Borek Heather A, Charlton Nathan P
Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.
J Emerg Med. 2019 Oct;57(4):e109-e111. doi: 10.1016/j.jemermed.2019.06.049. Epub 2019 Oct 4.
Paliperidone is an atypical antipsychotic that is approved to treat schizophrenia in patients 12 years of age and older. There are minimal data on the clinical effects of exposure in the < 12-year-old age group.
We report the case of a 7-year-old girl who was accidentally dosed with paliperidone for 3 days. Her clinical course was notable for a dystonic reaction and profound sinus tachycardia, with a heart rate peaking at 201 beats/min. The tachycardia persisted for over 64 h after her last dose. The mechanism of tachycardia has not been elucidated and is likely multifactorial, with alpha blockade and anticholinergic effects probably contributing. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians should be aware that paliperidone ingestion in children may result in delayed, profound tachycardia and may require more prolonged observation times or admission to the hospital.
帕利哌酮是一种非典型抗精神病药物，被批准用于治疗12岁及以上患者的精神分裂症。关于12岁以下年龄组暴露于该药物的临床效果的数据极少。
我们报告了一名7岁女孩意外服用帕利哌酮3天的病例。她的临床过程以肌张力障碍反应和严重窦性心动过速为显著特征，心率峰值达到201次/分钟。心动过速在她最后一剂药物后持续超过64小时。心动过速的机制尚未阐明，可能是多因素的，α受体阻滞和抗胆碱能作用可能起了作用。急诊医生为何应知晓此事？：临床医生应意识到，儿童摄入帕利哌酮可能导致延迟出现的严重心动过速，可能需要更长时间的观察或住院治疗。
