated with celecoxib,and was significantly weak.Myalgia appeared in the course of treatment.Biochemical tests showed that the levels of creatine kinase increased.After discontinuation of celecoxib and voriconazole,the levels of creatine kinase returned to normal.Results Hoarseness is probably an adverse reaction caused by voriconazole,and the adverse effects of drug myopathy are due to the fact that voriconazole increased the concentration of celecoxib in plasma,leading to myasthenia.Conclusion Clinicians and pharmacists should pay close attention to the clinical drug safety,pay attention to the drug-drug interactions,and monitor the drug concentrations in plasma.
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