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Nimodipine treatment of subarachnoid hemorrhage secondary report of 29 cases of adverse reactions
Saline injection or diluted in human 500rid slow intravenous infusion, dark to maintain 6 ~ 8h, once a day, duration of treatment was 7 ~ lO days. 1.3 Adverse reactions: a total of 29 cases, including headache and dizziness 5 down. 1.4%; general weakness, a sense of 3, accounting for 08%; skin flushing in 13 cases, 36%; sweating irritability in 1 case, 0.3%; 3 guillotine peripheral edema, accounting for 08%; shock in 4 cases , accounting for 11%. J. 4 dealing with startling outcome: There is a variety of adverse reactions herein are on an immediate withdrawal. Headache, dizziness, general weakness, flu, skin flushing, sweating irritability, peripheral edema, and so on are gradually disappearing,[link widoczny dla zalogowanych], without causing serious consequences, and to the performance of Sheng as a serious shock. Shock occurred in this group of 4 down, in addition to mannitol dehydration also combined, but also cases of application of chlorine chlorine level l lytic cocktail in 2 cases, 2 cases of cimetidine, nifedipine l cases. In the course of treatment, respectively,[link widoczny dla zalogowanych], the first 9,5,10, l-day shock response occurs, with varying degrees of wells decreased level of consciousness, of which 2 cases of intermittent medication, shock treatment: stop using Nimotop needle. Intravenous products, colloid, and vasopressors to maintain blood pressure and 12 ~ 2,4 h. 3 cases of shock symptoms gradually lifted, and the other 1 case was found too late, blood pressure is 0, respiratory arrest, rescue invalid, circulatory failure and death. 2 to discuss a variety of adverse reactions occurred in this group may have the following five mechanisms: ① lack of effective circulating volume. Spinal shock in our hospital the patient m the rescue process, both the amount of water is restricted. Water treatment for removal of both temperature and gate units of the Third People's Hospital Department of Neurosurgery (325ND) I {good treatment, resulting in varying degrees the relative lack of patient use of effective circulating volume may be exacerbated after Nimotop patient decompensated shock. ② additive or synergistic effect of these drugs in 4 cases were found to have shock response by application of clozapine tablets, or hibernation station agent J number, or nifedipine, but no excessive administration, and these types of drugs have the role of dilation of blood vessels . When the two drugs at the same time application, is more likely to lack effective circulating volume leading to shock occurs while the Muck-W so that application of nimodipine also valproate, cimetidine, the biological activity of nimodipine to increase both male JJ 50%, 100% _l_. ③ considerable part of the role of drug accumulation few days later, the patient appeared in a variety of adverse drug reactions, currently part of the interval of the two doses appeared. That drugs accumulate in the body. Increase in toxicity. ④ individual patient differences in individual quality of the patient receiving the first dose of Nigeria through the laying of adverse reactions, did not apply any other vasodilator responses may lead to drugs, it is difficult to explain the mechanism mentioned above. ⑤ lay with Nepal through drip rate too fast can cause a more intense peripheral vasodilatation related to J word, Niger lay through the exact mechanism of adverse reactions remains to be further explored. Recommendations lay in Nepal through the application note the following power: ① Note adequacy of patient blood volume,[link widoczny dla zalogowanych], such as inadequate. Be and. 1 -* 1 - filling station and apply carefully as possible ② may cause low blood pressure or increase the Nepalese j lay each horizon should be biologically active drugs,[link widoczny dla zalogowanych], such as hibernation station agent. Other calcium antagonists, cimetidine, etc. ③ blood pressure monitoring and medication,[link widoczny dla zalogowanych], pay attention to changes in consciousness, if it is found adverse effects, early treatment of a Nigerian lay ① infusion speed can not pass too quickly, 10rag appropriate dose to 6 ~ 8h, rrIlet- F and other proposed infusion rate 2nN / h, the 38% of patients had hypotension J, Srarr ~ k-JJ so that the 2mg / h input wave velocity to increase in adverse reactions. 3
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