Ataxia and mental disorders due to compound phenytoin sodium, ephedrin hydrochloride and theophylline tablets

Abstract

A 70-year-old male patient with chronic obstructive pulmonary disease received compound phenytoin sodium, ephedrin hydrochloride and theophylline tablets(each tablet containing phenytoin sodium 50 mg, chlorpheniramine maleate 1 mg, ephedrine hydrochloride 5 mg, caffeine 7.5 mg, theobromine 12.5 mg, theophylline 12.5 mg, belladonna flow extract 0.009 ml) 3 tablets thrice daily by mouth. Gait instability and clumsiness of his lower limbs appeared after 29 months of medication and gradually worsened with mental disorders (such as sparoxysmal unconsciousness, increased daytime sleep and balderdash) after 35 months of medication. Laboratory tests showed that the blood phenytoin concentration was 30 mg/L. Phenytoin poisoning was considered. Compound phenytoin sodium, ephedrin hydrochloride and theophylline tablets were stopped, and symptomatic and supportive treatments were given. Ten days later, the patient became conscious, his mental disorders disappeared, and the blood phenytoin concentration decreased to be 15 mg/L. Fourteen days later, he could walk independently. Key words: Phenytoin; Ephedrine; Ataxia; Mental disorders