Modafinil造成Stevens-Johnson Syndrome案例報告

Modafinil Induced Stevens-Johnson Syndrome: The Case Reports

10.6168/FJCP.2017.2504.08

鄭幸宜(Hsing-I Cheng)；徐崇堯(Chung-Yao Hsu)；王嘉宏(Jia-Hong Wang)；蕭惠娟(Hui-Chuan Hsiao)

Modafinil ； 猝睡症 ； 史蒂文生氏－強生症候群 ； Modafinil ； Narcolepsy ； Stevens-Johnson Syndrome

臺灣臨床藥學雜誌

25卷4期（2017 / 10 / 31）

326 - 332

繁體中文

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.