Hsieh P F, Tsan Y T, Hung D Z, Hsu C L, Lee Y C, Chang M H
Department of Internal Medicine, Division of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Hum Exp Toxicol. 2007 Dec;26(12):971-3. doi: 10.1177/0960327107087797.
Bromism, chronic bromide intoxication, can be caused by a variety of medicines, but bromism due to pain-relieving injectable medications has not been reported. In this study, the methods used were internet searching on bromide-containing injectables available in Taiwan and the first case report of bromism due to mixed-formulated injectable medication. Many analgesic/antipyretic and antihistamine injections containing bromides are still being used in Taiwan. They contain sodium bromide up to 1000 mg/ampoule or calcium bromide up to 800 mg/amp. A 25-year-old female suffered from forgetfulness and unstable gait after long-term frequent injections of a preparation to relieve head and neck pain. Blood tests showed hyperchloremia (171 mEq/L) and a negative anion gap (-48.7 mEq/L). Serum bromide measured 2150 mg/L. She recovered completely in 3 days with saline treatment. Many bromide-containing injections are still being used in Taiwan. Clinicians should keep alert on this issue to avoid iatrogenic bromism or making misdiagnoses.
溴中毒，即慢性溴化物中毒，可由多种药物引起，但由止痛注射剂导致的溴中毒尚未见报道。在本研究中，采用网络搜索台湾地区可得的含溴注射剂，并报告首例因混合配方注射剂导致溴中毒的病例。台湾地区仍在使用许多含溴的止痛/退烧药及抗组胺注射剂。它们每安瓿含溴化钠高达1000毫克或每安瓿含溴化钙高达800毫克。一名25岁女性在长期频繁注射一种缓解头颈疼痛的制剂后，出现健忘和步态不稳。血液检查显示高氯血症（171毫当量/升）及阴离子间隙为负值（-48.7毫当量/升）。血清溴含量为2150毫克/升。经生理盐水治疗，她在3天内完全康复。台湾地区仍在使用许多含溴注射剂。临床医生应警惕此问题，以避免医源性溴中毒或误诊。
