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[精神药物中毒]

[Intoxication with psychotropic drugs].

作者信息

Bellmann R, Joannidis M

机构信息

Gemeinsame Einrichtung für Internistische Notfall- und Intensivmedizin, Universitätsklinik für Innere Medizin I, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.

出版信息

Med Klin Intensivmed Notfmed. 2017 Sep;112(6):557-575. doi: 10.1007/s00063-017-0323-8. Epub 2017 Aug 21.

Abstract

Psychotropic drugs are medications that are indicated for treatment of psychiatric disorders. Attempted suicide is the major reason for intoxication but inadvertent overdosing may also occur. Other psychotropic agents are taken because of their stimulating and hallucinogenic effects and many have a high addictive potential. Poisoning is usually due to accidental overdosing. For treatment of benzodiazepine and opioid intoxication, flumazenil and naloxone, respectively, are used as specific antagonists. For intoxication by tricyclic antidepressants, sodium bicarbonate is the treatment of choice. It can also be administered for poisoning caused by selective serotonin re-uptake inhibitors and neuroleptics, in cases of cardiotoxicity. Torsades de pointes can be terminated with defibrillation and intravenous magnesium. Symptomatic treatment is performed for intoxications caused by analeptics or hallucinogens. Beta blockers must be avoided in cocaine and amphetamine poisoning.

摘要

精神药物是用于治疗精神障碍的药物。自杀未遂是中毒的主要原因,但也可能发生意外过量用药。其他精神药物因其刺激和致幻作用而被使用,许多药物具有很高的成瘾潜力。中毒通常是由于意外过量用药。对于苯二氮䓬类和阿片类药物中毒,分别使用氟马西尼和纳洛酮作为特异性拮抗剂。对于三环类抗抑郁药中毒,碳酸氢钠是首选治疗方法。在出现心脏毒性的情况下,它也可用于治疗由选择性5-羟色胺再摄取抑制剂和抗精神病药物引起的中毒。尖端扭转型室速可用除颤和静脉注射镁来终止。对兴奋药或致幻剂引起的中毒进行对症治疗。在可卡因和苯丙胺中毒时必须避免使用β受体阻滞剂。

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