Hypotension induced by irrational use of urapidil injection
10.3760/cma.j.cn114015-20191211-01020
- VernacularTitle:乌拉地尔注射液不合理应用致低血压
- Author:
Jigang SI
1
;
Jian ZHOU
1
;
Qun ZHAO
1
;
Min SUN
1
Author Information
1. 山东省淄博市中心医院药学部 255036
- Publication Type:Journal Article
- Keywords:
Adrenergic alpha-antagonists;
Antihypertensive agents;
Medication errors;
Hypotension;
Urapidil
- From:
Adverse Drug Reactions Journal
2020;22(10):587-588
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old female patient with hypertension (196/93 mmHg) received a slow IV infusion of urapidil injection 100 mg diluted into 250 ml of 0.9% sodium chloride injection to reduce blood pressure. The infusion rate was controlled at 40 drops/min. If the blood pressure dropped to the target value, the drug would be stopped temporarily. The blood pressure dropped to 152/70 mmHg when urapidil injection was intravenously infused for 40 min (about 80 ml). Then the drug was stopped temporarily. The nurse on duty did not introduce the patient′s condition and the use of urapidil to the nurse who would take turn on duty. The successive nurse did not check the doctor′s order and mistakenly infused the remained urapidil 170 ml within 60 min (60 drops/min). Five minutes later, the patient developed dizziness, fatigue, and severe vomiting, and the blood pressure dropped to 136/66 mmHg. Rehydration treatment was given immediately. About 2 hours later, the patient′s blood pressure increased to 158/76 mmHg and the symptoms were relieved.
