查詢結果分析
來源資料
頁籤選單縮合
題名 | 組織胺第二型接受體拮抗劑引發之譫妄:四例報告=Delirium Caused by H[feaf]-Receptor Antagonists Treatment in Patients with Peptic Ulcer: Report of Four Cases |
---|---|
作者姓名(中文) | 曾國華; 蘇春霖; 吳東庭; 徐長庚; 陳喬琪; | 書刊名 | 臺灣精神醫學 |
卷期 | 11:3 1997.09[民86.09] |
頁次 | 頁94-98 |
分類號 | 415.981 |
關鍵詞 | 組織胺第二型接受體拮抗劑; 譫妄症; 扁豆素; H[feaf]-receptor antagonist; Delirium; Physostigmine; |
語文 | 中文(Chinese) |
中文摘要 | 目的︰Ranitidine與famotidine造成的譫妄症常常引起照會精神醫學上的注意,若停止該藥並給與扁豆素,則症狀很快就消失。病例報告︰個案甲與乙使用ranitidine引起譫妄症;而個案丙與丁使用famotidine引起譫妄症。停用該藥並給予扁豆素後,精神狀態皆迅速恢復正常。結論︰扁豆素0.3 mg至0.5 mg每1.5至2小時靜脈或肌肉注射(每天總量不超過2 mg),可以避免副作用,但仍然可以很有效地清除譫妄症狀。 |
英文摘要 | Objective: Four cases of H2 blocker induced delirium that were cleared up with repeated low dosage injections of physostigmine are reported. Case Reports: A 75-year-old man (patient A) suffered from gouty arthritis. As upper GI bleeding developed after high dosage treatment with NSAIDs, intravenous ranitidine 50 mg/8 hrs therapy was administered. Two days later, he was confused, disoriented, agitated, and restless all night. He was combative whenever the nursing staffs tried to restrain him in bed. A 60-year-old man (patient B) was admitted to the ICU because of congestive heart failure with pulmonary edema. Intravenous ranitidine 50 mg/8 hrs was administered to prevent stress ulcer. Three days later, he was very agitated, restless, confused, disoriented, and incoherent. He acted as though he had vivid auditory and visual hallucination. An 83-year-old man (patient C) who had received continous NSAIDs treatment for six years was admitted because of UGI bleeding. Two days after intravenous administration of famotidine 20 mg/12 hrs, he was delirious, confused, disoriented. He mumbled continuously and acted as though he was having vivid visual and auditory hallucination. A 76-year-old man (patient D) received total gastrectomy and B-Ⅱ anastomosis because of gastric cancer. Post-operatively, intravenous famotidine 20 mg/12 hrs was administered. Four days later, he was found to be confused and disoriented. He kept attempting to pull all the tubes and requested to leave his bed. As he became very agitated and violent, 20 drops of Haldol was given orally repeatedly at 30 minutes interval for 4 times without any success in calming him down. After cessation of H2 antagonist therapy and administration of physostigmine, symptoms of delirium disappeared completely. None of these patients experienced cholinergic side effects from physostigmine, therapy at a dose of 0.4~0.5 mg per 1.5 hours four or five times a day. The total daily dose did not exceed 2 mg/day. Conclusion: Due to high frequency of anticholinergic central toxicity caused by cimetidine, ranitidine and famotidine are utilized with increased frequency in recent years in the treatment of upper GI bleeding and the prevention of stress ulcer. However, our finding indicated that ranitidine and famotidine can too induce delirium, especially when they are administered parentally in elderly patients. Our successful treatment of these deliruious patients with physostigmine indicated that central toxicity in induced through their anticholinergic activity. Finally, cholinergic side effect of physostigmine can be minimized or avoided through repeated low dosage injections. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。