氨甲环酸氯化钠注射液致心慌和肌肉震颤1例及文献分析

doi:10.19803/j.1672-8629.2021.12.22

摘要/Abstract

摘要： 目的探讨氨甲环酸氯化钠注射液致心慌、肌肉震颤的原因及处置措施。方法分析1例氨甲环酸氯化钠致心慌、肌肉震颤的诊疗经过,结合文献检索,探索氨甲环酸氯化钠导致心慌、肌肉震颤的机制及应对措施。结果患者使用氨甲环酸氯化钠突发心慌、肌肉震颤,可能与滴注速度过快有关,注意给药剂量、速度、浓度可减少药品不良反应的发生;也可能是氨甲环酸诱发癫痫的前兆,早期脑电图监测有助于诊断,一些全身麻醉药物和苯二氮?类药物可用于治疗;还可能是氨甲环酸诱发的Ⅰ型药物过敏反应,应及时给予抗过敏处理。结论临床在使用氨甲环酸过程中应加强观察,如发生不良反应,应立即停药,针对不同情况,采取相应急救措施。

关键词: 氨甲环酸氯化钠, 药品不良反应, 心慌, 肌肉震颤, 异丙嗪

Abstract: Objective To explore the causes of palpitation and muscle tremor induced by tranexamic acid sodium chloride injection and the treatment measures.Methods The diagnosis and treatment of a case of palpitation and muscle tremor induced by tranexamic acid sodium chloride were analyzed. Combined with literature search, the mechanism and countermeasures of panic and tremor induced by tranexamic acid sodium chloride were explored. Results Sudden palpitation and muscle tremor in patients with tranexamic acid sodium chloride may be related to excessive infusion rate, pay attention to the dose, speed, concentration can reduce the occurrence of adverse drug reactions, may also be a precursor to tranexamic acid-induced epilepsy, early EEG monitoring is helpful for diagnosis, some general anesthesia drugs and benzodiazepines may be used for treatment; or may be tranexamic acid-induced typeⅠdrug allergy reaction, and anti-allergic treatment should be given in time.Conclusion In the course of clinical use of tranexamic acid, it is necessary to strengthen observation. In case of adverse reactions, the drug should be stopped immediately, and corresponding emergency measures should be taken according to different situations.

Key words: tranexamic acid sodium chloride, adverse drug reaction, palpitation, muscle tremor, promethazine

中图分类号:

R994.11

洪文英. 氨甲环酸氯化钠注射液致心慌和肌肉震颤1例及文献分析[J]. 中国药物警戒, 2021, 18(12): 1196-1197.

HONG Wenying. One Case of Palpitation and Muscle Tremor Induced by Tranexamicacid Acid Sodiwn Chloride Injection and Literature Analysis[J]. Chinese Journal of Pharmacovigilance, 2021, 18(12): 1196-1197.

参考文献

[1] Yang BF, Chen JG.Pharmacology(药理学)[M]. Beijing: People's Medical Publishing House, 2018: 271.
[2] Deng HY, Zhong H, Liu YH.A case of epilepsy caused by tranexamic acid injection[J]. Zhongnan Pharmaceutical(中南药学), 2020, 18(2): 329-331.
[3] Tang ZZ.A case of ankylosis of limbs caused by tranexamic acid and sodium chloride injection[J]. Chinese Journal of Pharmacist(中国药师), 2019, 22(7): 1314-1316.
[4] Huang YZ.Observation and analysis of adverse reactions of tranexamic acid and sodium chloride injection[J]. Chinese Community Physician(Medical Specialty)(中国社区医师(医学专业)), 2013, 15(9): 11.
[5] Wang YT, Li WW, Xie JW, et al.A case of anaphylactic shock caused by tranexamic acid injection[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2018, 15(8): 501-502.
[6] Wang DX.A fatal case of acute myocardial infarction induced by tranexamic acid[J]. New Medicine(新医学), 1996,12: 626.
[7] Quan H, He J.A case of dizziness caused by tranexamic acid[J].Chinese Journal of Clinical Medical Research(中华临床医学研究杂志), 2005, 12(11): 22-23.
[8] Lu RT, He SQ.One case of transient blindness caused by tranexamic acid[J]. China Practical Medicine(中国实用医药), 2012, 7(19): 201-202.
[9] An HY.3 cases of deep vein thrombosis caused by tranexamic acid[J].Journal of Practical Medicine(实用医药杂志), 2008, 25(9): 1116-1117.
[10] Berman M, Cardone D, Sharples L, et al.Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: review of 200 patients[J]. Annals of thoracic surgery, 2010, 90(5): 1432-1436.
[11] Keyl C, Uhl R, Beyersdorf F, et al.High-dose tranexamic acid is related to increased risk of generalized seizures after aortic valve replacement[J]. Eur J Cardiothorac Surg, 2011, 39(5): e114-e121.
[12] Hao ML, Hao MQ, Du YF.Research progress of tranexamic acid-related epilepsy[J]. Medical Review(医学综述), 2017, 23(2): 332-335.
[13] National Adverse Drug Reaction Monitoring Center. Guidelines for the Use of Adverse Drug Reaction Terms(药品不良反应术语使用指南)[M]. Beijing: National Adverse Drug Reaction Monitoring Center, 2016: 39-40.
[14] Wang YH.Interpretation of the classification of tremor in the 2017 consensus statement of the tremor working group of the international society for parkinson's disease and movement disorders[J].World Clinical Drugs(世界临床药物), 2018, 39(7): 433-440.
[15] Li Y.Nursing experience of adverse reactions of tranexamic acid and sodium chloride injection[J]. Chinese and Foreign Health Digest(中外健康文摘), 2013, (26): 292-293.
[16] Zheng HY.The effect of controlling the drip rate of infusion in reducing the adverse reactions of tranexamic acid and sodium chloride injection[J]. Jilin Medicine(吉林医学), 2011, 32(11): 2249-2250.
[17] Zhou YY, Long F, Zhang L.Clinical observation of the optimal concentration and drip rate of tranexamic acid in preventing nausea and vomiting during joint replacement surgery[J]. Guizhou Medicine(贵州医药), 2019, 43(4): 609-610.
[18] Campbell RL, Li JT, Nicklas RA.Emergency department diagnosis and treatment of anaphylaxis: a practice parameter[J]. Ann Allergy Asthma Immunol, 2014, 113(6): 599-608.