Department of General Internal Medicine, Kamigoto Hospital, Japan.
Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Japan.
Intern Med. 2024 Jun 15;63(12):1829-1835. doi: 10.2169/internalmedicine.2012-23. Epub 2023 Nov 13.
This report describes a case of shock symptoms in a 72-year-old woman with epilepsy who had been in a state of polypharmacy, taking multiple antipsychotic drugs. After receiving a normal dose of periciazine, she exhibited impaired consciousness, hypothermia, and hypotension and was admitted to hospital. Despite poor response to vasopressors, conservative treatment led to gradual improvement. Subsequent pharmacokinetic analysis showed non-toxic blood concentrations of periciazine, suggesting that even small doses of phenothiazines could result in toxic symptoms. This case highlights the importance of monitoring for adverse reactions when prescribing multiple antipsychotic drugs, particularly in older polypharmacy patients.
本报告描述了一例 72 岁女性癫痫患者的休克症状,该患者处于多药治疗状态,服用多种抗精神病药物。在接受正常剂量的奋乃静后,她出现意识障碍、体温过低和低血压,并被收入医院。尽管对血管加压药反应不佳,但保守治疗导致病情逐渐改善。随后的药代动力学分析显示奋乃静的血药浓度无毒,表明即使小剂量的苯并嗪类药物也可能导致毒性症状。该病例强调了在开具多种抗精神病药物时监测不良反应的重要性,特别是在老年多药治疗患者中。