ID 原文 译文
1237 COVID-19患者合并基础疾病、用药种类复杂、涉及特殊人群用药。 COVID-19 patients are often complicated with underlying diseases receiving multiple types of drugs.
1238 临床药物治疗时应关注药物不良反应和相互作用，避免药源性器官损伤，提高救治成功率。 Therefore, we should pay more attention to the adverse drug reactions and drug interactions so as to avoid drug-induced organ damage and improve the success rate of treatment.
1239 甄别药物不良反应 Identification of adverse drug reactions
1240 研究显示，使用洛匹那韦联合阿比多尔为主的抗病毒方案，肝功能异常发生率为51.9%，多元分析显示抗病毒药物和合并用药数是引起患者肝功能异常的独立危险因素。 It has been demonstrated that the incidence of abnormal liver function is 51.9% in COVID-19 patients who have received lopinavir/ritonavir combined arbidol antiviral treatment. Multivariate analysis revealed that antiviral agent s and more concomitant medications are two independent risk factors of abnormal liver function.
1241 应加强患者不良反应的监测，减少不必要的合并用药。 Therefore, monitoring of the adverse drug reactions should be strengthened; the unnecessary drug combinations should be reduced.
1242 抗病毒药物的主要不良反应： The main adverse reactions of antiviral agents include:
1243 1）洛匹那韦/利托那韦他和达芦那韦/考比司他：引起腹泻、恶心、呕吐，肝酶与黄疸 升高、血脂异常，乳酸增高等不良反应，停药后可恢复。 (1) Lopinavir /ritonavir and darunavir/cobicistat: diarrhea, nausea, vomit, the increase of serum aminotransferase, jaundice, dyslipidemia, the increase of lactic acid.Symptoms will recover after drug withdrawal.
1244 2）阿比多尔：肝酶及黄疸升高，与洛匹那韦联用时，发生率更高，停药后一般可恢复，偶可引起心率减慢，需避免与美托洛尔、普萘洛尔等β受体拮抗剂合用，心率低于60次/min时建议停药。 (2) Arbidol：the increase of serum aminotransferase and jaundice. When combined with lopinavir, the incidence rate is even higher. The symptoms will recover after drug withdrawal . Sometimes a slowdown of the hear t could be induced; thus it is necessary to avoid the combination of arbidol with β–receptor inhibitors such as metoprolol and propranolol . We suggest to stop taking the drugs when the heart rate drops below 60/min.
1245 3）法匹拉韦：可引起血尿酸升高、腹泻、中性粒细胞降低、休克、暴发性肝炎、急性肾损伤等不良反应，尤见于老年或合并细胞因子风暴的患者。 (3) Fapilavir: elevation of plasma uric acid, diarrhea, neutropenia, shock, fulminant hepatitis, acute kidney injury. The adverse reactions were commonly seen in elderly patients or patients complicated with cytokine storm.
1246 4）磷酸氯喹：可引起头晕、头痛、恶心、呕吐、腹泻、各种皮疹等，心脏骤停是最严重不良反应，眼部病变是最主要不良反应，用药前检查心电图，禁用于心律失常（如传导阻滞）、视网膜疾病，以及听力减退等患者。 (4) Chloroquine phosphate: dizziness, headache, nausea, vomit, diarrhea, different kinds of skin rash. The most severe adverse reaction is cardiac arrest. The main adverse reaction is the ocular toxicity. An electrocardiogram needs to be examined before taking the drug. The drug should be prohibited for patients with arrhythmia (e.g., conduction block), retinal disease, or hearing loss.