事件记录
面试官: 大发娱乐都知道大发娱乐必须小心家里的处方药, 但你知道心脏药物特别危险吗? 这就是下一期《大发娱乐》.
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面试官: 我和Dr. 汤姆•马丁. 他是犹他州中毒控制中心的医疗主任. 欢迎你,汤姆.
Dr. 汤姆·马丁: 谢谢你！.
面试官: 今天, 大发娱乐会讨论一下在家里使用心脏药物的危险. Everybody knows that they need to keep medications locked up and away from where small children can get at them, 但是心脏药物, 我想大发娱乐这样做是特别重要的. 这是为什么？?
Dr. 汤姆·马丁: 嗯，它们在低剂量下毒性特别大. 这意味着它们非常有效. 它们是给心血管系统较弱的人开的. They are often prescribed to older people and that means that many times there's grandchildren around and that's a bad combination.
面试官: 是什么让他们如此危险? 你说过小剂量的时候效果特别好. 这些药片本身的处方剂量总是很低吗?
Dr. 汤姆·马丁: 不，实际上不一定. 在缓释制剂中，有时一粒药的剂量相当于一天的剂量. 所以这实际上需要很大剂量的药物, 但它会慢慢溶解并被人体吸收. 然而，对于一个孩子来说，这个剂量对于一个成年人来说可能是非常致命的.
面试官: 当你说有持续释放时，孩子可能不会立即表现出症状.
Dr. 汤姆·马丁: 这是正确的. 所以这是其中一个非常危险的事情, 是说它们就像定时炸弹，孩子也能吞下一颗. 父母可能只是看到孩子拿着一个打开的瓶子, 我觉得他们表现得不错, 不要太担心. 几个小时后, 有时长达四到六个小时, 孩子可能病得很重, 也许比那早得多. 只是变化而已. 这取决于特定药物的配方. 但是持续释放的准备对大发娱乐来说确实是非常有问题的.
面试官: 心脏病药物中毒的孩子有哪些症状?
Dr. 汤姆·马丁: 好吧, 有不同类型的心脏药物, but generally I think the main concerns we have are that there would be severe drop in their blood pressure that can make them feel maybe very weak or dizzy or pass out or very drowsy, 有时它会使他们的心脏进入非常不正常的节奏. 这通常会导致一个非常突然的变化, although a very slow heart rate can come on gradually or a very rapid heart rate can come on gradually. There are other rhythms that can be very lethal and can come on very rapid and cause 一个孩子 or an individual just drop down and pass out.
面试官: 哇. 所以一旦你开始注意到一个孩子有被心脏病药物中毒的症状. 在事情变得非常非常危险之前你还有多久?
Dr. 汤姆·马丁: 好吧, certainly we recommend anytime anybody thinks 一个孩子 or a person who is not on these medications has had exposure, 有没有吞下这些药物, 他们应该给解毒中心打电话. They should call the 800 number which works throughout the United States and puts you in contact with your closest regional poison center because these can be very deadly.
We have a lot of experience with them and so we use our knowledge and our judgment with the experience to really try to manage these appropriately, 有时候确实是这样, 在某些情况下, 在家管理个人, but many times with these types of medications which have such lethal potential and they have the delayed effects, 都因延迟效应而臭名昭著吗, 通常最好是把他们带到医院来观察.
面试官: By the time the child may be exhibiting symptoms they probably have already absorbed a lot of what we might call the "active ingredient" that is actually causing these symptoms and poisoning them.
Dr. 汤姆·马丁: 是的, 所以当他们出现明显症状的时候, 所以如果一个外行人看着它们说, 我的天啊, 他们生病了.“那时他们可能病得很重. 现在, 如果他们只是有点昏昏欲睡，那是一回事, but if they are very weak or they are pale looking that would suggest that their blood pressures are very low and that would be very concerning and we wouldn't want that to happen at home if we can avoid. 如果发生这种情况，大发娱乐希望在医院里，大发娱乐可以快速治疗.
面试官: 所以一旦这些症状在孩子身上变得明显, 他们可能已经摄入了足够的药物, 好吧, 很明显，他们摄入的食物足够让他们至少生病并出现症状. 在那一刻，父母该有多担心呢? 我的意思是我知道他们会打电话给中毒控制中心或者他们会去急诊室. 我的意思是，一个孩子吃了这些心脏药物后预后如何?
Dr. 汤姆·马丁: 对于其中一些药物，一粒药就可能致命. 实际上，儿童死于这些过量药物的情况非常罕见，因为大发娱乐非常谨慎. 大发娱乐马上送他们去医院, 如果他们开始出现迹象和症状，大发娱乐会迅速治疗, 在医院环境中，大发娱乐通常可以支持他们，大发娱乐他们度过难关.
