Immediate nonallergic psychotic reaction to intramuscular procaine penicillin.

Autor: Einterz EM; Hôpital d'Arrondissement, Kolofata, Cameroun., Einterz RM
Jazyk: angličtina
Zdroj: International journal of dermatology [Int J Dermatol] 1995 Sep; Vol. 34 (9), pp. 627-9.
DOI: 10.1111/j.1365-4362.1995.tb01089.x
Abstrakt: Background: Though little known by medical personnel, an immediate nonallergic psychotic reaction to intramuscular procaine penicillin has been reported occasionally from many countries since 1951.
Materials and Methods: A case report describes a patient whose violent behavior, provoked by this reaction, resulted in legal action taken against him. Two other nonviolent cases are presented and are followed by a review of the literature.
Results: Signs and symptoms of this reaction that appears to be to the procaine component resemble a pressor response and are therefore contrary to the signs and symptoms of an anaphylactic reaction. Anxiety, hallucinations, hypertension, and tachycardia are characteristic. The reaction is self-limited. Long-term psychologic sequelae might be averted by adequate reassurance.
Conclusions: The importance of procaine penicillin as an essential drug in many parts of the world should not be diminished; however, recognition of acute nonallergic psychotic reactions is of paramount importance to assure proper patient management and to avoid misinterpretation of aggressive behavior.
Databáze: MEDLINE
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