PHENYTOIN-INDUCED HYPERGLYCEMIA
PHENYTOIN-INDUCED HYPERGLYCEMIA
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DOI：
10.1093/ajhp/38.10.1508
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发表时间：
1981-01-01
期刊：
影响因子：
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通讯作者：
STARKMAN, MT
中科院分区：
文献类型：
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作者：
CARTER, BL;SMALL, RE;STARKMAN, MT
一例糖尿病酮症酸中毒在一个64岁的黑人妇女与成熟发作的糖尿病接受苯妥英癫痫发作障碍报告。患者入院时有1天多尿和渴渴病史。入院前10个月，每日使用27单位异硫芬胰岛素混悬液控制糖尿病。她还口服苯妥英100毫克，每天三次。这是在大约六周前的一次非酮症性高渗性昏迷住院期间通过脑电图检测到的右侧局灶性癫痫的处方。没有服用其他药物。病人接受静脉输液和间歇性注射胰岛素治疗。患者病情迅速好转，出院时给予胰岛素锌混悬液每日35单位。苯妥英停用是因为癫痫发作障碍被认为是继发于先前的高渗性昏迷发作。本文对苯妥英引起的高血糖症进行了文献综述，包括以前的病例报告、可能的作用机制、监测指南和潜在的治疗用途。如果服用苯妥英的患者出现高血糖，特别是在开始苯妥英治疗或增加剂量后，应将药物性高血糖纳入鉴别诊断。
A case of diabetic ketoacidosis in a 64-year-old black woman with maturity-onset diabetes receiving phenytoin for a seizure disorder is reported.The woman was admitted to the hospital with a one-day history of polyuria and polydipsia. For the 10 months before admission, her diabetes was controlled with isophane insulin suspension 27 units daily. She also took phenytoin 100 mg orally three times a day. This was prescribed approximately six weeks earlier for right-sided focal seizures that were detected by electroencephalogram during a previous hospitalization for nonketotic hyperosmolar coma. No other medications were taken. The patient was treated with i.v. fluids and intermittent doses of i.v. insulin. Her condition rapidly improved and insulin zinc suspension 35 units daily was prescribed on discharge. Phenytoin was discontinued because the seizure disorder was considered secondary to the previous episode of hyperosmolar coma.A literature review of phenytoin-induced hyperglycemia is presented, including previous case reports, possible mechanisms of action, monitoring guidelines, and potential therapeutic uses.If hyperglycemia occurs in a patient taking phenytoin, especially after starting phenytoin therapy or increasing the dose, drug-induced hyperglycemia should be considered in the differential diagnosis.