Anaphylactic reaction and anaphylactic shock
Among the 36 cases of adverse reactions, 8 cases were allergic reactions, 1 case was taken orally (ethionine granules, which began to feel unwell after taking the medicine 10min), and the other 7 cases were intravenous drip, and the reaction occurred immediately after input. 4 cases of anaphylactic shock were all given intravenous drip, and the reaction occurred at 10s~ 15min after infusion. Anaphylactic reaction and anaphylactic shock death 1 case, both are
Neuropathy Qiu Xueyan reported that an 8-year-old boy was given 0.25g ethionine aspartic acid and 5%GS250mL intravenous drip for "acute upper respiratory infection". At the same time, 0.2g chuanhuning plus 10%GS 100mL intravenous drip was given, and antongding was given symptomatic treatment, and the condition was stable and he went home. After returning home, the child took some commonly used "cold medicine" orally, and his temperature was repeated. After12 hours, the child developed insanity (T38.2℃), which was characterized by gibberish, restlessness and hallucination. See a doctor again, give diazepam and calm down, and the symptoms of mental disorder will gradually ease. The next day, I changed cephalosporin and Chuanhuning to continue my treatment. Oral medication remains the same, and my temperature is as high as 39℃ repeatedly. There were no symptoms of mental disorder, and after five days of treatment, she recovered. Extrapyramidal reaction
Zhang Xinchun reported 1 case 1 1 year-old children with mycoplasma infection developed extrapyramidal reaction after intravenous infusion of erythromycin for 3 days. They were conscious, listless, had no rash, leaned back, stared intently, were sensitive to light reflex, had no abnormalities in heart, lung, liver and spleen, and had increased muscle tension in limbs. Physical examination: T36.7℃, P92 times/minute, R30 times/minute. That is, stopping ethionine, intramuscular injection of scopolamine and intravenous injection of flumethasone. After 1 hour, the extrapyramidal reaction disappeared, and there was no abnormality in skull CT and EEG. No discomfort was observed for 2 days, and erythromycin was used until it was cured. Wang Xuejie reported that 1 8-year-old children were slowly injected with isoniazid intravenously until the third day due to mycoplasma pneumonia. After dropping vitamin K 1 injection, the child developed symptoms of ankle pain, so he stopped using vitamin K 1 injection. However, on the fourth day, when ethionine was continuously infused, the pain symptoms of the children became worse. Subsequently, ethionine injection was stopped and erythromycin was injected intravenously the next day. The child reported no ankle pain.
Visual rotation and unstable gait
Deng Yibin reported that a 4-year-old child took ethionine granules 150mg (without other drugs) for about 20 minutes due to cough, but he had no headache, vomiting, blurred vision, tinnitus, abdominal pain, diarrhea and other symptoms. Physical examination showed no other symptoms and signs except gait instability. The child took the same box of medicine half a month ago without any discomfort. Therefore, stop using ethionine and give plenty of drinking water, cefazolin, vitamin C and rehydration therapy. After about 6 hours, dizziness and visual rotation disappeared and the gait was stable. By analyzing the literature, we can conclude that the adverse reactions caused by ethionine in children and adolescents have the following characteristics:
1, the main adverse reaction is preschool children under 6 years old, accounting for more than 60%. On the one hand, it is related to the great physiological and functional differences between preschool children and adults, on the other hand, it may be related to preschool children's susceptibility to infectious diseases and high frequency of ethionine use;
2. Adverse reactions occur in a short time, accounting for more than half within 2 hours, suggesting that patients' reactions should be closely observed after starting medication, whether it is intravenous administration or oral administration;
3. After timely treatment and rescue, the mortality rate of adverse reactions caused by ethionine is low, but the potential danger of intravenous administration to infants under 2 years old is great, so the administration method should be carefully selected and closely observed in clinical administration;
4, there are still a few cases of improper dosage, which should be paid attention to;
5. There are various types of adverse reactions of ethionine. On the one hand, clinicians should read more literature and think more, on the other hand, they should pay attention to the case reports of adverse reactions, especially rare cases, to ensure the safety of children's medication.