1例婴儿使用苯巴比妥和水合氯醛镇静导致中毒的病例分析

Toxicity caused by sedation of phenobarbital combined with chloral hydrate in an infant

药师对婴儿使用过量苯巴比妥和水合氯醛镇静的毒性进行分析。报道1例31日龄的男性婴儿,行头颅核磁共振检查(MRI)前口服10%水合氯醛5 mL,继以静脉注射苯巴比妥(20 mg·kg-1)一次后出现颜面苍白,伴口周发绀及四肢抖动等中毒症状。药师查阅资料,建议监测苯巴比妥药物浓度和CYP2C19代谢酶基因型,对两种镇静剂过量的毒性进行分析。支持治疗3 d后,患儿生命体征平稳,予以出院。药师通过对该病例的用药分析,为婴幼儿急性中毒事件的临床治疗方案提供了循证依据,为临床医师和患者提供个体化的药学服务。

Pharmacists analyzed the toxicity of overdose phenobarbital and chloral hydrate sedation in infants.A 31-day-old infant was reported to have orally administered of 5 mL 10%chloral hydrate before MRI,followed intravenous injection of phenobarbital 20 mg·kg-1.Pale face with perioral hair loss and poisoning symptoms such as limbs shaking were found.Pharmacists consulted the literature and recommended monitoring the phenobarbital drug concentration and the CYP2 C19 metabolic enzyme genotype to analyze the toxicity of the two sedatives in the infant.After 3 days of supportive treatment,the child’s vital signs were stable and discharged.In this case,pharmacists provided evidence for the clinical treatment of acute poisoning in infants,and individualized pharmacy service for clinicians and patients.