纳洛酮在血管紧张素转换酶抑制剂过量使用中的应用：一例报告
Use of Naloxone in Angiotensin-Converting Enzyme Inhibitor Overdose: A Case Report.
作者信息
Haluska Alexandra D, Davis Austin, Tarabishy Noor, Pena Margarita E
机构信息
Department of Emergency Medicine, Ascension St. John Hospital, Detroit, Michigan.
St. George's University School of Medicine, True Blue, Grenada, West Indies.
出版信息
J Emerg Med. 2023 Mar;64(3):397-399. doi: 10.1016/j.jemermed.2022.12.010. Epub 2023 Mar 15.
BACKGROUND
Angiotensin-converting enzyme (ACE) inhibitor overdose is an uncommonly presenting toxicologic emergency. Management is primarily supportive care, but a small body of evidence exists to support naloxone for management of hypotension.
CASE REPORT
We present a case of accidental ACE inhibitor overdose. The patient took approximately 300 mg lisinopril over 48 h and presented for evaluation of syncope. He was hypotensive and unresponsive to fluids. We administered naloxone with immediate and sustained resolution in hypotension. The mechanism of action is briefly discussed. WHY SHOULD AN EMERGENCY MEDICINE PHYSICIAN BE AWARE OF THIS?: Naloxone is a rapid, low-risk, low-cost, and effective intervention for hypotension due to ACE inhibitor toxicity. It is supported by basic science research and clinical experience.
背景
血管紧张素转换酶（ACE）抑制剂过量是一种较少见的中毒急症。治疗主要是支持性护理，但有少量证据支持使用纳洛酮治疗低血压。
病例报告
我们报告一例意外的ACE抑制剂过量病例。患者在48小时内服用了约300毫克赖诺普利，因晕厥前来评估。他血压低，对补液无反应。我们给予纳洛酮后，低血压立即且持续缓解。简要讨论了其作用机制。
急诊医生为何应了解这一点？：纳洛酮是治疗ACE抑制剂中毒所致低血压的一种快速、低风险、低成本且有效的干预措施。它有基础科学研究和临床经验的支持。
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