High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report  

作　　者：Shintaro Shimozawa Daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita 

机构地区：[1]Department of Emergency and Critical Care Medicine,Juntendo University Nerima Hospital,Nerima-city 177-8521,Tokyo,Japan [2]Clinical Training Center,Juntendo University Nerima Hospital,Nerima-city 177-8521,Tokyo,Japan [3]Department of Sports Medicine,Faculty of Medicine,Juntendo University,Bunkyo-city 113-8421,Tokyo,Japan

出　　处：《World Journal of Clinical Cases》2023年第16期3870-3876,共7页世界临床病例杂志

摘　　要：BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter medication.There has been a growing number of reported cases of toxicity in recent years.Generally,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive care.We presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her life.CASE SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide attempt.The patient had a history of drug abuse and multiple self-inflicted injuries.At the time of admission,she exhibited symptoms of shock and altered consciousness.However,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal intubation.The convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a vasopressor.Gastric lavage and activated charcoal were also administered after intubation.Through systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors ceased.The patient regained consciousness and was extubated.The patient was subsequently transferred to a psychiatric facility,as suicidal ideation persisted.CONCLUSION We report the first case of shock caused by an overdose of dextromethorphan.

关 键 词：DEXTROMETHORPHAN Drug overdose Shock SYMPTOM Treatment Case report 

分 类 号：R969[医药卫生—药理学]