http://tcm-toxic.kmu.edu.tw/index.php?action=history&feed=atom&title=Dilantin_%28phenytoin%29_%E4%B8%AD%E6%AF%92 2026-07-25T18:35:11Z 本站上此頁的修訂歷史 MediaWiki 1.16.2 http://tcm-toxic.kmu.edu.tw/index.php?title=Dilantin_(phenytoin)_%E4%B8%AD%E6%AF%92&diff=2332&oldid=prev 2012-07-05T02:57:46Z

<p></p> <table style="background-color: white; color:black;"> <col class='diff-marker' /> <col class='diff-content' /> <col class='diff-marker' /> <col class='diff-content' /> <tr valign='top'> <td colspan='2' style="background-color: white; color:black;">←上一修訂</td> <td colspan='2' style="background-color: white; color:black;">在2012年7月5日 (四) 02:57所做的修訂版本</td> </tr><tr><td colspan="2" class="diff-lineno">第1行：</td> <td colspan="2" class="diff-lineno">第1行：</td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;font size=5 color=green&gt;1. Dilantin (phenytoin) 中毒機轉&lt;/font&gt; &lt;font size=4&gt;</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 1) 鈉離子通道的穩定作用：</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 2) 降低腦部的抽搐、中樞神經抑制</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 3) 減少心臟 SA node 的自主活動</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 4) 增加房室間的傳導</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 5) 誘發肝臟 cytochrome P450 氧化酵素的活性</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 6) 低白蛋白血症</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 7) 腎臟衰竭</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 8) 肝衰竭</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 9) 代謝異常</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 10) 併用其他可能延長 phenytoin 代謝的藥物時 (phenobarbital、carbamazepine)</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;/font&gt;</ins></div></td></tr> <tr><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;font size=5 color=green&gt;2. Dilantin (phenytoin) 中毒症狀&lt;/font&gt; &lt;font size=4&gt;</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 1) 20-30μg/ml：眼震、步態不穩</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 2) 30-40μg/ml：昏睡、言語不清、垂直眼震、手抖、反射增強、更嚴重的步態不穩、甚至無法坐穩</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 3) 40-50μg/ml ：產生神智不清或昏迷、擴瞳、抽搐(較少發生需找其他原因)、呼吸抑制</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 4) 50-70μg/ml ：致死</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 5) 心搏變慢、心臟收縮力變差、低血壓、房室傳導阻礙、心室性心律不整(心臟問題 IV 較易發生)、嘔吐、高或低血糖</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 6) 慢性中毒：過敏性肝炎、megaloblastic anemia、osteomalacia 、 Stevens-Johnson syndrome</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;/font&gt;</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;"></ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;font size=5 color=green&gt;3. Dilantin (phenytoin) 中毒治療&lt;/font&gt; &lt;font size=4&gt;</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 1) 洗胃、活性碳灌洗、支持療法，但不催吐</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 2) 無特殊的解毒劑或幫助藥物排除的方法</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 3) 呼吸抑制：氣管插管</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 4) 低血壓： 補充水份、升壓劑</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 5) 抽搐：diazepam, lorazepam or phenobarbital</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 6) 心臟傳導阻礙： atropine 、心律調節器</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 7) 血糖高： 注射胰島素、足夠的水份；血糖低：補充血糖</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">* 8) 追蹤血中濃度，本院緊急生化可檢測</ins></div></td></tr> <tr><td colspan="2">&nbsp;</td><td class='diff-marker'>+</td><td style="background: #cfc; color:black; font-size: smaller;"><div><ins style="color: red; font-weight: bold; text-decoration: none;">&lt;/font&gt;</ins></div></td></tr> <tr><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td></tr> <tr><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"></td></tr> <tr><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"><div>[http://tcm-toxic.kmu.edu.tw/index.php/%E5%B8%B8%E8%A6%8B%E4%B8%AD%E6%AF%92%E8%99%95%E7%90%86%E6%96%B9%E5%BC%8F 返回常見中毒處理方式]</div></td><td class='diff-marker'> </td><td style="background: #eee; color:black; font-size: smaller;"><div>[http://tcm-toxic.kmu.edu.tw/index.php/%E5%B8%B8%E8%A6%8B%E4%B8%AD%E6%AF%92%E8%99%95%E7%90%86%E6%96%B9%E5%BC%8F 返回常見中毒處理方式]</div></td></tr> </table>

Kmutox520 http://tcm-toxic.kmu.edu.tw/index.php?title=Dilantin_(phenytoin)_%E4%B8%AD%E6%AF%92&diff=2325&oldid=prev 2012-07-05T02:29:58Z

<p>以內容「 [http://tcm-toxic.kmu.edu.tw/index.php/%E5%B8%B8%E8%A6%8B%E4%B8%AD%E6%AF%92%E8%99%95%E7%90%86%E6%96%B9%E5%BC%8F 返回常見中毒處理方式]」創建新頁面</p> <p><b>新頁面</b></p><div><br /> <br /> <br /> [http://tcm-toxic.kmu.edu.tw/index.php/%E5%B8%B8%E8%A6%8B%E4%B8%AD%E6%AF%92%E8%99%95%E7%90%86%E6%96%B9%E5%BC%8F 返回常見中毒處理方式]</div>

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