儿童精神类药物中毒的救治及药学监护

Treatment and Pharmaceutical Care of Psychiatric Medication Poisoning in Children

目的:探讨儿童精神类药物中毒的解救及药学监护重点,为临床诊治提供参考。方法:回顾1例13岁男孩因过量服用盐酸舍曲林、利培酮及马来酸氟伏沙明而中毒的诊治过程,分析儿童精神类药物中毒的解救及药学监护重点。医师及临床药师根据精神药物中毒表现及代谢特点制定救治方案,由医师及临床药师共同开展药学监护,保障患儿治疗效果。结果:患儿出现头晕、呕吐、惊厥、心功能不全、呼吸衰竭等多系统症状,予以住院治疗。患儿住院后经洗胃、呼吸机辅助通气、血液净化等治疗后,血液药物浓度下降,自主呼吸恢复,惊厥、震颤等神经系统症状好转。结论:儿童精神类药物中毒有危及生命的风险,需要积极干预治疗,医师及临床药师共同参与药学监护能更好地保障治疗效果。

Objective:To explore the rescue and pharmaceutical care of psychotropic medication poisoning,so as to provide reference for clinical diagnosis and treatment.Methods:Diagnosis and treatment of poisoning caused by overdose of sertraline hydrochloride,risperidone and fluvoxamine maleate in a 13-year-old boy was reviewed,and the rescue and pharmacological care of psychiatric medication poisoning were analyzed.Clinicians and clinical pharmacists formulated treatment regimens according to the manifestations and metabolic characteristics of psychotropic medication poisoning,and jointly carried out pharmaceutical care to ensure the therapeutic effect of children.Results:The child developed multiple system symptoms such as dizziness,vomiting,convulsions,cardiac insufficiency and respiratory failure,and was hospitalized.After hospitalization,the child received treatment including gastric lavage,assisted ventilation with respirator and blood purification.The blood drug concentration decreased,spontaneous breathing resumed,and neurological symptoms such as convulsions and tremors were improved.Conclusion:There is a life-threatening risk of psychotropic medication poisoning in children,which requires active intervention and treatment,and the participation of clinicians and clinical pharmacists in pharmaceutical care can better ensure the treatment effect.