Forrester Mathias B
Texas Department of State Health Services, Austin, TX, USA.
J Pharm Technol. 2016 Apr;32(2):60-64. doi: 10.1177/8755122515618217. Epub 2015 Nov 18.
Mefloquine is an antimalarial drug available in the United States that in 2013 was given a black box warning about the potential for neurologic and psychiatric adverse effects. This study describes mefloquine ingestions reported to a large statewide poison center system. The distribution of all mefloquine ingestions reported to Texas poison centers during 2010 to 2014 was determined for dose, year, patient age and gender, exposure site, ingestion reason, management site, medical outcome, clinical effects, and treatments. Of 63 total cases, the mean dose was 672 mg (range = 188-3500 mg). The patient age distribution was 5 years or less (27.0%), 6 to 19 years (12.7%), and 20 years or more (58.7%); 52.4% of the patients were male. Therapeutic errors accounted for 71.4% of the cases and adverse reactions 19.0%. The management site was 52.4% on site, 19.0% already at/en route to a health care facility, and 23.8% referred to a health care facility. The medical outcome was not serious in 79.4% of the cases. The most common adverse effects were gastrointestinal (28.6%) or neurological (20.6%) in nature. One case each was reported to have depression, paranoia, and almost psychotic presentation. Few mefloquine ingestions were reported to Texas poison centers. Those that were reported tended to involve adult males and were due to therapeutic error or adverse reaction. Although mefloquine ingestions may result in potentially serious side effects, the exposures reported to Texas poison centers tended not to be serious with few adverse effects and were managed outside of health care facilities.
甲氟喹是一种在美国可获取的抗疟药物,2013年它被给予黑框警告,提示存在神经和精神方面不良反应的可能性。本研究描述了向一个大型全州中毒控制中心系统报告的甲氟喹摄入情况。确定了2010年至2014年期间向德克萨斯州中毒控制中心报告的所有甲氟喹摄入情况的剂量、年份、患者年龄和性别、暴露地点、摄入原因、处理地点、医疗结局、临床效应及治疗情况。在总共63例病例中,平均剂量为672毫克(范围 = 188 - 3500毫克)。患者年龄分布为5岁及以下(27.0%)、6至19岁(12.7%)以及20岁及以上(58.7%);52.4%的患者为男性。治疗失误占病例的71.4%,不良反应占19.0%。处理地点为现场处理的占52.4%,已在/前往医疗机构途中的占19.0%,转诊至医疗机构的占23.8%。79.4%的病例医疗结局不严重。最常见的不良反应性质为胃肠道(28.6%)或神经方面(20.6%)。各有1例报告出现抑郁、偏执及近乎精神病性的表现。向德克萨斯州中毒控制中心报告的甲氟喹摄入情况较少。报告的那些病例往往涉及成年男性,且是由于治疗失误或不良反应所致。尽管甲氟喹摄入可能导致潜在的严重副作用,但向德克萨斯州中毒控制中心报告的暴露情况往往不严重,不良反应较少,且在医疗机构之外进行了处理。