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首页> 外文期刊>Canadian Journal of Emergency Medicine >Lactic acidosis following intentional overdose by inhalation of salmeterol and fluticasone
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Lactic acidosis following intentional overdose by inhalation of salmeterol and fluticasone

机译：吸入沙美特罗和氟替卡松故意过量后乳酸酸中毒

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Salmeterol, a long-acting β2-adrenergic receptor agonist used for the treatment of asthma and chronic obstructive pulmonary disease, has an adverse effects profile that is similar to that of salbutamol and other β2-agonists. We report a sympathomimetic syndrome with metabolic acidosis and hyperlactatemia after intentional inhalation of salmeterol in a suicide attempt. A 16-year-old female patient was admitted to the emergency department approximately 2 hours after having inhaled 60 puffs of a combination of salmeterol xinafoate 25 μg and fluticasone propionate 50 μg. She presented in an anxious state with complaints of palpitations and chest pain. The electrocardiogram demonstrated sinus tachycardia and ST-segment depression in the inferior and anterolateral leads. Laboratory findings showed hypokalemia, hypophosphatemia, and lactic acidosis. Cardiac troponin I and creatine kinase MB remained within the normal range. Treatment was supportive and included intravenous fluids and cautious potassium supplementation. The next day, electrocardiographic and laboratory findings returned to normal. We hypothesize that stimulation of β2-adrenergic receptors by inhalation of salmeterol caused this patient's lactic acidosis. This observation is consistent with the hypothesis that the hyperlactatemia observed during asthma attacks is due in part to the administration of high doses of β2-agonists. Salmeterol overdose by inhalation appears to be sufficient to cause lactic acidosis.
机译：沙美特罗是一种用于治疗哮喘和慢性阻塞性肺疾病的长效β2肾上腺素能受体激动剂，其不良反应与沙丁胺醇和其他β2激动剂相似。在自杀尝试中故意吸入沙美特罗后，我们报告了与代谢性酸中毒和高乳酸血症有关的拟交感神经综合征。一名16岁的女性患者在吸入60克25克沙美特罗新纳福酯和50克丙酸氟替卡松的组合后，约2小时被送往急诊室。她处于焦虑状态，主诉心pit和胸痛。心电图显示下，前外侧导线窦性心动过速和ST段压低。实验室检查结果显示低血钾，低血磷和乳酸性酸中毒。心肌肌钙蛋白I和肌酸激酶MB保持在正常范围内。治疗是支持性的，包括静脉输液和谨慎补充钾。第二天，心电图和实验室检查结果恢复正常。我们假设吸入沙美特罗刺激β2-肾上腺素能受体引起该患者的乳酸性酸中毒。该观察结果与以下假设相符：在哮喘发作期间观察到的高乳酸血症部分归因于高剂量的β2-激动剂的使用。吸入沙美特罗过量可能足以引起乳酸性酸中毒。

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