使用β受体阻滞剂和血液灌流治疗急性茶碱中毒。
Use of beta-blockade and hemoperfusion for acute theophylline poisoning.
作者信息
Biberstein M P, Ziegler M G, Ward D M
出版信息
West J Med. 1984 Oct;141(4):485-90.
Abstract
Five adults were treated successfully for severe theophylline poisoning due to intentional overdosage. Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. No seizures or deaths occurred despite very high serum theophylline concentrations (between 96 and 194 mug per ml). Extreme elevations of plasma catecholamines were documented and are implicated in the toxicity. beta-Blockade with intravenous administration of propranolol hydrochloride was the most effective therapy for theophylline-induced hypotension. All patients were treated with resin hemoperfusion, which resulted in significant clinical improvement and rapid lowering of the serum theophylline level.
摘要
五名成年人因故意过量服用导致严重茶碱中毒，经治疗成功康复。临床特征包括恶心、震颤、谵妄、低血压和心律失常、代谢性酸中毒、高血糖、低钾血症和低磷血症。尽管血清茶碱浓度非常高（每毫升96至194微克），但未发生癫痫发作或死亡。记录到血浆儿茶酚胺极度升高，这与毒性有关。静脉注射盐酸普萘洛尔进行β受体阻滞是治疗茶碱引起的低血压最有效的方法。所有患者均接受树脂血液灌流治疗，临床症状显著改善，血清茶碱水平迅速降低。
相似文献
1
Use of beta-blockade and hemoperfusion for acute theophylline poisoning.使用β受体阻滞剂和血液灌流治疗急性茶碱中毒。
West J Med. 1984 Oct;141(4):485-90.
2
Theophylline overdose: acute single ingestion versus chronic repeated overmedication.
Am J Emerg Med. 1985 Sep;3(5):386-94. doi: 10.1016/0735-6757(85)90195-0.
3
Theophylline intoxication: clinical features and pharmacokinetics during treatment with charcoal hemoperfusion.茶碱中毒：血液灌流治疗期间的临床特征及药代动力学
Isr J Med Sci. 1996 Sep;32(9):766-70.
4
[A patient with severe theophylline poisoning].[一名患有严重氨茶碱中毒的患者]
Ned Tijdschr Geneeskd. 1985 Sep 7;129(36):1741-3.
5
[Massive theophylline poisoning. A case with survival without hemoperfusion].[大剂量茶碱中毒。一例未进行血液灌流而存活的病例]
Ugeskr Laeger. 1993 Oct 25;155(43):3489-90.
6
Hypokalemia, hyperglycemia, and acidosis after intentional theophylline overdose.故意过量服用茶碱后出现低钾血症、高血糖和酸中毒。
Am J Emerg Med. 1985 Sep;3(5):408-11. doi: 10.1016/0735-6757(85)90199-8.
7
Overdose of methyldopa, indapamide and theophylline resulting in prolonged hypotension, marked diuresis and hypokalaemia in an elderly patient.一名老年患者因过量服用甲基多巴、吲达帕胺和茶碱，导致长时间低血压、显著利尿和低钾血症。
Pharmacoepidemiol Drug Saf. 2009 Oct;18(10):977-9. doi: 10.1002/pds.1807.
8
Theophylline toxicity and the beta-adrenergic system.茶碱毒性与β-肾上腺素能系统。
Ann Intern Med. 1985 Jun;102(6):766-9. doi: 10.7326/0003-4819-102-6-766.
9
Reassessment of theophylline toxicity. Serum concentrations, clinical course, and treatment.茶碱中毒的重新评估。血清浓度、临床病程及治疗。
Arch Intern Med. 1987 Apr;147(4):757-60.
10
Hemoperfusion/hemodialysis in the treatment of acute theophylline poisoning--description of a fatal case.血液灌流/血液透析治疗急性茶碱中毒——1例死亡病例报告
Int J Clin Pharmacol Ther Toxicol. 1986 Feb;24(2):85-7.
引用本文的文献
1
Symptomatic Supraventricular Tachycardia Resistant to Adenosine Therapy in a Patient with Chronic Theophylline Use.一名长期使用茶碱的患者对腺苷治疗耐药的症状性室上性心动过速
Case Rep Cardiol. 2021 Mar 27;2021:2806193. doi: 10.1155/2021/2806193. eCollection 2021.
