多奈哌齐过量:10倍剂量错误。
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牧羊人G, Klein-Schwartz W,爱德华R
多奈哌齐过量:10倍剂量错误。
Jul-Aug安Pharmacother。1999; 33 (7 - 8): 812 - 5。
- PubMed ID
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10466911 (在PubMed]
- 文摘
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目的:报告多奈哌齐政府10倍后产生的毒性剂量错误。案例总结:一个79岁的白人养老院阿尔茨海默病和高血压史患者不经意间被50毫克的多奈哌齐,而不是她一贯5毫克剂量。她呈现给急诊室,恶心,呕吐,和持续的心动过缓(人力资源在40年代)。常规实验室研究都在正常范围内。基部的罗音指出五小时后到来。她用阿托品治疗心动过缓(人力资源<所需0.2毫克,50胜/分钟);总共3.0毫克管理超过18个小时。每丸使她对1/2小时> 60次/分两个小时。没有进一步的呕吐或证据在她首次发作后肺水肿的发生。她回到基线的第二天(HR在70年代),并返回到养老院。 DISCUSSION: Donepezil is a centrally acting, reversible cholinesterase inhibitor that is used in the treatment of Alzheimer disease. Donepezil is highly specific for neural acetylcholinesterases, preferentially binding acetylcholinesterase by greater than three orders of magnitude over butyrylcholinesterases. This specificity minimizes peripheral adverse effects at therapeutic doses. Our patient mainly experienced bradycardia and had minimal secretory effects compared with what is usually seen with nonspecific cholinesterase inhibition. Medication errors like the one that produced this overdose are a common but preventable cause of morbidity in healthcare facilities. CONCLUSIONS: A tenfold dosing error caused donepezil toxicity. The main effect of this overdose was bradycardia, which responded to atropine therapy.