Severe hyperphosphatemia induced by a phosphate-containing oral laxative
Severe hyperphosphatemia induced by a phosphate-containing oral laxative
复制标题
DOI：
10.1177/106002809603000206
复制
发表时间：
1996-02-01
影响因子：
2.9
通讯作者：
Lassman, MN
中科院分区：
文献类型：
--
作者：
Peixoto, AJ;Lassman, MN
目的：描述一个严重的高磷血症的情况下，无意中过量与口服磷酸盐泻药，并提高注意使用这种药物在老年人的风险。病例摘要：一个84岁的白色妇女承认混乱8小时后，无意中摄入1/2液盎司的舰队磷苏打（而不是规定的1 1/2液盎司）前结肠镜检查。她的血清磷酸盐和离子钙浓度分别为10.3 mmol/L和0.56 mmol/L。她保守治疗与口服磷酸盐结合剂，并取得了平安无事的recovery.Discussion：以前的几份报告已经描述了高磷血症与磷酸盐泻药，特别是在肾脏或结肠疾病的患者。我们的病例再次提出了老年人使用磷酸盐泻药的两个重要问题：（1）经常被忽视的潜在肾功能不全，尽管血清肌酐值“正常”，但肾磷酸盐处理可能受损;（2）老年人药物滥用和依从性差的可能性。结论：在老年人中使用磷酸盐泻药时应谨慎，因为可能会产生潜在的严重代谢异常。
OBJECTIVE: To describe a case of severe hyperphosphatemia following unintentional overdosage with an oral phosphate laxative, and raise attention to the risks of using such medications in the elderly.CASE SUMMARY: An 84-year-old white woman was admitted with confusion 8 hours after inadvertently ingesting 12 fluid ounces of Fleet Phospho-Soda (instead of the prescribed 1 1/2 fluid ounces) prior to a colonoscopy. Her serum phosphate and ionized calcium concentrations were 10.3 mmol/L and 0.56 mmol/L, respectively. She was treated conservatively with oral phosphate binders and made an uneventful recovery.DISCUSSION: Several previous reports have described hyperphosphatemia in association with phosphate laxatives, especially in patients with renal or colonic disease. Our case again presents two important issues in the use of phosphate laxatives by the elderly: (1) the frequently overlooked underlying renal insufficiency in which, despite ''normal'' serum creatinine values, renal phosphate handling may be impaired; and (2) the potential for drug misuse and poor compliance in the elderly.CONCLUSIONS: Caution should be taken with the use of phosphate laxatives in the elderly in the face of potentially serious metabolic abnormalities that may be generated.