米诺地尔中毒1例。

Tetsuya Takahashi, Tetsuhiro Takei, Toshitaka Ito, Kazunari Sakamoto, Takeshi Nara, Keiichi Yagi
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引用次数: 0

摘要

一名26岁男子在口服120毫升RiUP X5®(含5克/100毫升米诺地尔)企图自杀后被发现无法移动。病人抱怨经常呕吐和虚弱被转到我们医院。到达时发现:GCS E4V5M6;呼吸频率24/ min;血压83/43 mmHg;脉冲152/min,常规;SpO₂97%(面罩氧气:6l /min);因此,病人处于休克状态。快速静脉滴注乳酸林格氏液2000 mL后,收缩压和脉搏率分别提高到约90 mmHg和约130/min。单靠肠外输液,他的循环系统有改善的趋势。然而,入院后40小时,由于过量静脉输液和与血管平滑肌松弛延迟相关的异常体液分布而发生心力衰竭;因此,机械通气开始了。同时,由于血压下降,开始静脉输注去甲肾上腺素。随后,随着患者呼吸和循环状况逐渐好转,停用机械通气,并于入院后108小时停用去甲肾上腺素输注。患者病情好转,于住院第9天出院。米诺地尔主要对心血管系统产生不良影响。由于米诺地尔是一种非处方药,公众很容易买到,急诊医生应该意识到它的严重毒性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case of minoxidil intoxication].

A 26-year-old man was found unable to move after oral consumption of 120 mL of RiUP X5® (containing 5 g/100 mL minoxidil) as a suicidal attempt. The patient complaining of frequent vomiting and weakness was transferred to our hospital. Findings on arrival: GCS E4V5M6; respiratory rate 24/ min; blood pressure 83/43 mmHg; pulse 152/min, regular; SpO₂97% (oxygen by mask: 6 L/min); thus, the patient was in shock. The systolic blood pressure and the pulse rate improved to about 90 mmHg and to about 130/min, respectively, in response to rapid intravenous infusion of 2,000 mL of lactated Ringer's solution. His circulatory condition tended to improve with parenteral fluid infusion alone. Forty hours after admission, however, heart failure developed due to excessive I.V. fluid infusion and abnormal body fluid distribution associated with delayed vascular smooth muscle relaxation; therefore, mechanical ventilation was initiated. Simultaneously, intravenous noradrenaline infusion was started because of a fall of the blood pressure. Subsequently, as the patient's respiratory and circulatory conditions gradually improved, he was weaned from mechanical ventilation, and the noradrenaline infusion was discontinued at 108 hours after admission. The patient made favorable progress and was discharged home on the 9th hospital day. Minoxidil exerts adverse effects mainly on the cardiovascular system. Since minoxidil is an over-the-counter drug readily available to the public, and emergency physicians should be aware of its severe toxicity.

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