拉莫三嗪过量所致毒性反应的文献分析  

Literature analysis on toxic reactions caused by lamotrigine overdose

作　　者：邓健浩[1] 郑文富[2] 张青霞[3] DENG Jian-hao;ZHENG Wen-fu;ZHANG Qing-xia(Department of Pharmacy,Longyan Second Hospital,Longyan FUJIAN 364000,China;Department of Neurology,Longyan Second Hospital,Longyan FUJIAN 364000,China;Department of Pharmacy,Xuanwu Hospital Capital Medical University/National Clinical Research Center for Geriatric Diseases,BEIJING 100053,China)

机构地区：[1]龙岩市第二医院药学部,福建龙岩364000 [2]龙岩市第二医院神经内科,福建龙岩364000 [3]首都医科大学宣武医院药学部/国家老年疾病临床医学研究中心,北京100053

出　　处：《中国新药与临床杂志》2023年第11期760-765,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：国家重点研发计划(2020YFC2008305);北京市科学技术委员会“北京老年人健康评估及维护关键技术研究”项目(D181100000218002)。

摘　　要：目的探讨拉莫三嗪过量所致毒性反应及临床救治要点。方法检索Pub Med、Embase、Cochrane Library、CINAHL、Psyc INFO、中国知网、万方、中国生物医学文献数据库和维普数据库中(截至2022年1月31日)拉莫三嗪过量的相关病例,对其临床资料进行汇总分析。结果共纳入文献44篇,患者49例,年龄12 d~55岁,拉莫三嗪剂量范围0.1~40 g。拉莫三嗪过量常见的毒性反应依次是继发癫痫(43%)、心动过速(27%)、共济失调(24%),QRS波延长(22%)、眼球震颤(20%)、意识障碍(18%)、呕吐(10%)和QT间期延长(10%)等。49例患者中,4例死亡,其余患者毒性反应经处理后预后良好,住院的时长为1~19 d。结论拉莫三嗪过量毒性反应发生较多的是神经毒性、心脏毒性、眼毒性、胃肠毒性。临床救治通过减少拉莫三嗪吸收,增加排泄,同时采用药物对症治疗。AIM To explore the toxic reactions and clinical management of lamotrigine overdose.METHODS Relevant cases of lamotrigine overdose in PubMed,Embase,Cochrane Library,CINAHL,PsycINFO,CNKI,WanFang database,SinoMed,and VIP database was retrieved(up to January 31,2022),and clinical data were summarized and analyzed.RESULTS A total of 44 articles were included,with 49 patients aged from 12 days to 55 years old,and the dosage of lamotrigine was from 0.1 g to 40 g.The common toxic reactions of lamotrigine overdose were secondary epilepsy(43%),tachycardia(27%),ataxia(24%),prolonged QRS complex(22%),nystagmus(20%),consciousness disorder(18%),vomiting(10%),QT interval prolongation(10%),etc.Among the 49 patients,4 died,and the remaining patients had good prognosis after treatment of toxicity.The duration of hospitalization for drug overdose toxicity ranged from 1 day to 19 days,CONCLUSION Neurotoxicity,cardiotoxicity,oculotoxicity,and gastrointestinal toxicity are the more common toxic reactions to lamotrigine overdose.Clinical treatment involves reducing absorption and increasing excretion of lamotrigine and using medication for symptomatic treatment in the meantime.

关 键 词：拉莫三嗪 药物过量 毒性反应 

分 类 号：R971.6[医药卫生—药品]