Miles M V, Greenwood R S, Hussey B
Division of Pharmacy Practice, School of Pharmacy, University of North Carolina, Chapel Hill 27599.
Am J Emerg Med. 1990 Jul;8(4):335-7. doi: 10.1016/0735-6757(90)90090-m.
Amoxapine is a second-generation antidepressant that has been reported to cause seizures, severe acidosis, cardiac dysrhythmias, hypotension, renal failure, coma, and cardiorespiratory arrest in poisoning exposures. This is a report of a previously normal 9-year-old child who presented with generalized tonic clonic seizures that led to an extensive workup for primary generalized epilepsy. Nothing in the patient's history or laboratory test results suggested ingestion of a toxin. It was not until 48 hours after admission, when the child admitted taking several of her mother's amoxapine tablets, that the correct diagnosis was made. Because of the risks and the diagnostic pitfalls associated with ingestion of amoxapine, clinicians should be mindful of the lessons taught by this case.
阿莫沙平是一种第二代抗抑郁药，据报道，在中毒暴露时可导致癫痫发作、严重酸中毒、心律失常、低血压、肾衰竭、昏迷和心肺骤停。本文报告了一名既往健康的9岁儿童，该患儿出现全身强直阵挛性发作，因此对原发性全身性癫痫进行了全面检查。患者的病史或实验室检查结果均未提示摄入毒素。直到入院48小时后，患儿承认服用了几片母亲的阿莫沙平片，才做出了正确诊断。由于摄入阿莫沙平存在风险且诊断存在陷阱，临床医生应牢记此病例所带来的教训。
