Treatment optimization for dermatitis medicamentosa in a patient with abnormal liver function associated with infection / 药学实践杂志

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Retrospective Analysis on the Adverse Drug Reactions(ADR) Induced by Second Generation Antihistamine Drugs / 中国药房

OBJECTIVE:To analyze the clinical features and correlation factors of ADR caused by second generation antihistamine drugs for references of clinical rational drug use.METHODS:A total of 128 cases ADR cases induced by second generation antihistamine drugs that met our criteria were obtained by retrieving the domestic literature database between 1986 and 2006,which were categorized and analyzed in accordance with the ADR categorization stipulated by WHO international drug monitoring cooperation center.RESULTS:Of the 128 ADR cases,more were seen in male than in female,38 presented cardiovascular system lesions,accounting for 29.69%,followed by lesions of skin and its appendants(28.13%) and systemic reactions(20 cases,15.63%).However,the prognosis of these ADR was satisfactory.CONCLUSION:The ADR caused by second generation antihistamine drugs are associated to many factors such as patients’ sex and physical condition as well as drug combination etc.Clinic should be alert to such ADR such as allergic shock and arhythmia in patients treated with second generation antihistamine drugs.