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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Phenazopyridine-lnduced Toxicity in an Elderly Patient Receiving a Prolonged Regimen of Therapeutic Doses
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Phenazopyridine-lnduced Toxicity in an Elderly Patient Receiving a Prolonged Regimen of Therapeutic Doses

机译：接受长期治疗剂量方案的老年患者中的苯并吡啶引起的毒性。

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Objective: To report a case of yellow skin pigmentation, acute renal failure, methemoglobinemia, and hemolytic anemia in a patient receiving a prolonged regimen of therapeutic doses of phenazopyridine.Case Summary: A 74-year-old female was admitted to the hospital with respiratory distress and acute renal failure, admission serum creatinine of 4.5 mg/ dL (reference range 0.7-1.4 rng/ dL), and blood urea nitrogen of 80 mg/dL (6-22 mg/dL). Upon admission, she had yellow skin pigmentation, methemoglobinemia with a methemoglobin level of 18.8% (0-3%), and hemolytic anemia with hemoglobin of 6.9 g/dL (12-16 g/dL), reticulocyte count of 5.1% (0.5-2%), and peripheral blood smear revealing Heinz body hemolysis. She had been taking phenazopyridine 200 mg 3 times per day for the 3 weeks prior to admission. Phenazopyridine was discontinued, and the patient was treated with intravenous methylene blue for methemoglobinemia and supportive care for acute renal failure, yellow skin discoloration, and hemolytic anemia. After 5 days in the hospital, the patient was discharged with baseline laboratory values and baseline respiratory status. An objective causality assessment revealed that acute renal failure was possibly and methemoglobinemia and hemolytic anemia were probably associated with phenazopyridine.Discussion: Phenazopyridine toxicity may occur with acute overdose or chronic administration of therapeutic doses. Severe toxicity with phenazopyridine is relatively uncommon, but when it does occur it may present as a serious clinical picture, with adverse drug reactions (ADRs) such as methemoglobinemia, hemolytic anemia, acute renal failure, and hepatitis. Removal of phenazopyridine and provision of supportive treatment for the ADRs usually results in reversal of the complications and return to baseline function. Severe cases of methemoglobinemia may need to be treated with intravenous methylene blue in addition to supportive care. This case presents the importance of understanding the risks with long-term use of therapeutic doses of phenazopyridine, especially in geriatric patients.Conclusions: The geriatric population and patients with renal insufficiency are at increased risk of phenazopyridine toxicity because of decreased renal clearance of phenazopyridine and its metabolites.
机译：目的：报告一例长期服用苯并吡啶治疗剂量的患者，皮肤黄染，急性肾功能衰竭，高铁血红蛋白血症和溶血性贫血一例。病例摘要：一名74岁的女性因呼吸系统入院危及急性肾功能衰竭，入院时血清肌酐为4.5 mg / dL（参考范围0.7-1.4 rng / dL），血尿素氮为80 mg / dL（6-22 mg / dL）。入院时，她的皮肤色素沉着为黄色，高铁血红蛋白含量为18.8％（0-3％），溶血性贫血的血红蛋白含量为6.9 g / dL（12-16 g / dL），网织红细胞计数为5.1％（0.5） -2％），并且外周血涂片显示亨氏身体溶血。入院前3周，她每天3次每天服用200mg吩唑吡啶。停用吡唑并吡啶，并为患者进行高铁血红蛋白血症静脉内注射亚甲蓝治疗，并为急性肾衰竭，皮肤黄变和溶血性贫血提供支持治疗。住院5天后，患者出院时基线实验室值和基线呼吸状况均得到了改善。客观因果关系评估表明，苯并吡啶可能与急性肾功能衰竭有关，而高铁血红蛋白血症和溶血性贫血可能与苯并吡啶有关。讨论：急性过量或长期给予治疗剂量可能会引起苯并吡啶毒性。吩唑并吡啶的严重毒性相对罕见，但一旦发生，可能会表现为严重的临床表现，并伴有药物不良反应（ADR），例如高铁血红蛋白血症，溶血性贫血，急性肾衰竭和肝炎。去除苯并吡啶并为ADR提供支持治疗通常会导致并发症的逆转并恢复至基线功能。除支持治疗外，严重的高铁血红蛋白血症病例可能还需要静脉注射亚甲蓝治疗。该病例表明了解长期使用治疗剂量的苯并吡啶的风险的重要性，尤其是在老年患者中。结论：由于苯并吡啶和二甲双胍的肾脏清除率降低，老年人群和肾功能不全的患者发生苯并吡啶毒性的风险增加。它的代谢产物。

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