盐酸羟考酮缓释片致5-羟色胺综合征1例分析

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【中图分类号】R971 【文献标识码】A

【Abstract】One female patient with cancer pain due to bone metastasis from breast cancer was initially treated with Xinhuang tablets，diclofenac sodium double-releaseenteric-soluble capsules， paracetamol dihydrocodeine tablets and paracetamol oxycodone tablets， before being switched to controlled-release oxycodone hydrochloride tablets. She regularly took oxycodone hydrochloride sustained-release tablets 20 mg，ql2h， no abnormalities were observed，and the dosage was increased to 40mg ，ql2h due to poor pain control. The patient was diagnosed with

5-hydroxytryptamine syndrome after of intermittent recurrent tremor， myotonia， scalp sweating，restlessness and elevated blood pressure. When oxycodone hydrochloride sustained release tablet was adjusted to 20mg ql2h and gabapentin capsule was added to 0.1g， tid， the frequency of tremor and myotonia attacks slightly decreased，and sweating and agitation symptoms were not relieved. After14 days，oxycodone hydrochloride sustained release tablets were stopped and morphine sulfate sustained release tablets 60mg; ql2h were replaced. Three days later， the patient's symptoms disappeared.During 5-month follow-up，the patient's pain was wellcontrdled，with no change in the dose of morphine sulfate sustained-release tablets，and no adverse drug reactions observed. Using the Naranjo’s Assessment Scale，the association between the patient's serotonin syndrome and the suspected drug oxycodone hydrochloride sustained-release tablets was evaluated as "probable". This case highlights the importance for clinicians to closely monitor adverse reactions induced by rapid opioid dose escalation to ensure medication safety in patients.

【Keywords】Oxycodone hydrochloride sustained-release tablets; 5-Hydroxytryptamine Syndrome Morphine sulfate sustained-release tablets; Adverse drug reaction

5-羟色胺综合征（5-hydroxytryptaminesyndrome）是由中枢和外周神经系统中过量5-羟色胺引发的可能致命的一组症状群[。（剩余7441字）