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[吗啡(从罂粟籽中提取)与右美沙芬中毒——病例报告]

[Morphine (obtained from poppy seeds) and dextrometorfan poisoning– a case report].

作者信息

Kwiecień-Obara Ewelina, Szponar Jaroslaw, Krajewska Anna, Witkowska Agnieszka, Radoniewicz Anna, Szponar Magda

出版信息

Przegl Lek. 2016;73(8):596-8.

PMID:29677437
Abstract

Morphine is one of the many, and pharmacologically most important, opium poppy alkaloid (Papaver somniferum). A poppy plant consists of a lot of alkaloids. Most of them are morphine, codeine, narcotine, papaverine, thebaine, narceine and narcotoline. Most of the alkaloid is in the poppy milk - opium..It is a dried and properly processed juice with precut immature poppy-heads. It induces euphoria, somnolence, has an analgesic effect. In the study was presented a 24-yearold patient who was admitted to the Department of Toxicology and Cardiology because of suspicion of poisoning with unknown drugs. In retrospect, it turned out that he was poisoned brew with 5 kg of poppy and dextromethorphan. In the past, he drank alcohol heavily, used legal highs, amphetamine, methamphetamine, opiates, diazepam, cannabinoids. At the time of admission to the department, his general condition was severe, he was unconscious, with periodic breathing disorders, pinpoint pupils. In the laboratory: opiates>2000 ng/ml, other toxicological tests were negative. On the subsequent days of his stay he remained in a generally very severe condition; he was unconscious. Some electrolyte disorders were observed, as well as characteristics of developing rhabdomyolysis. With the applied intensive medical therapy, a gradual improvement of his general condition was achieved. Due to quadriplegia on the 30th day of the hospitalization, the patient was transferred to the Department of Neurology for further treatment.

摘要

吗啡是众多罂粟生物碱(罂粟)中在药理学上最为重要的一种。罂粟植物含有多种生物碱。其中大部分是吗啡、可待因、那可汀、罂粟碱、蒂巴因、那碎因和去甲劳丹碱。大部分生物碱存在于罂粟乳汁——鸦片中。它是一种由未成熟罂粟头预先切割后干燥并经过适当加工的汁液。它会引起欣快感、嗜睡,具有镇痛作用。在这项研究中,介绍了一名24岁的患者,他因疑似未知药物中毒被收治到毒理学和心脏病学科室。回顾发现,他是因饮用了含有5千克罂粟和右美沙芬的 brew 而中毒。过去,他大量饮酒,使用过合法兴奋剂、安非他命、甲基苯丙胺、阿片类药物、地西泮、大麻素。入院时,他的总体状况严重,昏迷不醒,伴有周期性呼吸障碍,瞳孔针尖样缩小。实验室检查结果显示:阿片类药物>2000纳克/毫升,其他毒理学检查均为阴性。在他住院的后续日子里,他的总体状况一直非常严重;他一直昏迷。观察到一些电解质紊乱以及横纹肌溶解症的症状。通过采用强化医疗治疗,他的总体状况逐渐得到改善。由于住院第30天时出现四肢瘫痪,该患者被转至神经科进行进一步治疗。

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