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1例54岁男性患者,因患慢性支气管炎服用复方妥英麻黄茶碱片(每片含有苯妥英钠50 mg,马来酸氯苯那敏1 mg,盐酸麻黄碱5 mg,咖啡因7.5 mg,可可碱12.5 mg,茶碱12.5 mg,颠茄流浸膏0.009 ml)治疗1年余。患者每天服用数量不等,平均每天6片,有时增至每日8片。服药1年后,出现口周麻木、行走不稳、饮水呛咳、言语不清、吞咽困难、头晕、视物模糊及眼球震颤。头颅MRI示轻度脑白质变性。检测苯妥英血浓度为94.12×103μg/L,诊断为苯妥英中毒。停用该药,改为茶碱缓释片口服,补充叶酸,维生素B12。1周后患者可独立行走,头晕缓解。
A 54-year-old male patient with chronic bronchitis was treated with compound narcissus ephedrine tablets (each containing 50 mg phenytoin, 1 mg chlorphenamine maleate, 5 mg ephedrine hydrochloride, 7.5 mg caffeine, Theobromine 12.5 mg, theophylline 12.5 mg, belladonna flow extract 0.009 ml) for more than 1 year. Patients take varying amounts daily, with an average of 6 tablets a day, sometimes up to 8 tablets a day. One year after taking medicine, perioral numbness appears, walking unstable, drinking cough, unclear speech, difficulty swallowing, dizziness, blurred vision and nystagmus. Head MRI showed mild white matter degeneration. Detection of phenytoin blood concentration of 94.12 × 103μg / L, the diagnosis of phenytoin poisoning. Disable the drug to theophylline sustained release tablets oral, folic acid supplementation, vitamin B12.1 weeks after the patient can walk independently, dizziness, ease.