抄録
We describe a presumed case of drug-induced gastric perforation arising during treatment of rheumatoid arthritis in an outpatient. A 48-year-old male was given diclofenac sodium and misoprostol at the University Hospital. However, the patient also took two non-prescription drugs produced in Taiwan without the consent of his doctors or pharmacists for about three months. The patient was then admitted to another hospital due to upper abdominal pain. A diagnosis of peritonitis due to perforation of the digestive tract was made by thoracic and abdominal radiography, and extended gastrectomy was carried out. We detected indometacin and prednisolone from one non-prescription drug. From the findings, it was considered that the perforated gastric ulcer in this patient was induced by the concomitant use of a corticosteroid and NSAIDs. In this case, the adverse reaction might have been prevented by sufficient patient counseling about the medication. For high-quality and appropriate pharmaceutical care, the pharmacist must provide patient counseling about non-prescription as well as prescrintion drugs
