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首页> 外文期刊>The Canadian journal of clinical pharmacology =: Journal canadien de pharmacologie clinique >Sulfonylurea intoxication at a tertiary care paediatric hospital
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Sulfonylurea intoxication at a tertiary care paediatric hospital

机译：三级儿科医院的磺脲类药物中毒

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Background: Unintentional poisoning with sulfonylurea hypoglycaemic drugs is a serious danger to infants and children, as the ingestion of relatively small amounts can be fatal. Although the administration of octreotide is considered effective in patients that remain hypoglycaemic despite glucose administration, experience in children is limited. Methods: A retrospective chart review of the clinical features of all children following sulfonylurea ingestion presenting between April 2001 and November 2008 at the Hospital for Sick Children in Toronto. Results: Ten children were identified with sulfonylurea exposure; six were classified as suspected ingestion and four had confirmed signs of sulfonylurea overdoses (mean age: 8.2 years; range 1.5 - 15). All four patients with confirmed ingestion were exposed to glyburide and developed severe hypoglycaemia; two were toddlers and two teenagers. Ingestion was accidental in the case of the toddlers, and suicidal attempts in the case of the adolescents. All patients were initially treated with glucose infusions. Both toddlers also received octreotide with favourable response and no rebound hypoglyacemia. The two teenagers were treated only with prolonged glucose infusions; in both cases rebound hypoglycaemia and increased glucose requirements were observed. Discussion: Glyburide-induced hypoglycaemia was pronounced in all patients identified. Treatment with octreotide proved effective in the 2 infants treated, agreeing with the limited experience reported to date in the literature, and suggesting that octreotide should be considered the treatment of choice in children.
机译：背景：磺脲类降血糖药无意中毒对婴儿和儿童来说是严重的危险，因为摄入相对少量会致命。尽管认为奥曲肽对尽管服用葡萄糖仍能降血糖的患者有效，但儿童的经验有限。方法：回顾性分析2001年4月至2008年11月在多伦多病童医院就诊的所有磺酰脲类摄入儿童的临床特征。结果：确定有10名儿童接触了磺脲类; 6例被归类为可疑摄入，另外4例已证实有磺脲类药物过量的迹象（平均年龄：8.2岁;范围1.5-15）。全部四名确诊摄入的患者均暴露于格列本脲，并出现严重的低血糖症;两个是幼儿，两个是青少年。对于幼儿来说，这是偶然的摄入，对于青少年来说，是有自杀企图的。最初所有患者均接受葡萄糖输注治疗。两个学步儿童都接受了奥曲肽治疗，反应良好，没有反弹性低血糖症。这两个少年仅接受了长时间的葡萄糖输注;在这两种情况下，均观察到反弹性低血糖和葡萄糖需求增加。讨论：在所有确定的患者中均发现格列本脲引起的低血糖症。用奥曲肽治疗证明对2例婴儿有效，这与迄今为止文献报道的有限经验相吻合，并建议奥曲肽应被视为儿童的首选治疗方法。

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