摘要
一個年齡十一歲,有氣喘病史的男孩,在與父母爭 吵後,吞了十顆phyllocontin (2.250mg theophylline)意圖自殺。一小時左右之後,發生腹部劇烈疼痛與合膽汁的 嘔吐,接著他被送到急診處。當時心跳加快(每分鐘140 下) ,血糖上升(174mg/dL) ,白血球上升13.150/mm3,血鉀降低(2.8 mEq/L) ,心電圖顯示沒有心率不整。當時我們給予病人插鼻胃管,使用生理食鹽水洗胃,並給予活性碳吸附毒物。當時theophylline的血中濃度為9.2 ug/mL，在治療後的20小時後血中濃度為23.8 ug/mL，估計發生在食後第8小時之血中最高theophylline濃度為66.7ug /mL。此病患在我們治療後情況改善,於三天後出院,沒有其他的後遺症。我們提出此病例是要提醒大 家,茶鹼類的藥物如果食用過量還是有致死的可能。不管已經服藥多久,都必須要給予活性碳吸附毒物。如果 病人病情不佳或沒有好轉,則需考慮、使用血液透析治療。
並列摘要
An 11-year-old boy, a patient of bronchial asthma, took 10 tablets of phyllocontin (2,250 mg aminophylline in total) as a suicide attempt after an argument with his parents was reported. Severe intermittent abdominal pain and intractable bilious vomiting were noted one hour later. He was soon brought to our ER, where sinus tachycardia (140 beats/min), hyperglycemia (174 mg/dl), leukocytosis (13, 150/mm3) and hypokalemia (2.8 mEq/L) were noted. Electrocardiography showed sinus tachycardia. Immediate gastric irrigation followed by active charcoal and MgSO4 lavage through nasogastric tube was given. Serum theophylline level was 9.2 ug/mL at 3 hours and 23.8 ug/mL at 20 hours after the suicide-attempt swallowing. The patient recovered without any sequel after supportive care. Theophylline intoxication can result in morbidity and mortality. Those who take theophylline for anti-asthma treatment should be carefully guarded to avoid intoxication. In case theophylline intoxication has happened, active charcoal can be applied to alleviate theophylline intoxication. Hemodialysis can be the alternative therapeutic choice if the patient’s condition is still unstable after initial treatment.