氟哌啶醇致meige综合征1例

<正> 抗精神病药所致Meige综合征临床上少见,较易漏诊或误诊为迟发性运动障碍。此类病例国内尚未见报告。我院近遇到1例,予以报告。女,21yr。因精神失常4yr于1988年4月第3次住院治疗。诊断为精神分裂症-未分型。既往曾接受过氯丙嗪和五氟利多治疗。家庭和既在无眼睑痉挛史,无神经系统病史。入院后首选氟派啶醇治疗。当加至44mg/d,wk3时,出现眼皮跳动,     

氟哌啶醇

美国强生公司和FDA于近日通知医务人员：精神药物氟哌啶醇（haloperidol）商品名Haldol，Haldol Decanoate（癸酸酯）和Haldol Lactate（乳酸酯）警示语和处方信息已被修改。新的心血管方面的内容已被列入，包括以本品，特别是静脉注射和高于推荐剂量治疗时，病人可能出现猝死、QT间期延长和j方尖端扭转型室性心动过速（Torsadesde Pointes，TdP）。虽然FDA只批准氟哌啶醇肌肉注射使用，     

氟哌啶醇致尿潴留1例

患者,女,37岁。精神病史13a,1990年3月7日以精神分裂症首次住本院用氯丙嗪治疗后痊愈出院,4a如常人。1994年5月,因故复发,表现少眠、话多、语无伦次、哭笑无常、举止怪异等,在当地肌内注射氟哌啶醇3次,量不详。在家2d未解小便,发烧,咳嗽,吐粘液痰。以偏执型精神分裂症和尿潴留收住我院。体检:体温38.5℃,脉博100次·min1,呼吸率19次·min1,血压135/75mmHg(1mmHg=0133kPa)。发育良好,营养中等。自动体位,皮肤干燥,口唇干裂有血痂。听诊可闻及双肺干性音,以右中下肺为重。膀胱充盈较重。心电图、胸部X线片检查不合作。血常规、肝功能…     

氟哌啶醇致心动过缓6例

氟哌啶醇系丁酰苯类抗精神常药的代表,由于对心血管系统、肝脏毒性较小,常用于年老体弱及伴随躯体疾病患者.其常见不良反应为锥体外系作用,偶见心动过速.心动过缓甚少.但我们两所医院在1994～1997年188例服用氟哌啶醇的住院患者中出现6例心动过缓.临床资料 一般情况:6例患者均系单用抗精神病药物氟哌啶醇治疗(上海黄河制药厂,批号:940401),使用剂量(21.7±4.6)mg/d(18～28mp/ d),均合并盐酸苯海索片4mg/d,5例合并VitB_1 40mg/d,4例合并VitB_6 60mg/d;其中男性2例.女性例心动过缓.临床资料 一般情况:6例患者均系单用抗精神病药物氟哌啶醇治疗(上海黄河制药厂,批号:940401),使用剂量(21.7±4.6)mg/d(18～28mp/ d),均合并盐酸苯海索片4mg/d,5例合并VitB_1 40mg/d,4例合并VitB_6 60mg/d;其中男性2例.女性     

氟哌啶醇致锥体外系反应1例

氟哌啶醇致锥体外系反应１例黄孟华，王金华（宁德地区第一医院邮编３５５０００）患者男性，１１岁，体重２１ｋｇ，患左慢性化脓性中耳炎（胆脂瘤型），并重度传导聋，行左乳突根治术。术前肌注苯巴比妥钠１００ｍｇ、阿托品０．４ｍｇ。９时０５分静注吸替啶３５ｍｇ、...     

氟哌啶醇致小儿严重锥体外系不良反应

患儿,女,13岁。因“四肢抖动,斜颈4年,手呈捻药丸伴伸舌1年”,于2004年3月入我院就诊。家长代述病史:患儿4年前到九寨沟、黄龙旅游,因高原反应、水土不服,出现头晕、恶心呕吐1天。其父送成都市某医院就诊,医生处方氟哌啶醇6片,每片剂量及用法用量不详,未给予其他药物。该6片氟哌啶醇患儿约1天半服完。次日,出现坐卧不安、四肢抖动,痉挛性斜颈,双眼不自主向上凝视,当日于成都某医院就诊,只给予“东莨菪碱”口服,未作其它处理,患儿症状有所缓解。四年内该症状反复发作,近1年症状加重,遂入我院就诊。查体:神志清楚,四肢肌张力增高,手呈捻药丸、…     

