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林丹中毒:医学文献综述

Lindane toxicity: a comprehensive review of the medical literature.

作者信息

Nolan Katherine, Kamrath Jacqueline, Levitt Jacob

机构信息

Department of Dermatology, Mount Sinai School of Medicine, New York, NY 10029, USA.

出版信息

Pediatr Dermatol. 2012 Mar-Apr;29(2):141-6. doi: 10.1111/j.1525-1470.2011.01519.x. Epub 2011 Oct 13.

Abstract

Lindane is an organochloride pesticide, first introduced as a scabicide for human use in the 1950s. Because of its low cost and efficacy, it quickly became a first-line treatment for scabies and head lice, but not long after its use became widespread, its safety was called into question, primarily regarding its neurotoxic effects. We intend to show through review of the literature and databases that lindane has been associated with numerous severe and fatal adverse reactions. This review will summarize 67 cases of adverse reactions and deaths associated with the medical use of lindane. Many of the most serious events and fatalities occurred in pediatric and geriatric populations. We concede that toxicity frequently arises from misuse, but labeled usage of lindane caused 43% of the serious adverse reactions of this review. Moreover, the numerous instances of lindane misuse elucidate the importance of clear labeling and instructions, especially with a product with a narrow therapeutic index. Therefore, this report attempts to elucidate the dangers of lindane as a medical treatment for scabies and head lice by providing a comprehensive review of all documented adverse drug reactions since its introduction.

摘要

林丹是一种有机氯杀虫剂,于20世纪50年代首次作为治疗疥疮的药物引入用于人类。由于其成本低且疗效好,它很快成为疥疮和头虱的一线治疗药物,但在其广泛使用后不久,其安全性就受到质疑,主要涉及其神经毒性作用。我们打算通过对文献和数据库的回顾表明,林丹与众多严重和致命的不良反应有关。本综述将总结67例与林丹医疗使用相关的不良反应和死亡病例。许多最严重的事件和死亡发生在儿童和老年人群中。我们承认毒性常常源于误用,但林丹的标签注明用法导致了本综述中43%的严重不良反应。此外,林丹的大量误用案例阐明了清晰标注和说明的重要性,尤其是对于治疗指数较窄的产品。因此,本报告试图通过全面回顾自林丹引入以来所有记录在案的药物不良反应,阐明其作为治疗疥疮和头虱的药物的危险性。

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