Tianyi Frank-Leonel, Agbor Valirie Ndip, Njim Tsi
Sub-Divisional hospital Mayo Darley, Mayo Darley, Cameroon.
Ibal sub-Divisional hospital, Oku, North west region, Cameroon.
BMC Res Notes. 2017 Jan 7;10(1):32. doi: 10.1186/s13104-016-2342-6.
Metoclopramide is a commonly used anti-emetic drug known to cause extrapyramidal symptoms as adverse effects, amongst which are dystonic reactions. These reactions are more frequent at high doses of metoclopramide, in female patients, children and adults less than 30 years of age. We hereby present the case of a 16 year old female who had dystonic reactions from metoclopramide, highlighting its unpredictable nature and the shortcomings of the management in resource-limited settings.
A 16 year old female Muslim from the Extreme North of Cameroon with no significant past history, was treated for severe malaria and associated refractory vomiting using intravenous quinine and metoclopramide respectively. She developed dystonic reactions after being administered her second dose of metoclopramide. The drug was discontinued and she was administered 8 mg of chlorpheniramine by mouth. Her symptoms resolved after 4 h. She was discharged 2 days later with no further complaints.
Metoclopramide causes dystonic reactions which are often unpredictable and is frequently prescribed by health providers. This creates an environment of anxiety for the patient and the caregiver, and can result in life threatening consequences. Patients on metoclopramide should be monitored closely to detect these reactions early, and health facilities should be equipped to cope with the adverse effects before administration.
甲氧氯普胺是一种常用的止吐药，已知会引起锥体外系症状等不良反应，其中包括肌张力障碍反应。这些反应在高剂量使用甲氧氯普胺时、女性患者、儿童以及30岁以下成年人中更为常见。我们在此报告一例16岁女性因甲氧氯普胺出现肌张力障碍反应的病例，强调其不可预测性以及在资源有限环境下管理的不足之处。
一名来自喀麦隆最北部的16岁穆斯林女性，既往无重大病史，分别使用静脉注射奎宁和甲氧氯普胺治疗严重疟疾及相关难治性呕吐。在给予第二剂甲氧氯普胺后，她出现肌张力障碍反应。药物停用，并口服给予8毫克氯苯那敏。4小时后症状缓解。两天后出院，无进一步不适主诉。
甲氧氯普胺可引起肌张力障碍反应，这些反应往往不可预测，且卫生保健人员经常开具此药。这给患者和护理人员造成焦虑环境，并可能导致危及生命的后果。使用甲氧氯普胺的患者应密切监测，以便早期发现这些反应，卫生机构在给药前应具备应对不良反应的能力。
