Lin M H, Hung K L, Wang N K, Shen C T
Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
Acta Paediatr Taiwan. 2001 Nov-Dec;42(6):355-8.
Imipramine is the most commonly prescribed tricyclic antidepressant of acute life threatening self-poisoning. We report a 15-month-old boy of accidental poisoning with imipramine, who developed generalized tonic-clonic convulsions and drug-related cardiac conduction abnormalities with PR prolongation, QRS widening, and QTc lengthening. The patient's imipramine level was 1389 ng/ml. The rapid resolution of intraventricular conduction delay and normalization of the QRS-T complexes after gastric lavage, installation of activated charcoal and alkalinization of the blood strongly implicates imipramine intoxication in the etiology of the cardiotoxicity. The patient made a full recovery without neurological sequelae.
丙咪嗪是急性危及生命的自我中毒中最常用的三环类抗抑郁药。我们报告一名15个月大的男孩意外服用丙咪嗪中毒,出现全身性强直阵挛性惊厥以及与药物相关的心脏传导异常,表现为PR间期延长、QRS波增宽和QTc间期延长。患者的丙咪嗪水平为1389纳克/毫升。洗胃、给予活性炭和血液碱化后,室内传导延迟迅速缓解,QRS - T复合波恢复正常,这有力地表明丙咪嗪中毒是心脏毒性的病因。患者完全康复,无神经后遗症。