Gentamicin-Induced Serum Electrolytes Abnormalities

Gentamicin所造成的血清電解質異常

簡陳榮(Chen-Lung Chien) ； 陳炎勳(Yan-Shiun Chen) ； 師明哲(Min-Tsir Shih) ； 李家琨(Chia-Koon Lee) ； 黃漢文(Han-Wen Huang)

《Journal of Medical Sciences》 5卷3期 (1984/06) Pp. 1997-2002

摘要

我們深知病人在長期且大量地使用Gentamicin後，易造成第八對腦神經和腎臟的傷害。至於因使用Gentamicin而造成血清電解質異常的現象，文獻上的報告並不多見。本院有一婦癌病人在手術後發生泌尿道感染而使用Gentamicin治療，在用藥一段時間後，病人因腎臟鎂離子和鉀離子的流失而造成血鎂，血鈣和血鉀過低的現象；但在Gentamicin停止使用一個月以後，病人腎臟鎂離子和鉀離子不再流失，故血鎂、血鈣和血鉀濃度都回復到正常值。這是一個病人用Gentamicin而造成血清電解質異常的典型病例。由這個臨床經驗，提醒我們若病人須長期且大量地使用Gentamicin，則須時常測其血鎂、血鈣和血鉀的濃度，一有異常即應停止使用Gentamicin，以免造成嚴重的併發症。

並列摘要

The syndrome of hypomagnesemia. hypocalcemia and even hypokalemia occurs in neonatal tetany (1), in acute and chronic alcoholism (2), during long-term dietary magnesium deprivation (3) and with certain drugs, such as gentamicin, crpreomycin and viomycin (4-6).We recently observed a patient developed hypomagnesemia, hypocalcemia and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin for postoperative urinary tract infection. One month after the discontinuation of gentamicin therapy, renal loss of magnesium and potassium ceased, and serum magneuim, calcium and potassium returned toward normal.This patient represents an example of hypomagnesemic hypocalcemia and hypokalemia induced by inappropriate magnesuria and hyperkaluria, possibly caused by gentamicin. The nature of these electrolytes disturbances warrants the monitoring of serum magnesium, potassium and calcium in those patients who receive large doses of gentamicin.