氟哌啶醇致静坐不能1例

患者,男,20岁,学生。主诉间断性精神失常5年,加重4 d于2011年2月11日入院。患者缘于2005年7月因未考入理想的学校而出现情绪低落,话少,精神差,不出门,考虑问题多。2007年出现全身不适,胸闷,眼痛,有时双眼交替疼痛,就诊于北京安定医院,诊断为“阴性抑郁”,给予舍曲林治疗,10d后眼痛减轻能上学。2010年6月4日因病情波动2周入住我院,患者院外表现说话明显增多,认为家属不理解自己,情绪不稳,易激动,表示自己在学校受了大委屈而哭泣,自觉聪明。住我院诊断“双相情感—躁狂发作”。给丙戊酸钠,碳酸锂,富马酸喹硫平片治疗26d病情痊愈后出院。本次住院前4d,患者因情绪不稳,发脾气,拒绝服药,再次住院。住院后因拒药给氟哌啶醇注射液10mg肌内注射,20min后患者出现表情痛苦,烦躁不安、不能静坐、反复走动或原地踏步。极度痛苦,脉搏118次／min,给东莨菪碱0．3mg,氯硝西泮1mg肌内注射,上述症状仍无明显缓解,患者睡眠时和转移注意力后症状缓解,其余时间反复找大夫要药,说自己受不了,踏步踏样动作,左脚、右脚,轮流不停。后给予盐酸普奈洛尔、异丙嗪、地西泮口服,3d后症状逐渐缓解。     

氟哌啶醇致休克2例报告

氟哌啶醇(Haloperidol)一向被认为是一种比较安全的抗精神病药,但最近我们遇到2例肌注氟哌啶醇后引发休克的患者,现报告如下。例1,女,18岁,未婚。于1997年12月7日以胡言乱语行为紊乱为主诉首次发病住院。入院体检:T38.5℃,咽充血,心肺(-)。入院前食量少,入院当天给予氯丙嗪150mg/日,复方氯丙嗪50mg加入10%葡萄糖液500ml静滴,1次/日,至第三天因能进食而暂停。隔日因行为紊乱加重于上午8时以氟哌啶醇5mg肌注,注射后1小时突然步态不稳、面色苍白、呼吸困难跌倒在地,此时即刻停药经平卧灌热水、给氧后血压、脉搏从0至正常及至入院时原水平。清…     

氟哌啶醇致不良反应的文献分析

目的探讨氟哌啶醇所致不良反应(ADR)的发生原因、规律、特点,为临床安全、合理用药提供参照。方法检索1989年1月—2017年7月中国学术期刊(网络版)、万方数字化期刊全文库、中文科技期刊全文数据库(维普)及Pub Med数据库收录的全部中医药期刊,收集报道氟哌啶醇致不良反应的文献进行统计和分析。结果共检索到94篇文献,122例病例。男性明显多于女性,年龄集中在18~40岁。用药1~7 d出现ADR的例数最多,占45.10%。氟哌啶醇引发的不良反应主要涉及神经系统、心血管系统、皮肤损害,其中神经系统损害的患者63例,占51.6%,所占比例最高。心血管系统和皮肤损害ADR占比分别为14.8%、10.7%。结论氟哌啶醇引发的不良反应较为常见,临床应重视氟哌啶醇不良反应的危害性,加强药学监护,尽量避免或减少其所致不良反应的发生,确保患者用药安全。     

氟哌啶醇致恶性症状群并感染1例临床分析

目的了解抗精神病药致恶性症状群的发生原因、临床特征、治疗及预后,并提出预防措施。方法探讨笔者所在医院发生的1例氟哌啶醇致恶性症状群并感染病例的临床特征、治疗及预后。结果患者治疗后好转出院。结论临床工作中应注意抗精神病药物联合应用的安全性,注意加强患者营养,及时纠正脱水倾向,避免快速增加抗精神病药物的剂量,可避免恶性症状群的发生。     

