哌拉西林钠他唑巴坦钠致过敏性休克合并胆碱能危象1例  

One Case of Anaphylactic Shock with Cholinergic Crisis Induced by Piperacillin Sodium and Tazobactam Sodium

作　　者：孙旭[1] 熊芬[1] 苏芬丽[1] 蔡庆群[1] SUN Xu XIONG Fen SU fenli CAI Qingqun(Dept. of Pharmacy, the First Affiliated Hospital of Guangzhou University of TCM , Guangzhou, Guangdong 510405, China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《今日药学》2017年第1期40-41,共2页Pharmacy Today

摘　　要：1例54岁女性重症肌无力患者因住院7日后继发肺部感染予哌拉西林钠他唑巴坦钠2.5 g静滴抗感染,用药9 min后出现注射部位皮肤红疹、瘙痒,予肌注异丙嗪25 mg未见好转,进而红疹扩散至胸背部,并出现面色紫绀、四肢厥冷、血压下降、意识丧失等过敏性休克症状,同时伴有眼、鼻分泌物增多、视力模糊、心率减慢、呕吐等胆碱能危象表现。立即停药,并予地塞米松5 mg、肾上腺素针0.5 mg、阿托品针1 mg静注,约1 min后患者意识转清。随后予盐酸多巴胺针80 mg静泵维持,约5 min后患者症状好转。次日改用左氧氟沙星针,未再出现上述症状。An 54-year-old female patient with myasthenia gravis received an IV infusion of piperacillin sodium and tazobactam sodium 2.5g for secondary pulmonary infection. Seven days later,just after about 9 minutes of administration,she developed erythema and pruritus on injection site. After treatment with promethazine 25 mg,the symptoms was not improved,then the erythema spread to the chest and back,followed by peripheral coldness,complexion cyanosis and decreased blood pressure,and then she lost consciousness,which was accompanied by increased nasal secretions and eye discharge,decreased heart rate and emesis. Piperacillin sodium and tazobactam sodium was stopped immediately,then an intravenous injection of dexamethasone 5 mg,epinephrine 0.5 mg and atropine 1 mg were administered and 1 minute later,her consciousness restored. And an IV injection of dopamine 80 mg was given.After 5 minutes,the symptoms alleviated gradually. The next day,she didn＇t experience similar conditions after exchange of levofloxacin injection.

关 键 词：哌拉西林钠他唑巴坦钠 胆碱能危象 过敏性休克 

分 类 号：R969.3[医药卫生—药理学]