螺内酯致乏力和嗜睡

Hypodynamia and lethargy caused by spironolactone

1例24岁男性继发性高血压病患者,为排除原发性醛固酮增多症而接受螺内酯的诊断性治疗,分别于午餐后、晚餐后、次日清晨口服螺内酯各20 mg。第1次服药后约3 h患者突然出现四肢乏力、眩晕、头痛,经卧床休息和吸氧,约30 min后症状缓解。第2次服药后3 h出现乏力。第3次服药后约2 h上述症状复现并伴嗜睡,2 h后自行缓解。停用螺内酯。5 d后患者于晚餐后口服螺内酯20 mg,服药后约2 h以及次日清晨再现眩晕、乏力及嗜睡,后自行缓解。

A 24-year-old male patient with secondary hypertension received a therapeutic trial （diagnostic treatment） with spironolactone in order to exclude primary aldosteronism. He was given oral spironolactone 20 mg after lunch, after dinner and the next morning, respectively. About 3 hours after taking the first dose, the patient developed weakness of limbs, dizziness, and headache. The patient underwent bed rest and oxygen inhalation. About 30 minutes later, his symptoms relieved. Three hours after taking the second dose, he developed weakness. About two hours after taking the third dose, the above-mentioned symptoms recurred, accompanied by lethargy. The symptoms relieved spontaneously 2 hours later. Spironolactone was withdrawn. Five days later, the patient was retreated with oral spironolactone 20 mg after supper. Two hours after the drug use and the next morning, dizziness, hypodynamia, and lethargy recurred. Then, the symptoms relieved spontaneously.