社團法人臺灣臨床藥學會

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【案例報告】Megestrol Acetate 導致血糖惡化之案例報告
Exacerbation of Hyperglycemia Induced by Megestrol Acetate:Report of Two Cases
Megestrol Acetate、癌症惡病質、糖尿病、Megestrol Acetate, Cancer Cachexia, Diabetes Mellitus
黃微瑄Wei-Hsuan Huang 、吳佳憓Chia-Hui Wu 、涂淑倩Shu-Chien Tu 、蕭惠娟Hui-Chuan Hsiao*
1高雄醫學大學附設中和紀念醫院藥劑部
Megestrol acetate 為一合成口服具活性的孕酮類製劑,用於治療癌症及後天免疫缺乏症候群患者之惡病質引起的體重減輕。目前認為megestrol acetate 促進體重增加是透過刺激食慾,但確切的機轉仍不是很清楚。常見臨床的不良反應包括周邊水腫、呼吸困難、勃起障礙、月經不規則、深層靜脈栓塞。在此報告兩例肺腺癌案例,因接受megestrol acetate 治療發生嚴重的高血糖症。接受egestrol acetate 治療的癌症患者有潛在的糖尿病病史應密切監測血糖值變化。臨床醫療人員照顧癌症惡病質病患時應警覺megestrol acetate 可能造成嚴重的,但可逆的高血糖狀態。
 
Megestrol acetate, a synthetic orally active progestational agent used for the treatment of weight loss and cachexia associated with cancer and acquired immunodeficiency syndrome. It is thought that megestrol acetate promotes weight gain by stimulating appetite; however, the exact mechanism remains unknown. Common reported clinical adverse events with megestrol acetate including peripheral edema, dyspnea, impotence, menstrual irregularities and deep vein thrombosis. Two patients with lung adenocarcinoma developed severe hyperglycemia after receiving megestrol acetate. Patients who receive progestational therapy with megestrol acetate for cancer cachexia should be monitored closely for blood sugar change, especially if they have a history of diabetes mellitus. Clinicians caring for patients with cancer-related cachexia should be aware that megestrol acetate can cause a severe but reversible hyperglycemic state.
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