急性Zopiclon（Imovne（上標®））藥物過量的臨床經驗

Clinical Experience of Acute Zopiclone(Imovne(superseript ®)) Overdose

侯民波(Min-Po Ho) ； 楊振昌(Chen-Chang Yang) ； 鄧昭芳(Jou-Fang Deng)

《中華民國急救加護醫學會雜誌》 9卷2期 (1998/06) Pp. 59-66

https://doi.org/10.30018/JECCM.199806.0003

摘要

Zopiclone（Imovne（上標®））為新一代的非苯重氮基鹽類安眠藥物，在臨床上的用途主要為治療一般失眠及手術前之安眠給藥。Zopiclone近年來在臺灣地區雖然使用量逐浙增多，但其中毒症狀仍不十分清楚。為瞭解台灣地區因Zopiclone過量而引起的毒性症狀及臨床處理，回顧了臺北榮民總醫院毒藥物防治診詢中心在1994年4月至1997年7月問，所有因服用zopiclone而中毒的個案。在這期間共有17名服用zopiclone過量的個案，但在扣除掉7名基本資料不全、服用劑量未知或無法追蹤的個案後，其他10名個案之症狀主要呈現嗜睡、全身無力、昏迷等類似傳統苯重氮基鹽類安眠藥物過量之症狀。在10名個案中，有8人併服酒精或其他藥物，且有2人初始時產生嚴重的症狀，但最終並無死亡個案。對於zopiclone藥物過量的治療，主要為觀察及支持性療法，另有3名病患曾接受flumazenil注射，且有良好反應。這10名病患的症狀大多數皆在2天內即消失，且未產生任何的後遺症。由本研究可知zopiclone之中毒症狀多半很輕微，除非產生併發症，否則其預後應相當良好。

關鍵字

苯重氮基鹽類安眠藥物 ； γ-aminobutyric acid(GABA) ； flumazenil(Anexate (superseript ®)) ； 藥物過量 ； zopiclon(Imovne(superseript ®))

並列摘要

Zopiclone ((Imovane (superseript ®)) is a new non-benzodiazepine hypnotic which has been used in the treatment of insomnia and preoperative sedation. Although it is gaining popularity in Taiwan, its toxic effects remain unclear. To better understand the clinical features and management of zopiclone overdose, we conducted a retrospective study on patients with zopiclone overdose reported to the poison center in the Veterans General Hospital-Taipei between April, 1994 and July, 1997. Totally 17 patients were recorded. After excluding 7 patients with inadequate general information, unknown ingested doses or lost follow-up, the major manifestations of the other 10 patients were symptoms mimicking benzodiazepine overdoses, e.g. drowsiness, generalized weakness, and coma. No fatality was recorded in this study although 8 out of 10 patients coingested alcohol or various drugs and 2 of them initially presented with severe symptoms. Management of zopiclone overdose comprises mainly observation and supportive measures. Flumazenil has been used in 3 patients with a good response and the majority of patients with zopiclone overdose recovered well within 2 days without any sequelae. Based on the findings of this study and literature reports, it is concluded that zopiclone overdose usually results in only mild toxicity. A good outcome should therefore be anticipated unless there are concomitant major complications.

並列關鍵字

benzodiazepines ； y-aminobutyric acid (GABA), flumazeni1(Anexate(superseript ®)) ； drug overdose ； zopiclone (Imovne(superseript ®))