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研究生:鄒雨寰
研究生(外文):Yu-Huan Tsou
論文名稱:案例報告:克多炎止痛藥引發的急性氣喘發作
論文名稱(外文):Ketorolac-induced Asthma with Acute Exacerbation: A Case Report
指導教授:吳聰能吳聰能引用關係
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:公共衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:13
中文關鍵詞:氣喘克多炎止痛藥案例報告
外文關鍵詞:KetorolacAsthmaCase Report
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氣喘為人體的一種呼吸道慢性發炎疾病,大部分的氣喘病人在平常可以擁有如一般人的生活品質,但當經歷誘發因子的誘導後就有可能會產生急性過敏症狀。這些又發因子包含內在因素(例:情緒壓力)、外在因素(例:塵螨),以及醫源性因素(例:醫療藥物)等。

克多炎止痛藥(Ketorolac)是一種非類固醇類消炎鎮痛藥(NSAIDs),目前被廣泛運用在急診的病人以及手術後病人的疼痛照護。然而,有些發生急性氣喘的案例被指出有可能與這類非類固醇類消炎鎮痛藥物藥理作用機轉有關。而此篇案例報告將會呈現一位患有氣喘的病人因為克多炎止痛藥物而引發的急性氣喘發作。

根據之前的案例報告、相關文獻探討、藥物機轉認識,以及此次的案例經驗,我們認為克多炎止痛藥物有可能會誘發急性氣喘發作。因此,我們建議醫療照護人員對於過去患有氣喘疾患的病人,在施予克多炎止痛藥物時需要非常小心謹慎,同時對於病人的過去疾病病史應該要詳細詢問與瞭解。即便初步排除了危險因子而決定給予藥物,在施予藥物後也需要密切觀察病人有無任何不適的狀況。


Asthma may be described broadly as a chronic inflammatory disorder of the airways. Most patients could have stable asthma for weeks or months, and then suddenly develop an episode of acute asthma. As we know, different patients may react to various factors and several triggering agents, like house dust mite, emotional stress, and iatrogenic factor.

Ketorolac is an analgesic that belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs). It is frequently used in medicine for the patients who need pain control. However, the drug was suspected in previous study that it may induce adverse reaction after injection the drug. In this case report, we describe that a patient with the past history of asthma had asthmatic exacerbation after administering the Ketorolac, and then she experienced the life-threatening complication.

According to previous reports and our case experience, we suggest that healthcare professionals should pay great attention to the patient with past history of asthma before prescribing Ketorolac. Detail history taking and closely monitoring after injecting the drug are required.


誌謝 i
中文摘要 iii
Abstract iv
目錄 v
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第二章 文獻探討 3
第三章 案例報告 4
第四章 討論 6
第五章 結論與建議 9
第一節 結論 9
第二節 研究限制 10
第三節 應用與建議 11
參考文獻 12


1.National Asthma Education and Prevention Program: Expert panel report III: guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute 2007.

2.Baxi SN, Phipatanakul W: The role of allergen exposure and avoidance in asthma. Adolesc Med State Art Rev. Apr 2010; 21(1): 57-ix

3.Chesanow N, Fleming H. Physicians’ Desk Reference. 2005. Toradol (ketorolac tromethamine). 59th ed. Montvale, NJ: Thompson PDR; 2005:2932.

4.Plaza V, Serrano J, Picado C, et al: Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma. Eur Respir J. 2009; 33(5):1240.

5.Goetz CM, Sterchele JA, Harchelroad FP: Anaphylactoid reaction following ketorolac tromethamine administration. Ann Pharmacother 1992; Oct;26(10):1237-8

6.Campobasso CP, Procacci R, Caligara M: Fatal adverse reaction to ketorolac tromethamine in asthmatic patient. The American Journal of Forensic Medicine and Pathology 2008; Volume 29, Number 4


7.Rod NH, Kristensen TS, Lange P, et al: Perceived stress and risk of adult-onset asthma and other atopic disorders: a longitudinal cohort study. Allergy. 2012; Nov;67(11):1408-14

8.HilárioI MOE, TerreriII MT, Arnaldo Len C: Nonsteroidal anti-inflammatory drugs: cyclooxygenase 2 inhibitors. Jornal de Pediatria 2006; Vol. 82, No.5(Suppl)

9.Hebert WG, Scopelitis E: Ketorolac-precipitated asthma. South Med J. 1994; Feb;87(2):282-3.

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