目的：以dipyridamole 進行藥物壓力心肌灌注造影已廣泛被使用在無法進行運動壓力式檢查的病人其冠狀動脈疾病的評估，而因這方面檢查所引起dipyridamole 相關的藥物不良反應報告被藥師關注的機會較少，故本研究主要是探討dipyridamole 使用在心肌灌注造影所可能引起的藥物不良反應、發生率與處置。
方法：回溯性收集某區域醫院自2015 年1 月至12 月期間接受以dipyridamole 進行藥物壓力心肌灌注造影的病人共2,374 位，記錄dipyridamole 給藥過程中所產生的不良反應，統計其發生率及不良反應症狀來評估dipyridamole 的安全性，必要時，在給與放射性標記藥物後，靜脈注射aminophylline 125 mg 以緩解dipyridamole 引起的不良反應。
結果： 研究期間並未發現嚴重型不良反應； 整體不良反應發生率為53.9% (1,279/2,374)，最常發生的症狀包括：頭暈16.6% (394/2,374)、胸悶／胸痛16.4% (390/2,374) 及低血壓14.4% (342/2,374)。使用aminophylline 來緩解症狀者有62.1% (794/1,279)，且其不良反應均可被aminophylline 所緩解，無轉送急診處置的案例。
結論：Dipyridamole 用在心肌灌注造影是安全的，而靜脈注射 aminophylline 125 mg 可緩解壓力態心肌灌注造影過程中dipyridamole 所引起輕微的不良反應。
Objective: Dipyridamole myocardial perfusion imaging (MPI) is widely used for evaluation of coronary artery disease in patients who cannot exercise to a sufficient workload. The adverse drug reactions (ADRs) of dipyridamole MPI were less reported to pharmacists. The aim of this study is to investigate the overall dipyridamole-related ADRs, the frequency and the management in MPI.
Methods: From January to December 2015, a total of 2,374 consecutive patients undergoing dipyridamole MPI were reviewed retrospectively. The symptomatic side effects were assessed during the dipyridamole MPI. The occurrence and types of dipyridamole-related ADRs were collected to evaluate the safety of dipyridamole. A dose of 125 mg intravenous aminophylline was infused after administration of the radiopharmaceutical to reverse ADRs if necessary.
Results: No severe ADRs were observed. The incidence of overall ADRs was 53.9% patients (1,279/2,374). The most frequent ADRs were dizziness 16.6% (394/2,374), chest tightness or pain 16.4% (390/2,374), and hypotension 14.4% (342/2,374). Aminophylline was used to relieve symptoms in 62.1% patients (794/1,279). All patient’s discomforts were relieved by aminophylline and no one was transferred to emergency room (ER).
Conclusions: This study demonstrates that dipyridamole MPI is generally safe and 125 mg intravenous aminophylline is sufficient to relieve mild dipyridamole-related ADRs during stress MPI.
