中国药物警戒 ›› 2024, Vol. 21 ›› Issue (2): 204-207.
DOI: 10.19803/j.1672-8629.20230190

• 安全与合理用药 • 上一篇    下一篇

氨氯地平过量致多器官功能障碍综合征1例分析

郭清华1, 彭笑笑1, 朱萍1, 刘西霖1, 杨颖华1, 陈志海2,*   

  1. 1首都医科大学大兴教学医院急诊科,北京 102600;
    2首都医科大学附属北京地坛医院感染性疾病临床中心,北京100102
  • 收稿日期:2023-03-31 出版日期:2024-02-15 发布日期:2024-02-06
  • 通讯作者: *陈志海,男,主任医师,感染性疾病。E-mail: chenzhihai0001@126.com
  • 作者简介:郭清华,女,副主任医师,急诊医学与全科医学。
  • 基金资助:
    国家重点研发计划（2022YFF1203201）

One case of multiple organ dysfunction syndrome caused by amlodipine overdose

GUO Qinghua1, PENG Xiaoxiao1, ZHU Ping1, LIU Xilin1, YANG Yinghua1, CHEN Zhihai2,*   

  1. 1Emergency department, Daxing Teaching Hospital, Capital Medical University, Beijing 102600, China;
    2Clinical Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
  • Received:2023-03-31 Online:2024-02-15 Published:2024-02-06

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摘要： 目的 强调独居老人氨氯地平的规范化使用,提高临床医生对药品不良反应或过量的认识。方法 分析1例独居老人氨氯地平过量引起多器官功能障碍综合征（MODS）的临床资料,查阅国内外相关案例报道,总结临床特征、治疗方法和预后。结果 氨氯地平过量可能会引起MODS,主要表现为心率减慢、严重的心肌抑制、高乳酸血症、难治性休克、肝肾功能不全。治疗方法以停用责任药物,脏器功能支持为主,包括呼吸支持、循环支持、肾脏替代治疗等。结论 氨氯地平在特殊人群中存在MODS风险,对于不明原因MODS患者要警惕药品不良反应或过量中毒的风险,尽早识别并采取相应的治疗措施可改善预后。

关键词: 氨氯地平, 中毒, 多器官功能障碍综合征, 药品不良反应, 血浆置换, 体外膜氧合, 过量

Abstract: Objective To emphasize the standardized use of amlodipine in the elderly living alone, and to improve clinicians’ awareness of adverse drug reaction or overdose. Methods The clinical data of a case of multiple organ dysfunction syndrome (MODS) caused by amlodipine overdose in an old man living alone was analyzed, relevant case reports at home and abroad were reviewed, and the clinical features, treatment methods and prognosis were summarized. Results Amlodipine overdose may cause MODS, mainly manifested as slow heart rate, severe myocardial depression, hyperlactic acidemia, refractory shock, liver and kidney insufficiency, and the treatment method is to stop the responsible drug and support the organ function. Conclusion Amlodipine has the risk of MODS in special populations. For patients with MODS of unknown cause, we should be alert to the risk of adverse drug reactions or overdose poisoning. Early identification and corresponding treatment measures can improve the prognosis.

Key words: amlodipine, poisoning, multiple organ dysfunction syndrome, adverse drug reaction, plasma exchange, extracorporeal membrane oxygenation, overdose

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