药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
Adverse Drug Reactions Journal
2015年
4期
318-319
,共2页
地高辛%心房颤动%房室传导阻滞
地高辛%心房顫動%房室傳導阻滯
지고신%심방전동%방실전도조체
Digoxin%Atrial fibrillation%Atrioventricular block
1例72岁女性患者因慢性心功能不全于7 d 内误服地高辛40片（10 mg），出现恶心、呕吐、视物模糊、黄视、绿视，伴头晕。入院时心率38次/ min，血压135/75 mmHg。心电图示心房颤动伴Ⅲ度房室传导阻滞。诊断为洋地黄中毒。给予氨茶碱200 mg 口服，山莨菪碱10 mg 肌内注射。2.5 h后心率无回升，给予阿托品0.5 mg 肌内注射，每间隔0.5 h 后再分次静脉注射阿托品0.5、1.0 mg。患者心率仍持续下降，最低降至19次/ min，并出现意识不清、幻觉。立即给予异丙肾上腺素1 mg，以0.5μg/ min 的速度持续静脉泵入。患者心率升至40次/ min。第2天，患者意识恢复。心电图示心房颤动伴室性早搏二联律。停用异丙肾上腺素，室性早搏二联律消失，心率38次/ min。第5天，患者视物模糊、黄视、绿视消失。第6天，患者恶心、呕吐消失。第8天，患者心电图示心房颤动，心率54次/ min。
1例72歲女性患者因慢性心功能不全于7 d 內誤服地高辛40片（10 mg），齣現噁心、嘔吐、視物模糊、黃視、綠視，伴頭暈。入院時心率38次/ min，血壓135/75 mmHg。心電圖示心房顫動伴Ⅲ度房室傳導阻滯。診斷為洋地黃中毒。給予氨茶堿200 mg 口服，山莨菪堿10 mg 肌內註射。2.5 h後心率無迴升，給予阿託品0.5 mg 肌內註射，每間隔0.5 h 後再分次靜脈註射阿託品0.5、1.0 mg。患者心率仍持續下降，最低降至19次/ min，併齣現意識不清、幻覺。立即給予異丙腎上腺素1 mg，以0.5μg/ min 的速度持續靜脈泵入。患者心率升至40次/ min。第2天，患者意識恢複。心電圖示心房顫動伴室性早搏二聯律。停用異丙腎上腺素，室性早搏二聯律消失，心率38次/ min。第5天，患者視物模糊、黃視、綠視消失。第6天，患者噁心、嘔吐消失。第8天，患者心電圖示心房顫動，心率54次/ min。
1례72세녀성환자인만성심공능불전우7 d 내오복지고신40편（10 mg），출현악심、구토、시물모호、황시、록시，반두훈。입원시심솔38차/ min，혈압135/75 mmHg。심전도시심방전동반Ⅲ도방실전도조체。진단위양지황중독。급여안다감200 mg 구복，산랑탕감10 mg 기내주사。2.5 h후심솔무회승，급여아탁품0.5 mg 기내주사，매간격0.5 h 후재분차정맥주사아탁품0.5、1.0 mg。환자심솔잉지속하강，최저강지19차/ min，병출현의식불청、환각。립즉급여이병신상선소1 mg，이0.5μg/ min 적속도지속정맥빙입。환자심솔승지40차/ min。제2천，환자의식회복。심전도시심방전동반실성조박이련률。정용이병신상선소，실성조박이련률소실，심솔38차/ min。제5천，환자시물모호、황시、록시소실。제6천，환자악심、구토소실。제8천，환자심전도시심방전동，심솔54차/ min。
A 72-years-old woman mistook digoxin 40 tablets(10 mg)within 7 days for chronic cardiac insufficiency. She developed nausea, vomiting, blurred vision, xanthopsia, chloropsia and dizziness. After admission,her heart rate was 38 beats/ min and blood pressure was 135 / 75 mmHg. Electrocardiogram revealed atrial fibrillation with 3rd degree atrioventricular block. Digitalis poisoning was diagnosed. She was given oral theophylline 200 mg,intramuscular injection of 10 mg anisodamine. After 2. 5 hours,the heart rate did not significantly change. She was given intramuscular injection of atropine 0. 5 mg, intravenous infusion of atropine 0. 5 mg and 1. 0 mg once every 0. 5 hour. Her heart rate continued to decline,the lowest heart rate was 19 beats/ min,and developed unconsciousness and hallucination. She received isoprenaline 1 mg by a continuous infusion pump delivering 0. 5 μg per minute. The heart rate was maintained at about 40 beats/ min. On day 2,the patient regained consciousness. Electrocardiogram showed atrial fibrillation with ventricular bigeminy. Isoprenaline was stopped and ventricular bigeminy disappeared. Her heart rate was 38 times/ min. On day 5,the blurred vision,xanthopsia and chloropsia disappeared. On day 6,the nausea and vomiting disappeared. On day 8,the electrocardiogram revealed atrial fibrillation with a heart rate of 54 beats/ min.
