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美FDA建议在白三烯受体拮抗剂的药物标签上应提及其对情绪会产生影响

Labels for leukotriene receptor antagonists should mention mood problems, FDA suggests

2009-06-30 【发表评论】
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ST LOUIS (MD Consult) - On June 12, 2009, the US Food and Drug Administration (FDA) issued an update after completing its safety review of the class of asthma drugs known as leukotriene modifiers. The drugs mentioned in the FDA communication include montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). Neuropsychiatric events have been reported in some patients who have taken these medications, and the FDA is now requesting that manufacturers include a precaution in the drug prescribing information.

 

The post-market reports from patients receiving these leukotrienes include cases of neuropsychiatric events. Some of these reports include clinical details consistent with a drug-induced effect. The neuropsychiatric events that have been reported include agitation, aggression, anxiousness, tremor, hallucinations, depression, dream abnormalities, insomnia, irritability, and restlessness, as well as suicidal thinking and behavior (including suicide). In the clinical trial data submitted by manufacturers, neuropsychiatric events were not commonly observed. However, the available data were limited because the trials were not designed to specifically gather information on neuropsychiatric events.

圣路易斯(MD Consult)——2009612,美国食品药品管理局(FDA)在完成对一类称为白三烯调节剂的哮喘药物的安全审查后发布一项更新通告。该FDA通告中提到的药品包括孟鲁司特(montelukast,商品名:Singulair )、扎鲁司特(zafirlukast,商品名:安可来、Accolate)和齐留通(zileuton ,商品名:ZyfloZyflo CR)。部分患者服用上述药品后发生不良神经精神事件,因此FDA现要求制药商在此类药物处方信息中加入相关的注意事项。

 

服用此类白三烯药物的患者在后市场报告中提到了包括神经精神事件。其中一些报告包括与药物诱导效应相一致的临床细节。报告的神经精神事件包括激越、攻击、焦虑、震颤、幻觉、抑郁、梦境异常、失眠、烦躁、不安以及自杀想法和行为(包括自杀)。在制药商提供的临床试验数据中神经精神事件并不多见。然而,现有数据尚不充分,因为设计的试验并不是以特定地收集神经精神事件为目的。


Subjects:
pulmonology, mental_health
学科代码:
呼吸病学, 精神病学
2009/7/1 19:45:07
ssj 说:
好久没有看过敏性药物的文章了。不错、还是头一次知道zafirlukast有精神上的不良反应。看来应该看看原文了。

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疾病资源中心  疾病资源中心
 病例分析

 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者,女,69岁。2009年1月无明显诱因下出现乏力,当时程度较轻,未予以重视。2009年3月患者乏力症状加重,尿色逐渐加深,大便习惯改变,颜色变淡。4月18日入我院感染科治疗,诉轻度头晕、心慌,体重减轻10kg。无肝区疼痛,无发热,无腹痛、腹泻、腹胀、里急后重,无恶性、呕吐等。入院半月前于外院就诊,查肝功能:ALT 601IU/L,AST 785IU/L,TBIL 97.7umol/L,白蛋白 41g/L,甲状腺功能:游离T3 30.6pmol/L,游离T4 51.9pmol/L,心电图示快速房颤。
 

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