Sawyer D R, Conner C S, Rumack B H
Clin Pharm. 1982 Nov-Dec;1(6):529-33.
The symptomatology and management of toxicity caused by nonprescription stimulants is reviewed. Nonprescription stimulants contain (singly or in combination) the same basic active ingredients: caffeine 100-200 mg, phenylpropanolamine 25-50 mg, and ephedrine 25 mg. Generally, toxic reactions involve excessive CNS stimulation (e.g., increased motor activity, anxiety, and agitation) and mildly elevated pulse rate and blood pressure that resolve in six to eight hours without specific treatment. However, reactions following the ingestion of these stimulants have included severe hypertension, possible renal failure, cerebral hemorrhage, and cardiac arrhythmias. Neither ephedrine nor caffeine ingested as single entities have been reported to produce increases in blood pressure associated with end-organ damage; however, severe hypertension has followed therapeutic doses of phenylpropanolamine. General management in the overdosed patient involves establishing respiration, initiating emesis, administering activated charcoal and a cathartic, and monitoring the patient's blood pressure, ECG, fluid intake, and urinary output. The increased availability of tablets and capsules containing substantial quantities of phenylpropanolamine, caffeine, and ephedrine creates a potential for drug-induced morbidity and mortality.
本文综述了非处方兴奋剂所致毒性的症状及处理方法。非处方兴奋剂（单独或联合使用）含有相同的基本活性成分：咖啡因100 - 200毫克、苯丙醇胺25 - 50毫克和麻黄碱25毫克。一般来说，毒性反应包括过度的中枢神经系统刺激（如运动活动增加、焦虑和激动）以及轻度的脉搏率和血压升高，在六至八小时内无需特殊治疗即可缓解。然而，摄入这些兴奋剂后的反应包括严重高血压、可能的肾衰竭、脑出血和心律失常。单独摄入麻黄碱或咖啡因均未报告可导致与终末器官损害相关的血压升高；然而，治疗剂量的苯丙醇胺可导致严重高血压。对过量服用患者的一般处理包括建立呼吸、催吐、给予活性炭和泻药，并监测患者的血压、心电图、液体摄入量和尿量。含有大量苯丙醇胺、咖啡因和麻黄碱的片剂和胶囊的可获得性增加，造成了药物所致发病和死亡的可能性。
