PDF(Pubmed)
Abstract：
Pregabalin (PB) overdose causes mild symptoms and coma is rarely seen unless the patient has also ingested sedatives and/or has preexisting renal disease. We present a case report of a suicide attempt with PB where the patient presented in a comatose state that was successfully treated with continuous renal replacement therapy (CRRT). Treatment of PB overdose is usually supportive. However, previous reports of PB overdose have been treated with intermittent hemodialysis (IHD) in patients with preexisting renal disease. The problem with IHD is that it is only available in specialist centers and unsuitable for unstable patients. In the following case report, the patient presented to the emergency department (ED) unconscious and hypotensive. It was thought that the patient tried to commit suicide by taking an overdose of zopiclone tablets, as empty packets of zopiclone tablets were found beside the patient. There was no effect with flumazenil treatment, so the patient was intubated, mechanically ventilated, and admitted to the intensive care unit (ICU) where inotropic support was started. Despite supportive therapy, there was no improvement in the patient\'s condition. Further investigation into the patient\'s medical records uncovered prescriptions of PB. Based on this finding, plasma PB levels were measured and found to be 20 times the upper limit of the therapeutic reference range. CRRT was instituted and after 6 h of treatment the patient woke up. Hospitals with ICUs often have CRRT available in their units whereas IHD is less readily available. This case report demonstrates that CRRT is an effective method for treating PB overdose in an unconscious unstable patient that was unsuitable for transfer to another hospital.
摘要：
普瑞巴林（PB）过量会引起轻度症状，除非患者还摄入镇静剂和/或患有肾脏疾病，否则很少见到昏迷。我们提供了一例尝试自杀的案例报告，其中患者处于昏迷状态，并通过连续肾脏替代疗法（CRRT）成功治疗。PB过量的治疗通常是支持性的。然而,既往有报道称,在既往有肾脏疾病的患者中,使用间歇性血液透析(IHD)治疗PB过量.IHD的问题在于，它仅在专科中心可用，不适合不稳定的患者。在以下案例报告中，患者出现在急诊科（ED）昏迷和低血压。人们认为患者试图通过服用过量的佐匹克隆片来自杀，因为在病人旁边发现了一包空的佐匹克隆片剂。氟马西尼治疗没有效果，所以病人被插管,机械通风,并进入开始使用正性肌力支持的重症监护病房（ICU）。尽管有支持治疗,病人的病情没有改善。对患者病历的进一步调查发现了PB的处方。基于这一发现,测量血浆PB水平,发现是治疗参考范围上限的20倍.开始CRRT，治疗6小时后患者醒来。有ICU的医院通常在其单位中提供CRRT，而IHD则不那么容易获得。该病例报告表明，CRRT是治疗无意识不稳定患者的PB过量的有效方法，该患者不适合转移到另一家医院。
