Lipid therapy for serotonin syndrome after intoxication with venlafaxine, lamotrigine and diazepam.
Lipid therapy for serotonin syndrome after intoxication with venlafaxine, lamotrigine and diazepam.
复制标题
文拉法辛、拉莫三嗪和地西泮中毒后的血清素综合征的脂质治疗。
作者：
O. Dagtekin;H. Marcus;C. Müller;B. Böttiger;F. Spöhr
一名44岁的女性发生昏迷和癫痫发作活动后，故意摄入200毫克地西泮，20克拉莫三嗪和4.5克文拉法辛。在我们的重症监护室中，观察到明显的僵硬和反射亢进。这种状态不受入院后直接开始的血液透析的影响。在开始血液透析前测定摄入药物的血浆浓度（560 µg/L地西泮、42.4 mg/L拉莫三嗪和1254 µg/L文拉法辛）。血液透析开始后8小时，静脉推注150 mL（2.5 mL/kg）20%脂肪乳剂。在给予脂质输注后不久，明显的僵硬和反射亢进消失。接下来的过程平安无事。
A 44-year-old woman developed coma and seizure activity after intentional ingestion of 200 mg diazepam, 20 g lamotrigine and 4.5 g venlafaxine. In our intensive care unit a distinct rigidity and hyperreflexia was observed. This status was not influenced by haemodialysis which was initiated directly after admission. Plasma concentrations of the ingested drugs were determined before hemodialysis was started (560 µg/L diazepam, 42.4 mg/L lamotrigine and 1254 µg/L venlafaxine). Eight hours after the start of haemodialysis a 150 mL (2.5 mL/kg) intravenous bolus of 20% lipid emulsion was given. Soon after administration of the lipid infusion the distinct rigidity and hyperreflexia disappeared. The further course was uneventful.