Giampreti Andrea, Lonati Davide, Locatelli Carlo, Rocchi Loretta, Campailla Maria Teresa
Pavia Poison Control Center and National Toxicology Information Centre, Toxicology Unit, IRCCS Maugeri Foundation and University of Pavia, Italy.
Clin Toxicol (Phila). 2009 Sep;47(8):827-9. doi: 10.1080/15563650903081601.
Yohimbine is an alkaloid obtained from the Corynanthe yohimbe tree and other biological sources. Yohimbine is currently approved in the United States for erectile dysfunction and has undergone resurgence in street use as an aphrodisiac and mild hallucinogen. In recent years yohimbine use has become common in body-building communities for its presumed lipolytic and sympathomimetic effects. We describe a 37-year-old bodybuilder in which severe acute neurotoxic effects occurred in 2 h after yohimbine ingestion. The patient presented with malaise, vomiting, loss of consciousness, and repeated seizures after ingestion of 5 g of yohimbine during a body-building competition in a gymnasium. His Glasgow Coma Score was 3, requiring orotracheal intubation. Two hours after admission, vital signs were blood pressure 259/107 mmHg and heart rate 140 beats/min. Treatment with furosemide, labetalol, clonidine, and urapidil and gastrointestinal decontamination were performed. Twelve hours later the patient was extubated with normal hemodynamic parameters and neurological examination. The yohimbine blood levels at 3, 6, 14, and 22 h after ingestion were 5,240; 2,250; 1,530; and 865 ng/mL, respectively, with a mean half-life of 2 h. Few data are available about yohimbine toxicity and the related blood levels. This is a case of a large ingestion of yohimbine in which severe hemodynamic and neurological manifestations occurred and elevated blood levels of yohimbine were detected.
育亨宾是一种从育亨宾树及其他生物来源中提取的生物碱。育亨宾目前在美国被批准用于治疗勃起功能障碍，近年来在街头作为壮阳药和轻度致幻剂再度流行起来。近年来，由于其假定的脂肪分解和拟交感神经作用，育亨宾在健身群体中使用变得普遍。我们描述了一名37岁的健美运动员，在摄入育亨宾后2小时出现了严重的急性神经毒性作用。该患者在健身房参加健美比赛期间摄入5克育亨宾后，出现不适、呕吐、意识丧失及反复癫痫发作。他的格拉斯哥昏迷评分是3分，需要进行气管插管。入院两小时后，生命体征为血压259/107 mmHg，心率140次/分钟。给予速尿、拉贝洛尔、可乐定和乌拉地尔治疗，并进行了胃肠道去污处理。12小时后，患者拔管，血流动力学参数和神经学检查正常。摄入育亨宾后3、6、14和22小时的血药浓度分别为5240、2250、1530和865 ng/mL，平均半衰期为2小时。关于育亨宾毒性及相关血药浓度的数据很少。这是一例大量摄入育亨宾后出现严重血流动力学和神经学表现且检测到育亨宾血药浓度升高的病例。
