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在去年12月份出版DICP(Drug in-telligence and clinical pharmacy)刊出的论文提醒我们在急性超量情况下醋氨酚(扑热息痛)所致的严重肝脏毒性。可是,根据病人,医生和药剂师的私人通讯认为,对该药长期应用后的潜在肝脏毒性有时似乎被忽视了。虽然经有些调查研究发现病人摄取近于最高治疗剂量(4 g/d)2 yr或更长时间并未见肝脏副作用,但亦有因每日服用醋氨酚而发生肝脏损害的报道。在许多病例中,所用剂量都在推荐的治疗剂量范围之内。因此,识别危险因素和建立监测参数是重要的,以尽可能使本药的应用达到最佳安全性和疗效。
A paper published in December last year in the Drug In-telligence and clinical pharmacy reminds us of severe liver toxicity caused by acetaminophen (paracetamol) in acute overdoses. However, based on the personal communications among patients, doctors and pharmacists, the potential for long-term hepatotoxicity of this drug appears to be sometimes overlooked. Although some studies found that patients who received nearly 4 g / day of the therapeutic dose (4 g / d) for 2 yr or longer did not have liver side effects, there were reports of liver damage due to taking acetaminophen daily. In many cases, the doses used are within the recommended therapeutic dose range. Therefore, it is important to identify risk factors and establish monitoring parameters in order to achieve the best possible safety and efficacy of the drug.