Adrenaline-resistant anaphylactic shock caused by contrast medium in a patient after risperidone overdose: a case report.

IF 1.2 Q4 PHARMACOLOGY & PHARMACY
Takafumi Nakano, Yoshihiko Nakamura, Keisuke Sato, Yoshito Izutani, Hiroto Iyota, Misaki Aoyagi, Taisuke Kitamura, Toshinobu Hayashi, Koichi Matsuo, Kenichi Mishima, Hidetoshi Kamimura, Hiroyasu Ishikura, Takashi Egawa
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引用次数: 1

Abstract

Background: In Japan, the use of risperidone in combination with adrenaline is contraindicated, except in cases of anaphylaxis. Therefore, there is limited clinical evidence regarding the interaction of these two drugs. Here, we report the clinical course of a case of adrenaline-resistant anaphylactic shock induced by a contrast medium injection after a risperidone overdose.

Case presentation: A man in his 30s was transported to our hospital after attempting suicide by taking 10 mg of risperidone and jumping from a height of 10 m. To determine the location and severity of his injuries, he was injected with an iodinated contrast medium, after which he developed generalized erythema and hypotension and was diagnosed with anaphylactic shock. A 0.5 mg dose of adrenaline was administered with no improvement, followed by another 0.5 mg dose that did not change his blood pressure. After infusion of a sodium bicarbonate solution (8.4%), administration of fresh frozen plasma, and additional administration of adrenaline (0.6-1.2 µg/min), his blood pressure improved, and he recovered from the anaphylactic shock.

Conclusions: This was a rare case of a risperidone overdose followed by adrenaline-resistant anaphylactic shock. The resistance is likely associated with the high blood concentration of risperidone. Our findings indicate that the potential for decreased adrenergic responsiveness should be considered in patients undergoing risperidone treatment in the event of anaphylactic shock.

Abstract Image

利培酮过量后造影剂引起的肾上腺素抵抗性过敏性休克1例报告。
背景:在日本,利培酮与肾上腺素联合使用是禁忌症,除了过敏反应的情况。因此,关于这两种药物相互作用的临床证据有限。在这里,我们报告一个病例的临床过程肾上腺素抵抗性过敏性休克后注射对比剂利培酮过量。病例介绍:一名30多岁男子服用10毫克利培酮,从10米高处跳下,企图自杀,被送往我院。为了确定他的损伤位置和严重程度,他被注射了碘造影剂,之后他出现全身红斑和低血压,并被诊断为过敏性休克。给他注射了0.5毫克肾上腺素,没有任何改善,随后又注射了0.5毫克肾上腺素,也没有改变他的血压。经输注碳酸氢钠溶液(8.4%)、新鲜冷冻血浆和额外肾上腺素(0.6-1.2µg/min)治疗后,患者血压有所改善,并从过敏性休克中恢复。结论:这是一个罕见的利培酮过量后出现肾上腺素抵抗性过敏性休克的病例。耐药可能与利培酮血药浓度高有关。我们的研究结果表明,在接受利培酮治疗的患者发生过敏性休克时,应考虑肾上腺素能反应性降低的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
29
审稿时长
8 weeks
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