Obtundation and seizure following ondansetron overdose in an infant
Obtundation and seizure following ondansetron overdose in an infant
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DOI：
10.1080/15563650802304401
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发表时间：
2008-12-01
影响因子：
3.3
通讯作者：
Shannon, Michael Wayne
中科院分区：
文献类型：
--
作者：
George, Mathew;Al-Duaij, Nadeem;Shannon, Michael Wayne
导论.昂丹司琼是一种越来越多地用于治疗各种病因的恶心和呕吐的5-HT 3拮抗剂，在治疗用途中具有良好的安全性。然而，很少有人知道它的影响，在设置一个过量。我们描述了第一例婴儿无意中摄入大量昂丹司琼的严重毒性。病例报告。一名12个月大的婴儿服用了7至8片母亲的枢复宁（昂丹司琼）ODT 8 mg，迅速出现迟钝和肌阵挛运动。在接受医疗保健提供者治疗期间，他出现癫痫发作、肝毒性、QTc间期延长和5-羟色胺综合征，需要气管插管和重症监护室管理。通过支持性护理，他的临床状况在24小时内得到改善，并出院回家，没有留下后遗症。讨论随着昂丹司琼在卫生保健提供者中的日益普及，特别是用于控制孕妇的恶心，家庭中的幼儿可能会无意中暴露于昂丹司琼毒性。该病例表明，尽管该药物在治疗剂量下安全，但过量时可能会出现严重毒性，特别是在婴儿中。结论卫生保健提供者应认识到昂丹司琼过量后急性毒性的风险，特别是在婴儿和幼儿中。
Introduction. Ondansetron, an increasingly prescribed 5-HT3 antagonist used in the management of nausea and vomiting of various etiologies, has a well-established safety profile in therapeutic use. However, little is known about its effects in the setting of an overdose. We describe the first case of severe toxicity in an infant who unintentionally ingested a large quantity of ondansetron. Case report. A 12-month-old infant who ingested seven to eight tablets of his mother's Zofran (ondansetron) ODT 8 mg rapidly developed obtundation and myoclonic movements. While treated by health care providers, he developed seizures, hepatotoxicity, QTc prolongation, and a serotonin syndrome that required endotracheal intubation and intensive care unit management. His clinical status improved over the course of 24 h with supportive care, and he was discharged to home with no sequelae. Discussion. With the increasing popularity of ondansetron among health care providers, particularly for the control of nausea in pregnant women, toddlers in the household may become inadvertently exposed to ondansetron toxicity. This case portrays that, despite the safety of this agent in therapeutic dosage, severe toxicity may be seen in excessive amounts, particularly in infants. Conclusion. Health care providers should recognize the risk for acute toxicity following ondansetron overdose, particularly in infants and toddlers.