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asbryobvrz · Wysłany: Śro 8:16, 16 Mar 2011

Intravenous pentoxifylline 1 case of anaphylactic shock caused

Date: 20034) 5-03 CLC number: R972 Document code: B Article ID :1007 -7693 (2004) 03-0229-01 pentoxifylline (pentoxifylline, PTX), the other scientific name of a dimethyl 3,7 xanthine-based, molecular formula C. 3H20N. 03, molecular weight 278.3l, is a methylxanthine derivative, is a non-selective phosphodiesterase inhibitor. The parent drug and its metabolites reduce blood viscosity through the improvement of blood rheology, increased red blood cell deformability, to improve the rheology properties of white blood cells, inhibition of neutrophil adhesion and excitement, increased peripheral arterial blood flow, affect the microcirculation and improve the organization's oxygen supply. Its exact mode of action and led to the role of clinical improvement has not been determined. With its study and understanding of pharmacological effects, drug use has been continuously developed, widely used in clinical, efficacy, and adverse reactions. Now encountered in the clinical case report of anaphylaxis l as follows. A case report patient, male, 55 years old, full right upper limb weakness due to aphasia 37d hospitalized. Physical examination: body temperature of 37 degrees, pulse 80 ~ / min, blood pressure 180/110mmHg,[link widoczny dla zalogowanych], conscious, aphasia, but the name of the implementation language, eye gaze left and right upper limbs 0, 3 right lower limb muscle strength, right Pakistan's sign (+), the right feel alive. The left side of the body to normal. CT diagnosis: the left cerebral hemisphere, and no hemorrhage. B-Tip: fatty liver. Laboratory examination: WBC and classification of normal. Liver function: GPT120U / L. GGT71U / L, GOT406U / L. Medical advice given to three groups of fluid infusion. (1) 5% glucose solution 250mL, days Baokang needle lOmL, 10% potassium chloride needle 5mL, qd. (2) 5% glucose solution 250mL, pentoxifylline needle 100mg, qd. (3) 0.9% sodium chloride solution 100mL, A glutathione-pin 1200mg, qd. Enter the second solution, the patient suddenly looking pale, body chills, shortness of breath, body temperature measured 38.3 degrees, breathing 32 times / min, heart rate ll6 /,[link widoczny dla zalogowanych], ~ / min, blood pressure 90/50mmHg, lung auscultation negative . Stop using the liquid, use (2) liquid infusion group, and give oxygen inhalation, intravenous dexamethasone 10mg needles, Ma Lei maleate (chlorpheniramine-pin) 100mg intramuscular injection, Journal of Modern Applied Pharmacy adrenal June 2004 Volume 3 No. 2l prime needle 0.5rag intramuscularly. Symptoms resolved after about 30min,[link widoczny dla zalogowanych], blood pressure 140/90mmHg, heart rate 96 ~ / min, body temperature gradually decreased to normal after a similar situation does not happen again. Discussion and analysis of 2 injections of pentoxifylline (Wuhan Haight pharmaceutical Co., Ltd., batch number: H20020567), tilting the drug or freeze-dried powder is white,[link widoczny dla zalogowanych], in the body is not bound to plasma proteins, mainly in the liver metabolism,[link widoczny dla zalogowanych], through the kidney, and its parent drug and its metabolites exclude half-life of about 0.5 of a 1.5h. For cerebral blood circulation disorders. Such as cerebral ischemia, stroke sequelae: Peripheral blood circulation disorders, thromboembolism, vasculitis, intermittent broken line, or rest pain; and eye blood circulation, inner ear circulation, such as age-related tinnitus, sudden ear deaf and so on. Usage requirements: patients supine intravenous drip. Initial dose of 100rag, at 2-3h, enter the maximum drip rate of not more than lOOmg / h. Maximum dose of each medication does not exceed 200mg. Hypotension and unstable blood pressure with caution, the elderly due to slow metabolism, medication should be appropriate reductions. Since this drug in clinical use, occasional nausea, dizziness, headache, anorexia, abdominal distention, vomiting, cardiovascular and nervous system toxicities were mild. The patients with intravenous injection of pentoxifylline. (1) is a sterile operation, as required by adding dilution liquid preparation, not combined with other drugs combined, it can exclude the possibility of sensitivity to other drugs. (2) patients with hypertension, blood pressure 180/l10mmHg, supine infusion, in line with medication requirements. (3) normal infusion drip rate, 25 drops / min, and drip rate control within the required time, enter the liquid of about 4 / 5 This symptom occurs when the amount. (4) not before the drug is not lost and the above symptoms, disable, about 0.5h after drug symptoms, allergy to apply effective. Rare allergic reactions in this case, suggesting that clinicians should be cautious using this medication. Received date :2004-01 .12 ChinJMAP, 2004June, 3229 '