【罂粟摘要】普瑞巴林中毒:剂量毒性关系的评价

       在我们的研究中（n=21名患者），最常见的症状是嗜睡（62%）、精神错乱（29%）和冷漠（24%）。 PSS评分为0分有3例(14%)，轻度15例（71%），中度3例（14%）。很多病例分析也报道了大多数中毒案例（69-100%）的PSS从零到轻微，对于34名个体患者（21名来自我们的研究，13名来自文献报道）， 根据剂量和临床疗程的详细数据可用于检验剂量-毒性之间的关系。PSS非次要组（“良性”）的中位剂量显著较低（8.6 mg/ kg，四分位间距（IQ25-75）5.0-17.6 mg/kg）与中重度组相比（“显著毒性”）（46.7 mg/kg，（IQ25-75）21.3-64.3 mg/kg）；中位数差异估计值=27.3 mg/kg（95%可信区间：10-48.6）。

Rietjens Saskia J., Sikma Maaike A., Hunault Claudine C., de Lange Dylan W., Hondebrink Laura.(2021). Pregabalin Poisoning: Evaluation of Dose-Toxicity Relationship. Br J Clin Pharmacol, 2021;1–10. doi:10.1111/bcp.15073

英文原文????

CONTEXT

Pregabalin poisoning is mostly benign, although coma and convulsions occasionally occur.

AIM

To determine the dose-toxicity relationship of pregabalin.

Results

In our study (n=21 patients), the most commonly observed symptoms were drowsiness (62%), confusion (29%), and apathy (24%). PSS was none in 3 (14%), minor in 15 (71%), and moderate in 3 patients (14%). Most case series also report a PSS of none to minor in the majority of poisonings (69% to 100%). For 34 individual patients (21 from our study and 13 from literature), detailed data on dose and clinical course were available to examine the dose-toxicity relationship. The median dose was significantly lower in the PSS none-minor group ('benign') (8.6 mg kg^-1, IQ25-75: 5.0-17.6 mg kg^-1 ) than in the PSS moderate-severe group ('significant toxicity') (46.7 mg kg^-1 , IQ25-75: 21.3-64.3 mg kg^-1 ); estimate of the median difference = 27.3 mg kg^-1 (95% CI [10 ; 48.6]).

Conclusion

In general, higher pregabalin doses result in more severe poisonings. Below 20 mgkg the majority of patients (83%) only suffer from mild poisoning. However, large interindividual differences exist in pregabalin-induced toxicity. Therefore, pre-hospital triage should not only include pregabalin dose, but also underlying illnesses, co-exposures and reported symptoms.