复杂的ADHD具有挑战性的案例:通过有限的药物表单来管理同时发生的注意力缺陷多动性障碍和先天性心脏病:墨西哥的一个案例
Angel Rios Medina1, Paul Hammerness2, Demvihin Ihyembe3
1Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
概括
甲基胺在患有心脏缺陷的儿科患者中改善了ADHD症状,但引起了色. 停止治疗可以缓解青症,但会使ADHD恶化,这就造成了临床困境.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 发育行为儿科 发展行为儿科
- 药理学 药理学是指药理学的学科.
背景情况:
- 一个8岁的男孩有后心房隔膜缺陷和部分异常的肺静脉回归,呈现出显著的学术和注意力困难.
- 医疗管理包括针对他的心脏病状况的富罗塞米德和螺旋,而手术修复则被推迟.
- 患者表现出与注意力缺陷/多动障碍 (ADHD) 一致的症状,主要是注意力不集中类型.
研究的目的:
- 评估甲基胺对已知心脏异常的儿科患者ADHD症状的影响.
- 在患者的心脏状况的背景下,评估甲基酸的潜在副作用,特别是色.
- 确定最佳的管理策略,平衡ADHD症状控制和心脏安全.
主要方法:
- 开始治疗Methylphenidate治疗ADHD的症状.
- 监测学业成绩,注意力和行为症状.
- 心血管评估包括体检,心率,血压和氧计.
- 根据观察到的作用和副作用,调整甲基酸的剂量.
主要成果:
- 甲基胺最初改善了注意力,冲动性和学业表现.
- 患者在开始服用甲基尼达后出现了环口腔和青症,在减少剂量和停止治疗后恢复.
- 停用甲基酸盐导致ADHD症状的复苏和学术衰退,尽管色症的解决.
结论:
- 甲基胺在治疗ADHD症状方面表现出有效性,但在这个患者身上表现出显著的心血管副作用 (阴光症).
- 这一案例凸显了兴奋剂药物,儿科心脏病和需要仔细评估风险和益处之间的复杂相互作用.
- 建议进一步评估心胸外科手术,重新评估手术候选人,同时挑战墨西哥有限的治疗选择.
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