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柜台后暗藏的危险:一名老年患者因伪麻黄碱引发癫痫发作

Behind the Counter Danger: Pseudoephedrine-Induced Seizure in an Elderly Patient.

作者信息

Mudarres Fawzi

机构信息

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2024 Aug 17;16(8):e67099. doi: 10.7759/cureus.67099. eCollection 2024 Aug.

Abstract

In this case report, the potential of pseudoephedrine to induce seizures as a side effect in elderly patients is discussed. Pseudoephedrine is commonly used to relieve nasal congestion caused by allergies, colds, or sinusitis. Still, it has been linked to several side effects, such as cardiovascular events, nervous system toxicity, and drug interactions. The report presents the case of an 83-year-old man with a medical history of diabetes, hypertension, and dyslipidemia who experienced a generalized tonic-clonic seizure after taking an over-the-counter medication containing loratadine and pseudoephedrine. The discussion underscores the need for caution when prescribing pseudoephedrine to elderly patients, particularly those with a history of seizures or other neurological conditions, and recommends alternative treatments like nasal saline irrigation or other decongestants. The case highlights the importance of comprehensive neurological assessment and diagnostic testing in patients with seizures to identify the underlying cause and guide appropriate management. Additional research is necessary to better understand the potential risks and benefits of using pseudoephedrine in elderly patients and explore alternative options for treating nasal congestion.

摘要

在本病例报告中,讨论了伪麻黄碱在老年患者中作为副作用诱发癫痫发作的可能性。伪麻黄碱常用于缓解由过敏、感冒或鼻窦炎引起的鼻充血。然而,它与多种副作用有关,如心血管事件、神经系统毒性和药物相互作用。该报告介绍了一名83岁男性患者的病例,他有糖尿病、高血压和血脂异常病史,在服用含有氯雷他定和伪麻黄碱的非处方药后发生了全身性强直阵挛性癫痫发作。讨论强调在给老年患者开伪麻黄碱处方时需要谨慎,尤其是那些有癫痫发作史或其他神经系统疾病史的患者,并推荐了替代治疗方法,如鼻腔盐水冲洗或其他减充血剂。该病例突出了对癫痫患者进行全面神经学评估和诊断测试以确定潜在病因并指导适当管理的重要性。需要进行更多研究,以更好地了解在老年患者中使用伪麻黄碱的潜在风险和益处,并探索治疗鼻充血的替代选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84c/11406002/b46ffb3dd0d3/cureus-0016-00000067099-i01.jpg

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