相关实验视频
Updated: Jun 14, 2025
07:40
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
7.6K
心力衰竭老年患者按催眠药类别重新住院的风险:利用日本行政索赔数据的队列研究
Tomoyuki Saito1, Shuko Nojiri1, Ryo Naito2,3
1Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Open heart
|August 30, 2024
概括
对于老年心力衰竭 (HF) 患者来说,相比于 benzodiazepines 或 Z-药物,suvorexant 可能会降低重新住院的风险. 这项研究强调了suvorexant作为潜在的更安全的睡眠辅助药物对这个脆弱的人群.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 老年病的医生 老年病的医生
背景情况:
- 关于老年心力衰竭 (HF) 患者的催眠安全性的数据有限.
- 素受体对抗剂 (suvorexant) 尚未直接与类药物或Z药物进行对比,用于HF患者.
- 调查与不同催眠药相关的高频率相关的再住院风险至关重要.
研究的目的:
- 在老年HF患者中,比较suvorexant与类药物或Z药物的安全性.
- 评估与这些催眠药类相关的急性高频率再住院风险.
- 在老年HF患者的睡眠障碍管理方面为临床决策提供信息.
主要方法:
- 使用行政索赔数据 (2008年4月至2020年12月) 采用了回顾性队列研究设计.
- 纳入标准确定年龄≥65岁,有HF住院病史的患者.
- 使用Kaplan-Meier生存分析和Cox比例危险模型来评估再住院风险.
主要成果:
- 这项研究包括1858名因HF住院的老年患者 (平均年龄82.7±7.6岁).
- 根据最初的催眠处方对患者进行分类:苏沃雷克桑 (n=490),二 (n=606) 和Z类药物 (n=762).
- 与suvorexant相比,调整后的危险比率表明,使用二类药物 (2.77) 和Z类药物 (2.98) 的再住院风险明显更高.
结论:
- 在老年患者中,相比于二类药物和Z型药物,suvorexant可能与急性HF相关再住院的风险较低.
- 这些发现表明,suvorexant对于患有高血压和睡眠障碍的老年患者来说是一种潜在的更安全的催眠选择.
- 这项研究为优化这种特定患者群体的催眠选择提供了有价值的证据.
相关概念视频
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
159
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
159
01:23Sedatives and Hypnotics: Overview
308
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
308
01:19Sedatives and Hypnotics Drugs: Benzodiazepines
214
Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
214
01:20Sedatives and Hypnotics Drugs: Barbiturates
225
Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
225
01:26Heart Failure Drugs: Inotropic Agents
545
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
545
01:19Management of Insomnia
235
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
235