Metformin引起之乳酸中毒及醫令警示－病例報告

Metformin Induced Lactic Acidosis and Clinical Decision Support System: Case Reports

李科鋒(Ko-Feng Lee) ； 吳淑娟(Shu-Chuan Wu)

《北市醫學雜誌》 預刊文章 Pp. 1-11

https://doi.org/10.6200/TCMJ.202201/PP.0005

摘要

依metformin藥品仿單及各文獻的記載，該藥有導致「乳酸中毒」的風險。乳酸中毒是metformin罕見而嚴重的不良反應，雖然發生機率極低，卻有極高的死亡率。Metformin是高腎排除藥物，在使用期間內需要有更多考慮面相及持續腎功能監測。本院一年內接獲三起疑似metformin造成的嚴重藥物不良反應，收集相關資料後，經合理用藥小組的努力下，偕同本院資訊室，新增metformin腎功能檢核功能，期望能避免因腎功能驟變而造成的藥物不良反應。

關鍵字

metformin ； 乳酸中毒 ； 警示系統

並列摘要

According to the package insert and literature, metformin has a risk of inducing lactic acidosis. Lactic acidosis is rare but yet a severe adverse drug reaction of metformin. Although the probability of the occurrence of lactic acidosis is exceptionally low, the mortality rate is exceptionally high. Metformin is eliminated mainly through renal excretion. Thus, continuous monitoring of renal function is required, and multiple aspects should be considered during application. Three cases of severe adverse drug reactions suspected to be caused by metformin were reported in our hospital. With data collection, efforts from the reasonable drug use group, and assistance from our information department, we have enabled the amendment of a renal check function in our computer system to trace the renal function records to avoid adverse drug reactions caused by sudden renal function changes.

並列關鍵字

metformin ； lactic acidosis ； clinical decision alert system