Shadnia Shahin, Moiensadat Mahsa, Abdollahi Mohammad
Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Vet Hum Toxicol. 2004 Apr;46(2):76-9.
In most severe cases of strychnine poisoning, the patient dies before reaching the hospital. This report describes the treatment and successful outcome of a patient who had taken a dose of strychnine that would normally be fatal. A 28-y-old man was admitted 2 h after ingestion of 1 to 1.5 g of strychnine. He had a Glasgow Coma Score of 14/15 and was severely agitated and in mild respiratory distress; blood pressure was 90/60 mmHg, pulse 110/min, and peripheral pulses weak. He had generalized hyperactive reflexes and had several generalized tonic-clonic convulsions in the emergency department. Treatment consisted of gastric lavage with water, oral administration of activated charcoal and sorbitol solution, continuous intravenous administration of midazolam and then sodium thiopental, furosemide, sodium bicarbonate and hemodialysis for acute renal failure. His clinical course included respiratory distress, agitation, generalized tonic-clonic convulsions, hyperactivity, oliguria and acute tubular necrosis prior to recovery in 23 days. This patient ingested what would normally be a fatal amount of strychnine, had signs and symptoms of severe toxicity and recovered, suggesting that with aggressive supportive care patients may have favorable outcomes.
在大多数士的宁中毒的严重病例中，患者在抵达医院前就已死亡。本报告描述了一名摄入通常会致命剂量士的宁患者的治疗情况及成功康复的结果。一名28岁男性在摄入1至1.5克士的宁后2小时入院。他的格拉斯哥昏迷评分为14/15，极度烦躁不安且有轻度呼吸窘迫；血压为90/60 mmHg，脉搏110次/分钟，外周脉搏微弱。他全身反射亢进，在急诊科发生了几次全身性强直阵挛性惊厥。治疗包括用水洗胃、口服活性炭和山梨醇溶液、持续静脉注射咪达唑仑然后硫喷妥钠、呋塞米、碳酸氢钠以及针对急性肾衰竭进行血液透析。他的临床过程包括呼吸窘迫、烦躁不安、全身性强直阵挛性惊厥、多动、少尿以及在23天康复前出现急性肾小管坏死。该患者摄入了通常会致命剂量的士的宁，出现了严重中毒的体征和症状并康复，这表明通过积极的支持性治疗，患者可能会有良好的预后。
