儿童洛哌丁胺中毒
Lomotil poisoning in children.
作者信息
Curtis J A, Goel K M
出版信息
Arch Dis Child. 1979 Mar;54(3):222-5. doi: 10.1136/adc.54.3.222.
45 children were admitted to hospital after ingesting varying quantities of diphenoxylate (Lomotil). One died and 44 recovered without any sequelae. Four patients were comatose, 32 were drowsy, and 9 suffered respiratory depression. No correlation was found between ingested dose and the severity of symptoms. Because of its action in rendering the gut atonic, removal of diphenoxylate by gastric lavage is mandatory, even in patients admitted at least 24 hours after drug ingestion. Naloxone is the narcotic antagonist of choice, and should be used in all cases where suspected diphenoxylate poisoning leads to respiratory depression or coma. The use of Lomotil as an antidiarrhoeal agent in children is difficult to justify.
45名儿童因摄入不同剂量的地芬诺酯（洛哌丁胺）而入院。其中1名死亡，44名康复且无任何后遗症。4名患者昏迷，32名嗜睡，9名出现呼吸抑制。摄入剂量与症状严重程度之间未发现相关性。由于地芬诺酯会使肠道张力缺乏，即使在服药至少24小时后入院的患者中，也必须通过洗胃清除地芬诺酯。纳洛酮是首选的麻醉拮抗剂，在所有疑似地芬诺酯中毒导致呼吸抑制或昏迷的病例中均应使用。在儿童中使用洛哌丁胺作为止泻药很难说得过去。
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