Department of Emergency Medicine, Regions Hospital, St Paul, MN, United States of America; Minnesota Poison Control System, MN, United States of America.
Minnesota Poison Control System, MN, United States of America.
Am J Emerg Med. 2019 Nov;37(11):2066-2071. doi: 10.1016/j.ajem.2019.02.044. Epub 2019 Mar 9.
Phenibut is a synthetically produced central nervous system (CNS) depressant that is structurally similar to the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Phenibut has been identified as a drug of abuse with numerous clinical effects in overdose and a withdrawal syndrome with chronic use. The purpose of this study is to report the incidence of exposure calls regarding phenibut to a poison center, describe the reasons for its use and clinical effects.
Study subjects were identified using Toxicall®, the electronic medical record utilized by the Minnesota Poison Control System. All phenibut exposure calls from January 2000 through December 2018 were included. Analysis was performed on incidence of exposure calls, reported reasons for use, signs and symptoms, coingestants, and outcome.
There were 56 exposure calls over 19 years with 48 (85.7%) calls within the past five years. Over 50% of patients had CNS effects and 10.7% had withdrawal concerns. Twenty-seven patients (48%) had abuse as the reason for use and 13 (23%) used phenibut to treat anxiety. There were documented coingestants in 35.7% of patients. No patients died due to reported phenibut use, though 11 patients (19.6%) were intubated.
Exposure calls to a regional poison center regarding phenibut have increased over the past five years. CNS depression was common, and associated with significant clinical outcomes including respiratory failure requiring intubation. As phenibut is easily attainable and exposures appear to be increasing, physicians should be aware of phenibut-associated CNS and respiratory depression and be prepared to manage airways appropriately.
苯环利定（Phenibut）是一种人工合成的中枢神经系统抑制剂，其结构与抑制性神经递质γ-氨基丁酸（GABA）相似。苯环利定已被确定为一种滥用药物，过量使用会产生多种临床效应，且长期使用会出现戒断综合征。本研究旨在报告某中毒控制中心接到的关于苯环利定暴露的发生率，并描述其使用原因和临床效应。
本研究通过明尼苏达中毒控制系统使用的电子病历 Toxicall®，确定了研究对象。本研究纳入了 2000 年 1 月至 2018 年 12 月期间所有关于苯环利定暴露的来电。分析了暴露发生率、报告的使用原因、体征和症状、共同摄入物以及结局。
在 19 年期间，共接到 56 个苯环利定暴露来电，其中 48 个（85.7%）来电是在过去 5 年内接到的。超过 50%的患者有中枢神经系统效应，10.7%的患者有戒断担忧。27 名患者（48%）因滥用而使用苯环利定，13 名患者（23%）用苯环利定治疗焦虑。35.7%的患者有共同摄入物。虽然有 11 名患者（19.6%）需要插管，但没有因报告的苯环利定使用而导致患者死亡。
过去五年，某区域性中毒控制中心接到的关于苯环利定的暴露来电有所增加。中枢神经系统抑制很常见，与包括需要插管的呼吸衰竭在内的显著临床结局相关。由于苯环利定很容易获得，且暴露似乎在增加，医生应该了解苯环利定相关的中枢神经系统和呼吸抑制，并准备适当管理气道。
