For prevention of infection and antiinflammatory and antalgic treatment after tooth extraction, enoxacin and fenbufen were given together to a patient, who then showed side effects of critical symptoms.
The side effects appeared after the second administration of the drugs, and were severe chronic convulsion and severe disturbance of consciousness. Diazepam was given as convulsion treatment, simultaneously with transfusion of a large amount of fluid containing diuretics for quick disintoxication and elimination. About 24 hours after appearance of the side effects, convulsion disappeared, and after 3 days disturbance of consciousness also disappeared. In laboratory examination, the peaks of GOT (546 KU) and GPT (251 KU) were found on the 3rd to the 5th days, and CPK and LDH became very high on the 3rd to 4th days.(CPK: 46, 575 IU, LDH: 1, 496 IU) In the isozyme analysis, strong spots appeared at LDH (V) and CPK (MM). On the 4th day the urinalysis revealed high occult blood reaction, but it would be due to the existence of a large amount of myoglobin in urine. The above-described test results suggested severe fatigue of skeletal muscles due to convulsion. In electroencepharography, slow waves were prominent 3 days after disappearance of convulsion, and then spikes were often seen.
The side effects will be caused by such a mechanism that fenbufen depresses the renal function to elevate the blood concentration of enoxacin, which results in exhibition of its specific activity to the central nervous system.
