阿米替林联用艾司唑仑引起COPD急性加重患者严重呼吸抑制致死亡  

Severe respiratory depression induced by combined use of amitriptyline and estazolam caused death in a patient with chronic obstructive pulmonary disease acute exacerbation

作　　者：刘高辉[1] 吴友根[1] 龙建军[1] 冯乃伟[1] 

机构地区：[1]中国十九冶集团有限公司职工医院药械科,四川省攀枝花市617023

出　　处：《药物不良反应杂志》2016年第6期471-472,共2页Adverse Drug Reactions Journal

摘　　要：1例80岁男性COPD急性加重患者因失眠、多梦给予阿米替林25 mg口服，2次/d。5 d后，患者睡眠障碍无改善，出现幻觉、幻听，加用艾司唑仑1 mg、每晚口服。2周后，患者仍多梦、夜间亢奋，艾司唑仑加量至每晚2 mg口服。2 d后，患者出现嗜睡，实验室查血清葡萄糖6.2 mmol/L，血钾6.6 mmol/L。约1 h后患者呼吸、心跳突然停止。立即行胸外心脏按压并静脉注射尼可刹米和肾上腺素。抢救约20 min后患者死亡。An 80-year-old male with chronic obstructive pulmonary disease acute exacerbation received oral amitriptyline 25 mg twice daily for insomnia and dreaminess. After 5 days, the sleep disorder was not improved, and he developed hallucination and phonism. Estazolam was given 1 mg orally every night. After 2 weeks, he still had dreaminess and exciting in the nights. Estazolam was added to 2 mg every night. Two days later, the patient developed somnolence. Laboratory test showed the levels of glucose and blood potassium were 6.2 mmol/L and 6.59 mmol/L. About one hour later, the patient developed sudden respiratory and cardiac arrest. He was given external-chest cardiac compression, intravenous injection of nikethamide and epinephrine. About 20 minutes later, the patient ultimately died despite resuscitation efforts.

关 键 词：阿米替林 艾司唑仑 呼吸功能不全 

分 类 号：R563.9[医药卫生—呼吸系统]