但并非总是如此. Sometimes they'll have enough absorbed that no matter what we do they still may end up getting very sick or even dying, 但这种情况并不常见.
面试官: 当孩子去医院时，他们会遇到什么样的治疗呢?
Dr. 汤姆·马丁: 好吧, 这取决于服药后多久以及他们可能摄入了何种制剂, 他们的胃可能会被清空. 所以有时大发娱乐可能会洗胃, sometimes we might give them activated charcoal to bind the toxin and then pass it through their intestines bound to the charcoal. 其他时候，这些药物有特殊的解毒剂. 有些非常不寻常.
Sometimes we use doses of medicine to raise their blood pressure that may be 10 to a 100 times the normal dose. 有时大发娱乐使用胰岛素, 它具有特殊的血流动力学特性或对心脏有益的特性, 有时大发娱乐给胰岛素的剂量是正常剂量的100到150倍. 很多时候医院里的药剂师也是如此, 如果他们熟悉这些协议, 他们对此感到非常惊讶, 所以大发娱乐必须传真给他们方案和文献来支持这些不寻常的疗法.
面试官: 听起来如果孩子们单独服用的话会中毒的.
Dr. 汤姆·马丁: 它们不是无害的治疗方法，必须非常仔细地观察.
面试官: 这是紧急情况, 所以你要做你该做的来挽救被毒害的人的生命.
Dr. 汤姆·马丁: 这是正确的.
面试官: 听起来像是, 根据大发娱乐目前的谈话, 我个人不吃心脏药物, 但如果我做了这些东西就会在我家的保险箱里. 这东西听起来对孩子很危险，我家里有四个孩子. 作为毒物控制专家, 你认为心脏病药物在处方药的危险程度上属于哪一类?
Dr. 汤姆·马丁: 朝向天平的顶端. 它们非常危险. Fortunately we don't get too many children that get into high doses and so we don't see a lot of deaths, but certainly we do see occasional deaths and we certainly see deaths in adults who take them intentionally.
That's part of the problem with these medications are they are often prescribed to older people with deteriorating cardiovascular systems and as they go from being older to becoming elderly they end up losing their loved ones, 他们最终失去了家人, 他们最终会自然而然地失去朋友, 这通常会导致抑郁, 有时是非常严重的抑郁症, and now they have a very potent medication with them and they may be severely depressed and that's a very bad combination.
面试官: 所以,博士. 马丁，很明显这些东西很危险. 但是大发娱乐有什么方法可以防止孩子们接触到它们呢? Or what are some behaviors that might put kids at risk that we need to watch out for and maybe correct for in order to protect them?
Dr. 汤姆·马丁: 当大发娱乐开强效药物时，大发娱乐建议使用儿童安全容器. 然而, older people sometimes have arthritis in their hands and sometimes just have weakness so that they struggle with childproof containers.
And many times for that reason or because of convenience they'll put them in a pill-minder which is a way of organizing your daily medications with a little flip-top and it's very convenient for seniors to have their medication in that fashion, 但对于一个非常好奇的孩子来说，这是很容易进入的, 当然，孩子们在探索药物的过程中是非常口服的, 把它们放进它们的嘴里. 你会想，如果味道不好，他们会直接吐出来, but their natural tendency is to just swallow it if it doesn't taste good and go for another one that looks different.
So that's important for grandparents to realize when their children's homes where there are grandchildren there that their behavior really has to change and they have to really mind those medications. 你不能把看守药丸的人排除在外, you can't take pills out of containers and put them on your dresser because children will find some way to get up there and play with those or eat them thinking they're candy.
One grandmother used her pill-minder and gave it to the child to play with as a rattle because it rattled when he shook it. 显然，这可能是非常危险的. 如果她转过身，门碰巧开了, 糖果掉在地板上，孩子很快地抓住它，放进嘴里.
面试官: 哇. 所以这听起来是一件值得警惕的事情，父母也应该意识到这一点, and from our discussion it seems that if there is even any suspicion that 一个孩子 has gotten access to these pills to just call poison control right way.
Dr. 汤姆·马丁: 好吧, 我想说的是，不仅仅是任何关于儿童摄入食物的怀疑, but anybody who you think may have taken a potent medication like this that is not prescribed for them that they're not used to it or taken more of that medication. Even a double dose of some of these medications can be very toxic on somebody who takes them all the time, but they are so potent and there's this narrow very therapeutic window that they could get very sick with just a double dose.
面试官: 你能告诉大发娱乐这个数字是多少吗，医生. 马丁?
Dr. 汤姆·马丁: 解毒中心的电话是800-222-1222.
面试官: 所以如果你怀疑一个家庭成员, 一个相对, 一个孩子, anyone has accidentally or intentionally exposed themselves to this medications in an appropriate way call the poison control center immediately.
Dr. 汤姆·马丁: 是的，没错.