2
Combined butalbital/acetaminophen/caffeine overdose: case files of the Robert Wood Johnson Medical School Toxicology Service.布他比妥/对乙酰氨基酚/咖啡因联合过量：罗伯特·伍德·约翰逊医学院毒理学服务病例档案
J Med Toxicol. 2012 Dec;8(4):424-31. doi: 10.1007/s13181-012-0261-z.
3
Haemodynamic study as guideline for the use of beta blockers in acute theophylline poisoning.血流动力学研究作为急性茶碱中毒时使用β受体阻滞剂的指导原则。
Intensive Care Med. 1996 Jun;22(6):585-7. doi: 10.1007/BF01708101.
4
Advances in the critical care of poisoned paediatric patients.中毒儿科患者重症监护的进展。
Drug Saf. 1994 Jan;10(1):83-92. doi: 10.2165/00002018-199410010-00006.
5
Physical assessment and differential diagnosis of the poisoned patient.中毒患者的体格检查与鉴别诊断。
Med Toxicol. 1987 Jan-Feb;2(1):52-81. doi: 10.1007/BF03259860.
6
Theophylline poisoning. Pharmacological considerations and clinical management.茶碱中毒。药理学考量与临床处理
Med Toxicol. 1986 May-Jun;1(3):169-91. doi: 10.1007/BF03259836.
7
Role of extracorporeal drug removal in acute theophylline poisoning. A review.体外药物清除在急性茶碱中毒中的作用。综述。
Med Toxicol Adverse Drug Exp. 1987 Jul-Aug;2(4):294-308. doi: 10.1007/BF03259871.
8
Theophylline poisoning--a review of 64 cases.茶碱中毒——64例病例综述
Intensive Care Med. 1990;16(6):394-8. doi: 10.1007/BF01735178.
9
Adverse reactions and interactions with theophylline.
Drug Saf. 1990 Jul-Aug;5(4):275-85. doi: 10.2165/00002018-199005040-00004.
本文引用的文献
1
Role of dialysis in the management and prevention of theophylline toxicity. Commentary.透析在氨茶碱中毒管理与预防中的作用。评论
Dev Pharmacol Ther. 1980;1(1):26-30.
2
Haemoperfusion for theophylline overdose.血液灌流治疗茶碱过量。
Br Med J. 1980 May 10;280(6224):1167. doi: 10.1136/bmj.280.6224.1167.
3
4
Stimulation of endogenous catecholamine release by theophylline: a proposed additional mechanism of action for theophylline effects.
J Allergy Clin Immunol. 1982 Nov;70(5):377-82. doi: 10.1016/0091-6749(82)90028-8.
5
Hemoperfusion in drug overdosage: a technique when conservative management is not sufficient.药物过量时的血液灌流：一种在保守治疗不足时采用的技术。
Clin Toxicol. 1980 Nov;17(4):583-602. doi: 10.3109/15563658008990008.
6
Use of hemoperfusion for treatment of theophylline intoxication.血液灌流用于治疗茶碱中毒。
Am J Med. 1983 Jun;74(6):961-6. doi: 10.1016/0002-9343(83)90790-8.
7
Massive theophylline overdose. Survival without hemoperfusion.大剂量茶碱过量。未进行血液灌流而存活。
JAMA. 1982 Oct 8;248(14):1742.
8
Self-poisoning with sustained-release aminophylline: secondary rise in serum theophylline concentration after charcoal haemoperfusion.缓释氨茶碱自服中毒：血液灌流后血清茶碱浓度二次升高
Br Med J (Clin Res Ed). 1982 Mar 27;284(6320):943. doi: 10.1136/bmj.284.6320.943.
9
Enhancement of theophylline clearance by oral activated charcoal.口服活性炭对茶碱清除率的提高作用。
Clin Pharmacol Ther. 1983 Mar;33(3):351-4. doi: 10.1038/clpt.1983.44.
10
Effect of intravenous aminophylline on plasma levels of catecholamines and related cardiovascular and metabolic responses in man.静脉注射氨茶碱对人体血浆儿茶酚胺水平及相关心血管和代谢反应的影响。
Circulation. 1983 Jan;67(1):162-71. doi: 10.1161/01.cir.67.1.162.
Zotero 插件