Khan Hamza R, Ali Asghar Sarrah, Kanwal Sharfa, Qadar Laila Tul, Qadri Kashif H
Internal Medicine, Quaid-e-Azam Medical College, Bahawalpur, PAK.
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2019 Oct 9;11(10):e5875. doi: 10.7759/cureus.5875.
Diphenoxylate-atropine (Lomotil) intoxication incidence was significantly high in the past, but seeing such cases in the present day of modern and advanced medicine, hints about the gaps in the practice of medicine. In our case, a general physician maltreated an infant for diarrhea with an adult dose of diphenoxylate-atropine (Lomotil), a Food and Drug Administration (FDA) unapproved drug, which caused labored breathing and pinpoint pupils. After being maltreated, at the time of presentation to the emergency room (ER), she was being misdiagnosed as a case of dehydration until doctors noticed miosis and reached the diagnosis of diphenoxylate-atropine (Lomotil) toxicity. Her condition completely reversed with a single dose of naloxone. Hence, this case highlights the need for basic knowledge about the dosage of drugs for different age groups, especially infants, along with the importance of adherence to the evaluation protocols for accurate management.
过去，地芬诺酯-阿托品（洛哌丁胺）中毒发生率显著较高，但在现代先进医学的当下仍出现此类病例，这暗示了医学实践中的差距。在我们的病例中，一名全科医生用成人剂量的地芬诺酯-阿托品（洛哌丁胺，一种未获美国食品药品监督管理局（FDA）批准的药物）治疗一名婴儿腹泻，导致呼吸困难和瞳孔针尖样缩小。在遭受不当治疗后，该婴儿被送往急诊室时，一直被误诊为脱水，直到医生注意到瞳孔缩小，才诊断为地芬诺酯-阿托品（洛哌丁胺）中毒。她仅用一剂纳洛酮后病情就完全好转。因此，该病例凸显了了解不同年龄组尤其是婴儿用药剂量基本知识的必要性，以及遵守评估方案以进行准确治疗的重要性。
