Pharmaceutical care of severe thrombocytopenia caused by cefoperazone sodi-um/sulbactam sodium combined with montelukast sodium

Published on Jun. 30, 2023Total Views: 2577 times Total Downloads: 1996 times Download Mobile

Author: Qiang YANG ¹ Yu YAO ² Peng ZHANG ¹ Xiao-Fen YE ³  Xun-Yan ZHANG ¹

Affiliation: 1. Department of Pharmacy, Suining Central Hospital, Suining 629000, Sichuan Province, China 2. Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suinning 629000, Sichuan Province, China 3. Department of Pharmacy, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China

Keywords: Cefoperazone sodium/sulbactam sodium Montelukast sodium Thrombo-cytopenia Pharmaceutical care

DOI: 10.19960/j.issn.1005-0698.202306014

Reference: Qiang YANG, Yu YAO, Peng ZHANG, Xiao-Fen YE, Xun-Yan ZHANG.Pharmaceutical care of severe thrombocytopenia caused by cefoperazone sodium/sulbactam sodium combined with montelukast sodium[J].Yaowu Liuxingbingxue Zazhi,2023, 32(6):710-714.DOI: 10.19960/j.issn.1005-0698.202306014.[Article in Chinese]  Copied

Abstract
Full-text
References

Abstract

A patient with acute exacerbation of chronic obstructive pulmonary disease developed severe thrombocytopenia (Plt 22×10⁹·L^-1) during hospitalization. Considering it as an adverse drug reaction, the most likely cefoperazone sodium/sulbactam sodium was discontinued and the patient was treated with platelet-raising therapy. However, the patient's platelets continued to decrease (Plt 4×10⁹·L^-1), and bleeding occurred. Then, the patient was treated with platelet transfusion. Bone marrow biopsy could not identify cause. The pharmacist considered that there may be other causes of thrombocytopenia. By medication analysis and literature reviewing, montelukast sodium was considered as another factor leading to thrombocytopenia. After discontinuation of montelukast sodium, the patient's platelets increased and the bleeding symptoms disappeared. After discharging from the hospital, the patient took montelukast sodium again and the thrombocytopenia was still existed (minimum Plt 7×10⁹·L^-1). Despite aggressive treatment, it was still in-effective. The pharmacist followed up the patient and advised the patient to stop using montelukast sodium. After 2 weeks of montelukast discontinuing, the platelets returned to normal (Plt 163×10⁹·L^-1).

Full-text

Please download the PDF version to read the full text: download

References

1.吴光华, 马姝丽. 孟鲁司特钠不良反应分析[J]. 医药导报, 2020, 39(6): 868-873. [Wu GH, Ma SL. Review of adverse reac-tions of montelukast sodium[J]. Herald of Medicine, 2020, 39(6): 868-873.] DOI: 10.3870/j.issn.1004-0781.2020.06.029.

2.刘丹娜, 苏田丽, 吴通, 等. 基于文献分析药学监护对化疗相关性血小板减少症的作用及流程[J]. 中国药师, 2022, 25(7): 1235-1239. [Liu DN, Su TL, Wu T, et al. Effects and procedures of pharmaceutical care in chemotherapy-induced throm-bocytopenia based on literature analysis[J]. China Pharmacist, 2022, 25(7): 1235-1239.] DOI: 10.19962/j.cnki.issn1008-049X.2022.07.024.

3.赵晖, 张千, 颜明明, 等. 基于上海市临床药事质量控制中心数据库的药物致血小板减少回顾性分析[J]. 药物流行病学杂志, 2022, 31(7): 454-462. [Zhao H, Zhang Q, Yan MM, et al. Drug-induced thrombocytopenia: a de-scriptive survey in adverse drug reaction spontaneous reporting database of Shanghai in China[J]. Chinese Journal of Pharmacoepidemiology, 2022, 31(7): 454-462.] DOI: 10.19960/j.cnki.issn1005-0698.2022.07.005.

