摘要
1例61岁女性患者因发热静脉滴注莫西沙星0.4 g，1次/d，静脉滴注74 min时患者突然双眼向右侧凝视，全身抽搐，颜面苍白，牙关紧闭，意识丧失，小便失禁。症状呈阵发性发作，每次发作持续3-4 s，1 min内共发作3次。心电图显示频发多源性室性早搏、短阵尖端扭转室性心动过速、心室扑动。立即停用莫西沙星，给予0.9%氯化钠注射液250 ml＋氯化钾0.7 g＋硫酸镁1.25 g静脉滴注。46 min后患者神志转清，心电监护示窦性心率，未见早搏。患者既往有精神分裂症史36年，长期服氯丙嗪（400 mg/d）。停用莫西沙星、氯丙嗪，先后给予哌拉西林钠舒巴坦钠、头孢他啶、奥氮平，患者发热消退。此后住院治疗20 d内未再出现尖端扭转型室性心动过速。
An 61-year-old woman with fever received an IV infusion of moxifloxacin 0. 4 g once daily. Seventy-four minutes after IV infusion,the patient stared at her right side,convulsions over the body, pallor,gnathospasmus,loss of consciousness and incontinentia urinae suddenly. Totally 3 paroxysmal attacks occurred,each persisted for 3-4 seconds in a minute. Electrocardiogram showed frequent ventricular premature beats,short array torsades de pointes ventricular tachycardia and ventricular flutter. Moxifloxacin was withdrawn immediately. She received an IV infusion of 0. 9% sodium chloride injection 250 ml plus potassium chloride 0. 7 g and magnesium sulfate 1. 25 g. Forty-six minutes later the patient regained consciousness,electrocardiographic monitoring showed sinus rhythm and the premature beat disappeared. The patient had a history of 36 years of schizophrenia and took chlorpromazine 400 mg/d for long time. The patient＆#39;s fever disappeared after moxifloxacin and chlorpromazine withdrawal and receiving piperacillin sodium and sulbactam sodium,ceftazidime,and olanzapine successively. After that her torsades de pointes did not recur in twenty days of hospitalization.
出处
《药物不良反应杂志》
CSCD
2014年第5期314-316,共3页
Adverse Drug Reactions Journal
关键词
莫西沙星
心动过速
室性
Moxifloxacin
Tachycardia,ventricular
