在患有功能下降的住院患者中评估加巴丁和普雷加巴林的使用
Gwendolyn M Knowles1, Grace E LaFleur2, Mariann D Churchwell3
1Department of Pharmacy Practice and Administration, University of Maryland Eastern Shore School of Pharmacy, Princess Anne, MD, USA.
概括
患有功能减弱 (CrCl <60毫升/分钟) 的患者经常接受高剂量的 gabapentinoids,增加不良事件的风险. 需要进一步的研究来证实剂量,功能和副作用之间的这种联系.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床药房 临床药房
背景情况:
- gabapentinoids (gabapentin,pregabalin) 是通过脏清除的.
- 有限的数据存在于对 gabapentinoid 剂量和不良反应 (AEs) 在功能减弱的患者.
研究的目的:
- 为了评估 gabapentinoid 剂量的适当性和 AE 发生率与医院入院时的肌素清除 (CrCl) 相比.
主要方法:
- 对286名成年住院患者进行了回顾性队列研究,这些患者接受了 gabapentinoid 处方和血清肌素.
- CrCl 分层为≥60,<60,15-29和<15毫升/分钟.
- 主要结局:基于CrCl.Cl的 gabapentinoid剂量的适当性.
主要成果:
- 34%的CRCl<60毫升/分钟的患者接受高剂量 gabapentin;22.7%接受高剂量普雷加巴林.
- 不适当的高剂量被给予48.8% (加巴丁) 和45% (普雷加巴林) 的CrCl为15-29毫升/分钟或<15毫升/分钟.
- 在CrCl<60毫升/分钟 (P=0.029) 的患者中,跌幅显著增加.
- 同时服用阿片类药物/精神药物增加了不论CrCl.Cl的AEs.
结论:
- 在CRCl<60毫升/分钟的患者中,不适当高的 gabapentinoid 剂量很常见.
- 需要进行更大规模的多中心研究,以充分阐明 gabapentinoid 剂量,功能和 AES 之间的关系.
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