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病例报告:自我用药引发的血清素能和胆碱能综合征。

Case report: Serotoninergic and cholinergic syndromes induced by self-medication.

作者信息

Orozco-Solano Sofía, Silva-Castro Martha Milena, Machuca Manuel

机构信息

Centro de Información de Medicamentos, Servicio de Farmacia, Hospital Dr R. A. Calderón Guardia, San José, Costa Rica.

Responsable de Investigación de la Sociedad Española de Optimización de la Farmacoterapia, Spain, Spain.

出版信息

Front Pharmacol. 2023 Feb 16;14:1080249. doi: 10.3389/fphar.2023.1080249. eCollection 2023.

Abstract

Self-medication is a part of the self-care practices carried out by the elderly in their environment. The aim of this case report is to show how the self-medication of fluoxetine and dimenhydrinate in an older adult can induce serotoninergic and cholinergic syndromes, showing symptoms such as nausea, tachycardia, tremor, loss of appetite, memory loss, decreased vision, falls, and increased urination. An older adult who has been diagnosed with arterial hypertension, dyslipidemia, diabetes mellitus, and a recent diagnosis of essential thrombosis is the subject of this case report. After the analysis of the case, cessation of fluoxetine was recommended to avoid withdrawal symptoms, therefore decreasing the need for dimenhydrinate and the medicines used for dyspepsia. After the recommendation, the patient showed an improvement in the symptoms. Finally, the comprehensive evaluation process of the medication in the Medicines Optimization Unit achieved the detection of the problem and improved the patient's health condition.

摘要

自我药疗是老年人在其生活环境中进行的自我保健行为的一部分。本病例报告的目的是展示一名老年人自行服用氟西汀和茶苯海明如何引发血清素能和胆碱能综合征,表现出恶心、心动过速、震颤、食欲不振、记忆力减退、视力下降、跌倒和排尿增多等症状。本病例报告的对象是一名已被诊断患有动脉高血压、血脂异常、糖尿病且最近被诊断为原发性血栓形成的老年人。对该病例进行分析后,建议停用氟西汀以避免戒断症状,从而减少对茶苯海明和用于治疗消化不良药物的需求。在给出建议后,患者的症状有所改善。最后,药物优化单元对该药物的综合评估过程发现了问题并改善了患者的健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5af3/9978782/073aeb78a1c2/fphar-14-1080249-g001.jpg

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