Dawson J K, Earnshaw S M, Graham C S
St Helens Hospital, Prescot, Merseyside, UK.
J Accid Emerg Med. 1995 Mar;12(1):49-51. doi: 10.1136/emj.12.1.49.
The clinical course is described of a 28-year-old woman who was severely ill following ingestion of a Do-Do tablet (which consists of ephedrine, caffeine and theophylline), 24 h after discontinuing phenelzine treatment. Signs and symptoms were delayed for 8 h after which she developed encephalopathy, neuromuscular irritability, hypotension, sinus tachycardia, rhabdomyolysis and hyperthermia. Her illness was complicated by pneumonia and adult respiratory distress syndrome (ARDS). The management of monoamine oxidase inhibitor (MAOI) toxicity, which can arise from interactions and overdoses, is discussed. It should be remembered that, despite the increase in use of alternative and safer antidepressants, MAOI interactions still occur and unless they are managed appropriately, are potentially fatal. Patients need to be warned that restrictions apply for up to 2 weeks after stopping the medication, and doctors need to be aware that serious interactions can occur in this time period.
本文描述了一名28岁女性的临床病程。该患者在停用苯乙肼治疗24小时后，因服用一粒含有麻黄碱、咖啡因和茶碱的“多多”片剂而病情严重。体征和症状延迟出现8小时后，她出现了脑病、神经肌肉兴奋性增高、低血压、窦性心动过速、横纹肌溶解和高热。她的病情因肺炎和成人呼吸窘迫综合征（ARDS）而复杂化。本文讨论了单胺氧化酶抑制剂（MAOI）毒性的处理方法，这种毒性可能由相互作用和过量用药引起。应当记住，尽管使用替代性更安全的抗抑郁药的情况有所增加，但MAOI相互作用仍会发生，除非得到适当处理，否则可能会致命。需要警告患者，停药后长达2周都有相关限制，医生也需要意识到在此期间可能会发生严重的相互作用。
