Lafolie P, Liliemark J, Björk O, Aman J, Wranne L, Peterson C
Department of Clinical Pharmacology, Karolinska Hospital, Stockholm.
Med Toxicol Adverse Drug Exp. 1988 May-Jun;3(3):248-52. doi: 10.1007/BF03259885.
Intrathecal cytarabine (cytosine arabinoside) is included in many protocols for the treatment of acute lymphoblastic leukaemia of childhood. We report here the accidental administration of 200mg cytarabine intrathecally to a 4-year-old boy with CNS relapse. After the overdose the patient had dilated pupils during the first hour. One month later an unsteady gait and mild intention tremor in the hands were noted. By the exchange of cerebrospinal fluid with isotonic saline started 1 hour after overdose through a lumbar needle, about 27% of the administered dose was recovered. The estimated recovery in view of the time elapsed between overdose and start/end of the exchange procedure was 36%. This indicates that this procedure is of value in managing patients with heavy overdose of intrathecal cytarabine in hospitals without neurosurgical facilities.
鞘内注射阿糖胞苷（胞嘧啶阿拉伯糖苷）被纳入许多儿童急性淋巴细胞白血病的治疗方案中。我们在此报告，一名4岁中枢神经系统复发的男孩意外鞘内注射了200毫克阿糖胞苷。过量注射后，患者在第一个小时内瞳孔散大。一个月后，发现患者步态不稳，双手有轻度意向性震颤。通过在过量注射后1小时经腰椎穿刺用等渗盐水置换脑脊液，回收了约27%的给药剂量。鉴于过量注射与置换程序开始/结束之间的时间间隔，估计回收率为36%。这表明，在没有神经外科设施的医院中，该程序对于处理鞘内注射阿糖胞苷严重过量的患者具有价值。
