大量服用安非他酮后出现心源性休克和癫痫持续状态。
Cardiogenic shock and status epilepticus after massive bupropion overdose.
作者信息
Morazin Florian, Lumbroso Agnès, Harry Patrick, Blaise Marcel, Turcant Alain, Montravers Philippe, Gauzit Rémy
机构信息
Département d'Anesthésie-Réanimation, CHU Jean Verdier--Assistance Publique Hôpitaux de Paris, Bondy Cedex, France.
出版信息
Clin Toxicol (Phila). 2007 Oct-Nov;45(7):794-7. doi: 10.1080/15563650701665076.
BACKGROUND
To describe a profound cardiac dysfunction and a status epilepticus after a massive bupropion overdose.
CASE REPORT
A 35-year-old man was admitted in coma following the deliberate ingestion of 12 g of bupropion. The course was marked by the rapid onset of severe and prolonged status epilepticus and cardiogenic shock. Plasma bupropion level determined four hours after the estimated time of ingestion was 1.4 mg/L. All clinical features resolved completely in response to symptomatic treatment.
CONCLUSION
Several cases of bupropion overdose, with sinus tachycardia and seizures rapidly corrected by symptomatic treatment, have been reported in the literature. To our knowledge, this case of overdose with bupropion alone, at very high doses, is the first to describe clinical features comprising severe and prolonged status epilepticus and direct cardiotoxicity with the development of cardiogenic shock documented by echocardiogram.
背景
描述一例大量服用安非他酮后出现的严重心脏功能障碍和癫痫持续状态。
病例报告
一名35岁男性因故意摄入12克安非他酮而昏迷入院。病程特点为迅速出现严重且持续时间长的癫痫持续状态和心源性休克。在估计摄入时间4小时后测定的血浆安非他酮水平为1.4毫克/升。经对症治疗后，所有临床症状完全缓解。
结论
文献中已报道了几例安非他酮过量病例，其窦性心动过速和癫痫发作经对症治疗后迅速得到纠正。据我们所知，这例单独超大剂量服用安非他酮的病例是首例描述包括严重且持续时间长的癫痫持续状态以及经超声心动图证实的心源性休克发展所导致的直接心脏毒性等临床特征的病例。
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