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目的探讨老年患者服用卡马西平致急性意识障碍等严重不良反应的因素、治疗及预后。方法对1例三叉神经疼痛老年患者服用卡马西平后的临床反应进行治疗观察。结果患者经给氧镇静、纳洛酮解毒及补钠利尿等抢救治疗后神志转清醒,血钠升至正常水平,不良反应消失。停用卡马西平,再无不良反应出现。结论老年患者药物依从性差,要慎用卡马西平并减量给药。在服药过程中,要警惕卡马西平引起的语言和意识障碍及低钠血症等严重不良反应,同时要加强口服药物的护理和管理,严格实行按餐给药,强化用药安全。
Objective To investigate the factors, treatment and prognosis of serious adverse reactions such as acute consciousness disturbance induced by carbamazepine in elderly patients. Methods A clinical trial of carbamazepine in one elderly patient with trigeminal neuralgia was performed. Results Oxygen sedation, naloxone detoxification and sodium rescue diuresis and other rescue after conscious mind sober, serum sodium rose to normal levels, adverse reactions disappear. Carbamazepine discontinued, no adverse reactions. Conclusion Elderly patients with poor compliance, to be used with caution and carbamazepine dose. In the course of taking medication, be alert to the serious adverse reactions such as language and disturbance of consciousness caused by carbamazepine and hyponatremia. At the same time, we should strengthen the care and management of oral drugs and strictly enforce meal-based medication to enhance drug safety.