CAJ | 학술논문

盐酸利托君为肾上腺素能β2受体激动剂，用于预防早产。该药对孕妇的影响包括引起心律失常、肺水肿、横纹肌溶解症、腮腺炎、粒细胞减少症、急性泛发性发疹性脓疱病、恶心呕吐及血糖升高等。上述不良反应的发生机制可能与盐酸利托君致电解质失衡，血钾降低，肺毛细血管锲压改变，低血钾使肌肉一过性缺血，唾液淀粉酶分泌增加，骨髓抑制，以及促进糖原分解等有关。该药致急性泛发性发疹性脓疱病的机制尚不明确。盐酸利托君对胎儿的影响包括致胎儿过度生长、胎儿心动过速和新生儿短暂中性粒细胞减少等，可能与该药致孕妇血糖升高刺激胎儿胰岛素分泌，通过胎盘屏障引起免疫介导的毒性反应，以及改变胎盘血流等有关。使用盐酸利托君时应密切观察孕妇心率，监测血糖，定期检测血象与肝肾功能，一旦出现不良反应应停药并给予对症治疗。对母亲曾应用盐酸利托君的新生儿必要时行超声心动图检测评价心脏功能，检测血糖，尽早开始母乳喂养或配方奶喂养。
염산리탁군위신상선소능β2수체격동제，용우예방조산。해약대잉부적영향포괄인기심률실상、폐수종、횡문기용해증、시선염、립세포감소증、급성범발성발진성농포병、악심구토급혈당승고등。상술불량반응적발생궤제가능여염산리탁군치전해질실형，혈갑강저，폐모세혈관계압개변，저혈갑사기육일과성결혈，타액정분매분비증가，골수억제，이급촉진당원분해등유관。해약치급성범발성발진성농포병적궤제상불명학。염산리탁군대태인적영향포괄치태인과도생장、태인심동과속화신생인단잠중성립세포감소등，가능여해약치잉부혈당승고자격태인이도소분비，통과태반병장인기면역개도적독성반응，이급개변태반혈류등유관。사용염산리탁군시응밀절관찰잉부심솔，감측혈당，정기검측혈상여간신공능，일단출현불량반응응정약병급여대증치료。대모친증응용염산리탁군적신생인필요시행초성심동도검측평개심장공능，검측혈당，진조개시모유위양혹배방내위양。
Ritodrine hydrochloride,a beta 2 adrenergic receptor agonist,is used for prevention of preterm birth. Maternal cardiac arrhythmias, pulmonary edema, rhabdomyolysis, parotitis, granulocytopenia,acute generalized exanthematous pustulosis,nausea,vomiting,and elevated blood glucose are the main adverse reactions induced by ritodrine hydrochloride in the pregnant woman. The possible mechanisms of the above-mentioned adverse reactions may be associated with ritodrine hydrochloride inducing electrolyte imbalance,hypokalemia,changes of pulmonary capillary wedge pressure,muscular transient ischemia due to hypokalemia,hypersecretion of salivary amylase,bone marrow suppression,and promoting of glycogenolysis. The mechanism of acute generalized exanthematous pustulosis induced by ritodrine hydrochloride is yet unknown. Fetal over growth,fetal tachycardia,and neonates transient neutrophil reduction may be the main adverse reactions induced by ritodrine hydrochloride in the fetuses. The possible mechanisms may be associated with fetal insulin hypersecretion which is due to maternal hyperglycemia induced by ritodrine hydrochloride,immune-mediated toxic reactions through placental barrier,as well as changes in placental blood flow. The maternal heart rate,blood glucose,routine blood tests,liver and kidney function should be checked regularly when the pregnant woman is receiving ritodrine hydrochloride. Once the adverse reactions occured,ritodrine hydrochloride should be discontinued and the symptomatic treatment should be given. In infants whose mother received ritodrine hydrochloride,cardiac function should be evaluated by echocardiography when necessary,blood glucose should be checked,and breast-feeding or formula feeding should be started as early as possible.