复方妥英麻黄茶碱片致苯妥英中毒4例

Compound phenytoin sodium,ephedrine hydrochloride and theophylline tablets-induced phenytoin poisoning in four patients

4例有哮喘症状的患者,男、女各2例,年龄54～65岁,口服复方妥英麻黄茶碱片4～9片/d,每片含苯妥英钠50mg,每日总剂量为200～450mg,服药时间1～4年。服药期间患者逐渐出现头晕、眼球震颤、步态不稳等症状及小脑性共济失调的体征。检测苯妥英血药浓度34.15～94.12μg/mL,为治疗血药浓度的1.7～4.7倍,诊断为苯妥英钠中毒。停用复方妥英麻黄茶碱片,4～7d后患者中毒症状消失。2例患者复查血药浓度,分别降至1.03、1.14μg/mL。

Four patients with asthma,2 men and 2 women aged 54-65 years,received 4-9 compound phenytoin sodium,ephedrine hydrochloride and theophylline tablets daily,each tablet contains phenytoin sodium 50 mg,the total daily dosage of phenytoin sodium was 200-450 mg,and the duration of treatment was 1-4 years,they developed dizziness,nystagmus,gait instability and signs of cerebellar ataxia during treatment.Laboratory tests showed that the blood phenytoin concentrations were 34.15-94.12 μg/mL and that were 1.4-4.7 times the therapeutic blood concentration.They were diagnosed with phenytoin poisoning.The tablets were discontinued.Four to seven days later,their manifestations mentioned above disappeared.On re-examination,two patient＇s blood phenytoin concentrations decreased to 1.03 μg/mL and 1.14 μg/mL,respectively.