去乙酰毛花苷和胺碘酮及呋塞米联用相关神志不清

Obnubilation associated with concomitant use of deslanoside,amiodarone,and furosemide

1例20岁男性患者因心力衰竭给予去乙酰毛花苷注射液0.4 mg,2次/d静脉滴注,胺碘酮注射液75 mg缓慢静脉注射后以1 mg/min持续泵入,呋塞米注射液20 mg,1次/d静脉滴注。治疗第3天患者出现神志不清、嗜睡,血压78/36 mm Hg(1 mm Hg=0.133 kPa),立即给予多巴胺、尼可刹米、洛贝林,并行呼吸机辅助呼吸等治疗。当日检测地高辛血药浓度高达7.3μg/L,停用去乙酰毛花苷、胺碘酮、呋塞米。鼻饲苯妥英钠片0.1 g,3次/d,治疗5 d后患者地高辛血药浓度降至0.82μg/L。

A 20-year-old man with heart failure received anⅣinfusion of deslanoside 0.4 mg twice daily,a slow intravenous injection of amiodarone 75 mg and then a continuous infusion of 1 mg/min via a pump,and furosemide 20 mg once daily.On day 3 of treatment,he developed obnubilation and somnolence,his blood pressure was 78/36 mm Hg.Dopamine,nikethamide,lobeline were given immediately,meanwhile he was placed on a respirator for assisted respiration.On the same day,his blood digoxin level reached 7.3μg/L.Deslanoside,amiodarone,and furosemide were stopped,nasal administration of phenytoin sodium 0.1 g was given three times daily.On day 5,his blood digoxin level decreased to 0.82μg/L.