Olanzapine-associated neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is a rare but potentially serious complication of neuroleptic drugs. It may vary in both presenting characteristics and severity. Several different criteria for diagnosis exist, and each differs from the others slightly. We describe a 66-year-old woman with chronic paranoid schizophrenia who was prescribed olanzapine along with several other psychiatric drugs and an antihypertensive drug. The patient displayed several characteristics of NMS during therapy with olanzapine, including fever, elevated creatine kinase level, leukocytosis, and mild muscle rigidity. When olanzapine was held, the signs and symptoms improved and then returned with rechallenge of olanzapine. For this reason, olanzapine was considered strongly associated with this patient's apparent NMS episode. The patient's beta-blocker therapy may have masked additional signs of NMS. In addition, the patient tolerated other neuroleptics that were started in the hospital after the suspected NMS episode. The variation among different diagnostic criteria makes this syndrome a challenging diagnosis at times, in particular when atypical antipsychotics are suspected as the causative agent.     

Haloperidol-induced emotional defecation: a possible model for neuroleptic anxiety syndrome

The neuroleptic haloperidol was found to produce increased defecation in laboratory rats when tested in well habituated environments. It is well known that haloperidol induces catalepsy through antagonism of striatal dopaminergic receptor mechanisms. When another cataleptic agent, morphine, was tested, no significant increases in defectation were detected. Another study focused on the possible role of peripheral dopamine receptor sites within the gastrointestinal tract on neuroleptic-induced defecation. When the peripheral dopamine receptor antagonist domperidone was tested, no significant differences in fecal elimination were recorded. Thus, it appeared that the cataleptic state per se, or the peripheral effects of haloperidol did not seem to be responsible for the increased defecation. Defection is often used as an index of emotionality. The fact that this measure increased following administration of a major tranquilizer suggested the need to study more directly the relationship of this phenomenon of defecation with the affective state of the animal. In a control study it was found that the antianxiety agent benzodiazepam did not by itself influence defecation. However, those animals which were pre-injected with diazepam followed by haloperidol did not show increased defecation. Thus under certain circumstances, normal rats given haloperidol show emotional defecation which seems to reflect increased anxiety. This finding may serve as a basis for the development of an animal model for some of the atypical side effects of major tranquilizers, such as akathisia, dysphoria, and neuroleptic anxiety syndrome.     

Aripiprazole and neuroleptic malignant syndrome

Aripiprazole, an atypical antipsychotic with a novel method of action, has only recently been awarded a license in the UK. We report our first patient to receive this drug, who had treatment-resistant schizophrenia and developed neuroleptic malignant syndrome (NMS) with aripiprazole. To our knowledge, this is the first published case report involving aripiprazole and NMS in a potentially fatal medical emergency. Further experience with this drug should indicate whether this is an isolated case (as described with other atypical antipsychotics) or constitutes a more serious risk than that suggested by the relatively beneficial therapeutic profile described in the literature to date.     

奥氮平致非典型的抗精神病药恶性综合征

1例73岁女性精神分裂症患者,口服氯丙嗪（早150 mg、晚100 mg）及苯海索（4 mg,2次/d）治疗30年,加用奥氮平10 mg,1次/d口服2个月后出现CK升高,达15 570 U/L,同时伴发热、肌张力增高、心动过速,P 105次/min。停用奥氮平,继续应用氯丙嗪及苯海索,并给予对症支持治疗,CK水平逐渐下降至接近正常值。停药第19天患者自行应用奥氮平10 mg,1次/d,4 d后CK再次升高达700 U/L,停药后恢复正常。     

Olanzapine induced neuroleptic malignant syndrome

An 18 year old male diagnosed as a case of bipolar affective disorder (BPAD), developed neuroleptic malignant syndrome (NMS) following treatment with olanzapine (20 mg per day), an atypical antipsychotic drug. NMS is usually seen with typical antipsychotic drugs. The patient was diagnosed as a case of NMS, offending agent was immediately withdrawn and prompt treatment with bromocriptine and levodopa produced a good recovery. The various features of the case are discussed in view of the potential mortality of the syndrome.KEY WORDS: Bipolar affective disorder, Neuroleptic malignant syndrome, olanzapine     

Neoplasia and the neuroleptic malignant syndrome

The association of neuroleptic malignant syndrome with neoplasia has not been previously reported. We report the case of a 64-year-old female patient who developed the classical picture of neuroleptic malignant syndrome in relation to a uterine leiomyosarcoma. This raises the question as to whether a biological predisposition exists in patients who develop neuroleptic malignant syndrome.