# AI计算甲醇中毒的甲吡唑负荷剂量时使用超过100kg的患者实际体重而未设上限，导致十倍过量

- **ID:** `medical/ethylene-glycol-methanol-dosing`
- **领域:** medical
- **类别:** data_error
- **错误码:** `TOX-DOSE-CAP-ERR-002`
- **验证级别:** ai_generated
- **修复率:** 80%

## 根因

甲吡唑（Antizol）负荷剂量为15 mg/kg静脉注射，但推荐单次最大剂量为1.5 g（体重>100kg的患者使用理想体重或上限100kg），以避免丙二醇溶剂的毒性；AI对150kg患者未设上限，计算为2.25g。

## 版本兼容性

| 版本 | 状态 | 引入 | 弃用 |
|------|------|------|------|
| Antizol Prescribing Information 2023 | active | — | — |
| Goldfrank's Toxicologic Emergencies 11th Ed | active | — | — |
| EXTRIP Workgroup Guidelines for Methanol Poisoning 2022 | active | — | — |

## 解决方案

1. ```
   Cap the weight at 100 kg for dose calculation: `dose_mg = min(patient_weight_kg, 100) * 15`. For a 150 kg patient: 100 * 15 = 1500 mg = 1.5 g (one vial). Verify with pharmacy: `python -c "print(min(150,100)*15)"`
   ```
2. ```
   Use ideal body weight (IBW) for obese patients: IBW (males) = 50 + 0.91*(height_cm - 152.4), IBW (females) = 45.5 + 0.91*(height_cm - 152.4). Then calculate dose = IBW * 15 mg/kg. Document in MAR: `Fomepizole 1.5 g IV (capped at 100 kg IBW)`
   ```

## 无效尝试

- **** — Using lean body weight formula (Boer) for all patients — underestimates dose for obese patients and may lead to subtherapeutic levels (65% 失败率)
- **** — Assuming the dose can be rounded up to nearest vial (1.5 g vial) — 2.25 g requires opening two vials and discarding part, risking contamination (55% 失败率)
- **** — Using adjusted body weight (IBW + 0.4*(ABW-IBW)) — not validated for fomepizole and may still exceed safe limits (75% 失败率)