药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2013年
5期
289-290
,共2页
奥硝唑%谵妄
奧硝唑%譫妄
오초서%섬망
Ornidazole%Delirium
1例67岁男性患者因牙龈炎口服奥硝唑(1.0g,1次/d)、头孢拉啶(0.5g,3次/d)和对乙酰氨基酚(0.5g,2次/d).3d后疼痛减轻,但出现头晕、头痛及乏力症状.停用头孢拉啶和对乙酰氨基酚,继续服用奥硝唑.4d后患者突然出现精神异常,症状昼轻夜重,脑电图检查示α波频率变慢,出现散在不规则θ波,诊断为谵妄.停用奥硝唑,给予氟哌啶醇5 mg,1次/d肌内注射;维生素B60.2 g、三磷酸腺苷40 mg、辅酶A200 U以及维生素C2.0g加入10%葡萄糖氯化钠注射液1000 ml中静脉滴注,1次/d;奥氮平5~10 mg,2次/d口服.3d后患者神志恢复,停用氟哌啶醇;奥氮平减量至0.25 g,1次/d口服.治疗第6天患者头晕、头痛及乏力消失,体力恢复,脑电图检查正常.第7天停用抗精神病药.随访3个月余,患者精神状态正常.
1例67歲男性患者因牙齦炎口服奧硝唑(1.0g,1次/d)、頭孢拉啶(0.5g,3次/d)和對乙酰氨基酚(0.5g,2次/d).3d後疼痛減輕,但齣現頭暈、頭痛及乏力癥狀.停用頭孢拉啶和對乙酰氨基酚,繼續服用奧硝唑.4d後患者突然齣現精神異常,癥狀晝輕夜重,腦電圖檢查示α波頻率變慢,齣現散在不規則θ波,診斷為譫妄.停用奧硝唑,給予氟哌啶醇5 mg,1次/d肌內註射;維生素B60.2 g、三燐痠腺苷40 mg、輔酶A200 U以及維生素C2.0g加入10%葡萄糖氯化鈉註射液1000 ml中靜脈滴註,1次/d;奧氮平5~10 mg,2次/d口服.3d後患者神誌恢複,停用氟哌啶醇;奧氮平減量至0.25 g,1次/d口服.治療第6天患者頭暈、頭痛及乏力消失,體力恢複,腦電圖檢查正常.第7天停用抗精神病藥.隨訪3箇月餘,患者精神狀態正常.
1례67세남성환자인아간염구복오초서(1.0g,1차/d)、두포랍정(0.5g,3차/d)화대을선안기분(0.5g,2차/d).3d후동통감경,단출현두훈、두통급핍력증상.정용두포랍정화대을선안기분,계속복용오초서.4d후환자돌연출현정신이상,증상주경야중,뇌전도검사시α파빈솔변만,출현산재불규칙θ파,진단위섬망.정용오초서,급여불고정순5 mg,1차/d기내주사;유생소B60.2 g、삼린산선감40 mg、보매A200 U이급유생소C2.0g가입10%포도당록화납주사액1000 ml중정맥적주,1차/d;오담평5~10 mg,2차/d구복.3d후환자신지회복,정용불고정순;오담평감량지0.25 g,1차/d구복.치료제6천환자두훈、두통급핍력소실,체력회복,뇌전도검사정상.제7천정용항정신병약.수방3개월여,환자정신상태정상.
A 67-year-old male patient with gingivitis received ornidazole orally 1.0 g once daily,cefradine 0.5 g thrice daily,and paracetamol 0.5 g twice daily.Three days later,the pain was relieved,but the patient developed dizziness,headache,and fatigue.Cefradine and paracetamol were stopped and ornidazole was continued.Four days later,the patient developed sudden mental disorder,which was mild during the daytime and severe at night.EEG examination revealed that frequency of α waves became slow and irregular and scattered θ waves appeared.The patient was diagnosed with delirium.Ornidazole was stopped.IM haloperidol 5 mg once daily,Ⅳ infusion of vitamin B6 0.2 g,adenosine triphosphate 40 mg,coenzyme A 200 U,and vitamin C 2.0 g in 10% glucose and sodium chloride injection 1000 ml,and oral olanzapine 5 to 10 mg twice daily were given.Three days later,the patient's consciousness recovered.Then,haloperidol was stopped and the dose of olanzapine was reduced to 0.25 g once daily.On day 6 of treatments,the patient's dizziness,headache,and fatigue disappeared,physical strength recovered,and EEG examination showed normal results.On day 7 of treatments,antipsychotics were discontinued.After more than 3 months of follow-up,the patient's mental state was normal.