药理之案例分析（A case study of Pharmacology）.docVIP

药理之案例分析（A case study of Pharmacology） Case study of Pharmacology (grade 09 Nursing) Case 1 A certain man, 24 years old. The patient was admitted to hospital with oral DDV15 20 ml before min. Physical examination: drowsiness, sweating, vomiting several times. No systemic clammy skin, muscle tremor. Bilateral pupillary diameters 2~3, mm, exist for light reflex. Body temperature, pulse, respiration and blood pressure are normal. Double lung breath sound coarse. Laboratory test: WBC14.2 * 109/L, neutral 93%. No abnormalities were observed. It is diagnosed as acute organophosphorus pesticide poisoning. After admission, lavage with 2% sodium bicarbonate water, intravenous injection of atropine 10 mg/ times, a total of 3 times. Another intravenous infusion of anisodamine, l0, Mg, iodine iodide phosphorus 1 g, and penicillin, gentamicin and infusion treatment, the pupil diameter of 5~6 mm, heart rate 72 times /min, law Qi, dry skin, facial red. Soon discharged. Discussion: (1) how to use atropine correctly? (2) why is iodine phosphate therapy prescribed when using the M receptor blocker? Reference answer: (1) rescue organophosphorus pesticide poisoning patients when the dosage of atropine, according to the condition determined by maximum limit, in principle, should as soon as possible, sufficient, repeated drug use, reaching atropinization after reduction maintenance. The signs of atropine are mydriasis, facial flushing, decreased glandular secretion, dry mouth, mild restlessness, and a marked decrease or disappearance of wet rales in the lungs. If there are symptoms of atropine overdose, such as delirium, restlessness, heart rate, elevated body temperature, should be reduced or suspended medication. (reference materials P32, 33, 36) (2) atropine is M receptor blockers, M like symptoms can effectively relieve patients of organophosphorus pesticide poisoning, such as vomiting, salivation, incontinence and breathing difficulties. But the central symptoms such as convulsions,