替尼泊苷注射液引起过敏性休克

Allergic shock following injection of teniposide

1例57岁女性患者,因右肺小细胞肺癌行第2次化疗。化疗前给予格拉司琼止吐、苯海拉明抗过敏。然后静脉滴注替尼泊苷注射液100mg+5%葡萄糖注射液250ml,60滴/min。用药约2min后,患者突然出现憋气、紫绀,随即意识丧失,呼吸、心跳停止。立即停药,给予心肺复苏、升压及抗过敏治疗。10min后患者呼吸、心跳恢复,HR150～160次/min,BP100/60mmHg,全身出现大面积红色皮疹。继续给予抗过敏、抗休克等治疗。12h后皮疹消退,17h后患者清醒,一般状况好转。

A 57-year-old woman was scheduled to undergo the second cycle of chemotherapy for right small cell lung cancer. She was given granisetron and diphenhydramine for pretreatment. Then she received intravenous infusion of teniposide 100 mg dissolved in 250 ml of glucose injection 5% at a speed of 60 drops/min. About two minutes after initiation of the infusion, the patient suddenly developed breath holding and cyanosis, and then loss of consciousness, cardiac and respiratory arrest. The infusion was stopped immediately, and she was given cardiopulmonary resuscitation, elevation of blood pressure and anti-anaphylactic treatment. Ten minutes later, her respiration and heartbeat recovered. She had a heart rate of 150 - 160 beats/min and a blood pressure of 100/60 mmHg, A large area of red skin rash appeared on her body. The anti-allergic and anti-shock therapy was continued and her skin rash resolved after 12 hours. And 17 hours later, the patient＇s consciousness recovered and her general condition improved.