Dettloff R W, Touchette M A, Zarowitz B J
Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI.
Ann Pharmacother. 1993 Jun;27(6):781-4. doi: 10.1177/106002809302700620.
To report the unusual and poorly understood occurrence of vasopressor-resistant hypotension following a suicidal ingestion of theophylline.
Single case report.
Eight-bed, respiratory intensive care unit in a 937-bed teaching hospital.
A 52-year-old man with a past medical history significant only for hypertension.
The additive influence of markedly elevated theophylline serum concentrations, status epilepticus, and vasopressor-resistant hypotension was associated with the patient's death. Intravenous dosages of epinephrine, norepinephrine, and phenylephrine (ranges 160-210, 32-105, and 200-250 micrograms/min, respectively) were ineffective in controlling the patient's dramatic hypotension.
In addition to the usual metabolic abnormalities and central nervous system effects seen in theophylline poisoning, severe hypotension can occur and prove resistant to commonly used vasopressors. Early identification and treatment of theophylline poisoning is warranted to prevent the development of severe sequelae.
报告因自杀性摄入茶碱后出现的不常见且了解甚少的对血管升压药抵抗的低血压情况。
单病例报告。
一家拥有937张床位的教学医院的八床位呼吸重症监护病房。
一名52岁男性，既往病史仅高血压较为显著。
血清茶碱浓度显著升高、癫痫持续状态以及对血管升压药抵抗的低血压的叠加影响与患者死亡相关。静脉注射肾上腺素、去甲肾上腺素和去氧肾上腺素（分别为160 - 210、32 - 105和200 - 250微克/分钟）均无法有效控制患者严重的低血压。
除了茶碱中毒常见的代谢异常和中枢神经系统效应外，还会出现严重低血压，且对常用血管升压药有抵抗性。有必要尽早识别和治疗茶碱中毒，以防止严重后遗症的发生。
