社團法人臺灣臨床藥學會

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【案例報告】Modafinil 造成Stevens-Johnson Syndrome案例報告
Modafinil Induced Stevens-Johnson Syndrome: The Case Reports
Modafinil、猝睡症、史蒂文生氏—強生症候群、Modafinil, Narcolepsy, Stevens-Johnson Syndrome
鄭幸宜Hsing-I Cheng1  、徐崇堯Chung-Yao Hsu2  、王嘉宏Jia-Hong Wang1  、蕭惠娟Hui-Chuan Hsiao1,*
1高雄醫學大學附設中和紀念醫院藥劑部 、2高雄醫學大學附設中和紀念醫院神經科
Modafinil 是一種中樞神經系統興奮劑,已被美國食品藥品管理局核准治療猝睡症引起的日間過度睡眠症、輪班工作者之睡眠障礙、阻塞性睡眠呼吸中止症候群。Modafinil 已知有一些皮膚副作用。史蒂文生氏—強生症候群 (Stevens-Johnson syndrome, SJS) 的特徵是皮膚起水泡、黏膜潰瘍、嚴重時全身皮膚脫落,具致命的危險性。在此報告兩起案例,因接受modafinil 治療引起SJS。醫師和患者需要意識到此嚴重皮膚不良反應的最初臨床症狀是,諸如發燒,類流感症狀,吞嚥困難或眼睛灼熱等情形,而立即停藥是改善患者SJS 預後的最佳途徑。

Modafinil is a central nervous system stimulant, which has been approved by the US Food and Drug Administration for the treatment of narcolepsy associated excessive daytime sleepiness, sleep disorder related to shift work, and obstructive sleep apnea syndrome. Modafinil is known to have several cutaneous side effects. Stevens-Johnson syndrome (SJS) is life-threatening and severe adverse cutaneous drug reactions characterized by epidermal detachment presenting as blisters and areas of denuded skin. Two cases of SJS due to modafinil treatment were reported in this article. Practitioners and patients need to be aware of the initial clinical signs of severe cutaneous adverse drug reactions such as fever, influenza-like symptoms, dysphagia or burning eyes. Early discontinuation of medication remains the best way to improve prognosis of patients with SJS.
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