Davido A, Hallali P, Boutchnei T
Hôpital de la Pitié, service des urgences-médecine, Paris.
Rev Med Interne. 1989 Mar-Apr;10(2):113-7. doi: 10.1016/s0248-8663(89)80090-6.
Glafenine-induced shock. Seven cases. Glafenine is a widely prescribed analgesic drug, and shock is one of its severe side-effects. We report six documented and one highly probable cases of such accidents. From these seven cases and a review of the literature, we have extracted the clinical characteristics of glafenine-induced shock. Shock usually occurs about 30 minutes on average after taking one single tablet. Previous use of the drug is found in more than 50 per cent of the patients, and it was often followed by a neglected side-effect. A series of cutaneous and respiratory manifestations precedes or accompanies the shock. Two physiopathological mechanisms of glafenine-induced shock have been postulated: either anaphylaxis or idiosyncratic reaction involving the prostaglandins. In vitro tests give highly variable results and therefore are of limited value. Glafenine-induced shock is rare; its incidence, probably underestimated, is about 0.7 in 10(5) treatments. Prevention is essential, cure relies on adrenaline.
格拉非宁所致休克。七例报告。格拉非宁是一种广泛应用的镇痛药，休克是其严重的副作用之一。我们报告了六例确诊病例和一例高度疑似病例。从这七例病例以及文献回顾中，我们总结出了格拉非宁所致休克的临床特征。休克通常在服用一片药后平均约30分钟发生。超过50%的患者曾使用过该药物，且往往之前有被忽视的副作用。一系列皮肤和呼吸道表现先于休克出现或伴随休克发生。关于格拉非宁所致休克的生理病理机制有两种推测：要么是过敏反应，要么是涉及前列腺素的特异反应。体外试验结果差异很大，因此价值有限。格拉非宁所致休克较为罕见；其发生率可能被低估，约为每10万次治疗中有0.7例。预防至关重要，治疗依赖肾上腺素。
