在严重三环类抗抑郁药过量中毒中长时间使用静脉脂质乳剂。
Prolonged use of intravenous lipid emulsion in a severe tricyclic antidepressant overdose.
作者信息
Agarwala Ravi, Ahmed Syed Zaki, Wiegand Timothy J
机构信息
Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA,
出版信息
J Med Toxicol. 2014 Jun;10(2):210-4. doi: 10.1007/s13181-013-0353-4.
Abstract
INTRODUCTION
Intravenous lipid emulsion (ILE) resuscitation is now frequently being used for severe overdoses due to lipophilic drugs. However, the optimal dose, duration, and safety are still unclear.
CASE REPORT
A patient with refractory cardiovascular collapse following an amitriptyline overdose was treated with ILE with initial improvement. Instability recurred after ILE discontinuation and lipid therapy was restarted, but high-dose treatment was complicated by severe lipemia. A low-dose infusion was instead used, and the patient did not experience further toxicity despite amitriptyline levels in the toxic range for 21 days. He survived to discharge without long-term sequelae.
DISCUSSION
A low-dose infusion of ILE was well tolerated and may have successfully prevented recurrent toxicity in a case of severe tricyclic antidepressant overdose.
摘要
引言
静脉注射脂质乳剂（ILE）复苏目前常用于因亲脂性药物导致的严重过量中毒。然而，最佳剂量、持续时间和安全性仍不明确。
病例报告
一名因阿米替林过量导致难治性心血管衰竭的患者接受了ILE治疗，最初病情有所改善。停用ILE后病情复发，于是重新开始脂质治疗，但高剂量治疗出现了严重脂血症并发症。取而代之的是采用低剂量输注，尽管阿米替林水平在中毒范围内持续了21天，但患者未出现进一步的毒性反应。他存活至出院，没有长期后遗症。
讨论
低剂量输注ILE耐受性良好，在一例严重三环类抗抑郁药过量中毒的病例中可能成功预防了毒性反应的复发。
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