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多潘立酮(吗丁啉)为外周多巴胺受体拮抗剂,具有外周阻滞作用,促进胃排空,恢复正常胃功能,不透过血脑屏障。临床广泛用于各种病因引起的恶心、呕吐、儿童厌食、腹胀、胆汁反流。最近遇有该药致小儿惊厥、推体外系症状和肌肉震颤病例。 例1 女性,3岁,因消化不良,腹胀,厌食服用多潘立酮,剂量1mg/kg,1日分3次口服,连服2周后出现全身频繁抽搐,无热,表现为眼上翻,牙关紧,唇发绀,双手握拳,数秒钟自行缓解,惊厥发作后意识清楚,即往无类似病史。血清钾、钠、氯、钙、脑电图,头颅CT、腰穿的正常。考虑为多潘立酮的中枢不良反应。停药后,未再次发作,随访未发现异常。
Domperidone (domperidone) is a peripheral dopamine receptor antagonist, with peripheral blockade, promote gastric emptying, restore normal gastric function, not through the blood-brain barrier. Clinical widely used in various causes of nausea, vomiting, children anorexia, bloating, bile reflux. Recently encountered the drug caused pediatric convulsions, extra-corporeal symptoms and cases of muscle tremors. Example 1 female, 3 years old, due to indigestion, bloating, anorexia taking domperidone, the dose of 1mg / kg, 1 day 3 times orally, even after 2 weeks of convulsive systemic convulsions, no fever, showed upturned, teeth tight , Lips cyanosis, hands fist, a few seconds to ease themselves, convulsions after the onset of consciousness, that is, to no similar history. Serum potassium, sodium, chloride, calcium, electroencephalogram, head CT, waist wear normal. Considered a central adverse effect of domperidone. After discontinuation, did not attack again, no abnormalities were found.