Diphenhydramine Overdose Related Delirium: A Case Report

抗組織胺過量引起譫妄：病例報告

侯民波(Min-Po Ho) ； 蔡光超(Kuang-Chau Tsai) ； 劉昌明(Chang-Ming Liu)

《中華民國急救加護醫學會雜誌》 17卷2期 (2006/06) Pp. 77-80

https://doi.org/10.30018/JECCM.200606.0005

摘要

服用過量抗組織臉藥物(diphenhydramine)，而中毒個案是在急診常見的急性中毒之一。它有抗乙醯膽鹼(anticholinergic)及鎮靜安眠的作用。根據以往的文獻報告指示服用抗組織安藥物包含局部的抗組織臉藥物引起妄想，錯覺，譫妄，寬波心搏過速，高體溫，抽搐，橫紋肌溶血症，抗乙醯膽鹼症候群等症狀。我們過有一位年輕女性病患服用二十四顆抗組織胺藥物(diphenhydramine)過量自殺，而引起譫妄的病例。雖然病患有接受早期治療包括臨床觀察及支持性療法，如洗胃，活性碳灌注及靜脈輸液等，但病患服用藥物後三小時出現混亂，迷失方向及短暫性記憶力喪失。這些症狀服用藥物後大約七小時時消失，且並無神經後遺症。

關鍵字

抗組織胺 ； 苯海拉明diphenhydramine, DPHM ； 譫妄 ； 過量

並列摘要

Diphenhydramine (DPHM) overdose is one of the most common causes of acute poisoning encountered in the emergency department. DPHM possesses both anticholinergic and sedative effects. Many authors have reported that topical and oral doses have led to hallucinatory psychosis, delirium, wide-complex tachycardia, hyperthermia, seizures and rhabdomyalysis, and the well-known anticholinergic syndrome has been well documented.
We report on a young female patient who presented with delirium after ingesting 24 pills (one pill contains 50 mg) of DPHM to attempt suicide. Although the patient was treated with early gastric emptying followed by activated charcoal and general supportive care, she developed mental confusion, disorientation and short-term memory loss three hours after ingestion of DPHM. These symptoms subsided about seven hours after ingestion without neuropsychiatric sequalae.

並列關鍵字

antihistamine ； diphenhydramine DPHM ； delirium ； overdose