Kicka Mariusz, Kłopotowski Tomasz, Picheta Sebastian, Bazylewicz Anna, Miśkiewicz Łukasz
Instytut Medycyny Pracy i Zdrowia Srodowiskowego w Sosnowcu Regionalny Ośrodek Ostrych Zatruć z Oddziałem Toksykologii Klinicznej.
Przegl Lek. 2011;68(8):543-5.
Lamotrigine is a phenyltriazine derivative used as antiepileptic drug with pharmacological profile similar to phenytoin. It is chemically unrelated to the other antiepileptic drugs and mechanism of anticonvulsant action is that lamotrigine inhibits sodium channels, resulting in neuronal membrane stabilization and block of excitatory neurotransmitter release. Mean therapeutical dose of lamotrigine is 200 - 400 mg/day. Overdose experience with lamotrigine is limited. In severe cases of poisonings there were serious effects such as: coma, respiratory depression, recurrent seizures and intraventricular conduction disturbances. We report massive suicidal poisoning with lamotirigine unknown dose. Clinical course was severe--we observed deep coma, respiratory depression, epileptical state, ventricular disrhytmias, atrio-venticular heart block, cardiovascular shock, rhabdomyolysis and hypokalemia. There was ventricular fibrillation in course of poisoning. The patient was successfully resuscitated and discharged on 18 hospital day.
拉莫三嗪是一种苯三嗪衍生物，用作抗癫痫药物，其药理特性与苯妥英相似。它在化学上与其他抗癫痫药物无关，其抗惊厥作用机制是拉莫三嗪抑制钠通道，导致神经元膜稳定并阻止兴奋性神经递质释放。拉莫三嗪的平均治疗剂量为200 - 400毫克/天。拉莫三嗪的过量用药经验有限。在严重中毒病例中会出现严重后果，如：昏迷、呼吸抑制、反复癫痫发作和室内传导障碍。我们报告了一例服用剂量不明的拉莫三嗪大量自杀性中毒病例。临床过程严重——我们观察到深度昏迷、呼吸抑制、癫痫状态、室性心律失常、房室传导阻滞、心血管休克、横纹肌溶解和低钾血症。中毒过程中出现了心室颤动。患者成功复苏，并于住院第18天出院。