4.杨保. 注射用头孢哌酮钠舒巴坦钠不良反应33例[J]. 中国医院药学杂志, 2006, 26(10): 1322-1323. [Yang B. Ad-verse reactions of cefoperazone sodium and sulbactam sodium for injection in 33 cases[J]. Chinese Journal of Hospital Pharmacy, 2006, 26(10): 1322-1323.] DOI: 10.3321/j.issn:1001-5213.2006.10.072.

5.刘颖, 袁晔, 宋立刚. 注射用头孢哌酮钠/舒巴坦钠的不良反应文献分析[J]. 中国药物警戒, 2007, 4(5): 285-288. [Liu Y, Yuan Y, Song LG. Analysis of cases on adverse drug reaction of cefoperazone sodium and sulbac-tam sodium for injection[J]. Chinese Journal of Pharmacovigilance, 2007, 4(5): 285-288.] DOI: 10.3969/j.issn.1672-8629.2007.05.008.

6.马丽娜, 冯明, 周英智. 头孢哌酮钠/舒巴坦钠致不良反应68例分析[J]. 中国临床药学杂志, 2009, 18(5): 299-300. [Ma LN, Feng M, Zhou YZ. Analysis of 68 cases of adverse reactions caused by cefoperazone sodi-um/sulbactam sodium[J]. Chinese Journal of Clinical Pharmacy, 2009, 18(5): 299-300.] DOI: 10.19577/j.cnki.issn10074406.2009.05.012.

7.李颖, 胡永芳, 彭芳辰. 头孢哌酮/舒巴坦引起血小板减少症的循证分析[J]. 中国药学杂志, 2009, 44(24): 1938-1941. [Li Y, Hu YF, Peng FC. Evidence-based analysis of thrombocytopenia caused by efopera-zone/sulbactam[J]. Chinese Pharmaceutical Journal, 2009, 44(24): 1938-1941.] DOI: 10.3321/j.issn:1001-2494.2009.24.026.

8.武东, 汪晓娟, 汪小五. 104例住院患者药源性血小板减少症不良反应报告分析[J]. 中国医院药学杂志, 2019, 39(17): 1766-1771. [Wu D, Wang XJ, Wang XW. Analysis of 104 cases of adverse reaction of drug-induced thrombocytopenia in hospitalized patients[J]. Chinese Journal of Hospital Pharmacy, 2019, 39(17): 1766-1771.] DOI: 10.13286/j.cnki.chinhosppharmacyj.2019.17.11.

9.Kam T, Alexander M. Drug-induced immune thrombocytopenia[J]. J Pharm Pract, 2014, 27(5), 430-439. DOI: 10.1177/0897190014546099.

10.Craig WA, Gerber AU. Pharmacokinetics of cefoperazone: a review[J]. Drugs, 1981, 22(Suppl 1): 35-45. DOI: 10.2165/00003495-198100221-00010.

11.The WHO Pharmaceuticals Newsletter. 日本警示孟鲁司特钠的血小板减少症风险[J]. 中国药物评价, 2015, (4): 201. DOI: 10.3969/j.issn.2095-3593.2015.04.005.

12.郑芸颖, 崔向丽, 刘丽宏. 药物引发血小板严重减少症1例[J]. 临床药物治疗杂志, 2017, 15(3): 64-66. [Zheng YY, Cui XL, Liu LH. A case of drug-induced severe thrombocytopenia[J]. Clinical Medication Journal, 2017, 15(3): 64-66.] DOI: 10.3969/j.issn.1672-3384.2017.02.016.

13.栗啸阳, 郭代红, 刘思源, 等. 注射用头孢哌酮钠舒巴坦钠相关血小板减少的自动监测研究[J]. 中国药物警戒, 2020, 17(12): 890-893, 903. [Li XY, Guo DH, Liu SY, et al. Automatic surveillance of cases of cefoperazone sodium and sulbactam sodium-related thrombocytopenia[J]. Chinese Journal of Pharmacovigilance 2020, 17(12): 890-893, 903.] DOI: 10.19803/j.1672-8629.2020.12.09.

14.国家药品不良反应监测中心. 药品不良反应报告和监测手册[EB/OL]. (2012-11-01) [2021-11-19]. http://www.cdradr.org.cn/xzzx/hyzl/hyzl2013nd/201304/t20130426 5436.html.