停用替扎尼定致血压反跳性升高  

Rebound hypertension following withdrawal of tizanidine

作　　者：董燕[1] 

机构地区：[1]武警浙江总队杭州医院康复二科,310051

出　　处：《药物不良反应杂志》2013年第5期292-293,共2页Adverse Drug Reactions Journal

摘　　要：1例69岁女性高血压病患者因脑外伤后肌痉挛给予替扎尼定口服。用药前血压135~174/73~90 mm Hg（1 mm Hg=0.133 kPa）,心率60~80次/min。替扎尼定剂量增至4 mg、3次/d的第2天,患者心率降至45次/min,停用替扎尼定。次日,患者血压180/100 mm Hg,心率120次/min。予卡托普利、硝苯地平调整血压、心率,效果不佳。给予替扎尼定2 mg,约1 h后,患者血压124/69mm Hg、心率65次/min。20 d后,因患者下肢肌张力偏高再次给予替扎尼定2 mg。半小时后,血压降至60/40 mm Hg,应用间羟胺后血压恢复正常。次日血压再次升至180/100 mm Hg。予苯磺酸氨氯地平、厄贝沙坦、卡托普利、硝苯地平联合降压,血压逐渐稳定。A 69-year-old woman with hypertension received oral tizanidine for muscle spasm due to traumatic brain injury.Her blood pressure was 135-174/73-90 mm Hg and heart rate was 60-80 beats/min before using the medicine.The dosage of tizanidine was increased to 4 mg thrice daily and,on day 2,her heart rate decreased to 45 beats/min.Tizanidine was stopped.The next day,her blood pressure was 180/100 mm Hg and heart rate was 120 beats/min.Captopril and nifedipine were given to adjust blood pressure and heart rate,but the effect was not good.Tizanidine 2 mg was given.About an hour later,her blood pressure was 124/69 mm Hg and heart rate was 65 beats/min.Twenty days later,tizanidine 2 mg was given again for hypermyotonia of lower extremity.Half an hour later,her blood pressure decreased to 60/40 mm Hg.Metaraminol was given and then the blood pressure returned to normal.Her blood pressure increased to 180/100 mm Hg again on the following day.The blood pressure tended to be stable gradually by concomitant use of amlodipine besylate,irbesartan,captopril and nifedipine.

关 键 词：替扎尼定 血压 心率 

分 类 号：R595.3[医药卫生—内科学]