过量服用通道阻塞剂:并非所有毒性都相同
Geoffrey K Isbister1,2, Shane Jenkins1, Keith Harris3,4
1Clinical Toxicology Research Group, University of Newcastle, Newcastle, Australia.
British journal of clinical pharmacology
|September 21, 2024
概括
基管阻断剂 (CCB) 过量服用正在增加,其中安洛迪平是最常见的. 过量服用迪尔蒂亚泽姆和维拉帕米尔会产生更严重的毒性,并且与二皮里丁相比,需要不同的治疗方法.
科学领域:
- 心脏病学 心脏病学
- 毒理学 毒理学 毒理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 通道阻塞剂 (CCB) 是广泛用于心血管疾病的药物.
- 过量服用CCB,特别是二皮里丁,构成了严重的毒理学挑战.
- 了解不同CCB过量剂的比较严重程度和管理对于临床实践至关重要.
研究的目的:
- 为了比较涉及不同类型通道阻塞剂的过量剂的严重程度和治疗策略.
- 分析CCB过量呈现的趋势,重点关注二二二的日益使用.
主要方法:
- 在2014年至2023年期间,对2个毒理学部门呈现的236个CCB过量剂的回顾性审查.
- 从临床数据库中提取数据,包括患者人口统计数据,摄入剂量,共摄入剂,临床并发症,治疗方法和患者结局.
- 对不同CCB药物的比较分析,重点是二二和非二二 (diltiazem,verapamil).
主要成果:
- 在研究期间,二皮里丁过量剂量显著增加, amlodipine 是最常见的药物 (147例).
- 与二二二相比,过量服用迪尔提亚和维拉帕米尔与更频繁的重症监护病房入院,心律失常和更长的住院时间有关.
- 在CCB过量服用中,低血压是常见的,因诺托普剂,血管压缩剂,高剂量胰岛素和的多样化使用,二皮里丁和非二皮里丁摄入之间存在差异. 发生了7起死亡 (3%).
结论:
- 双胺,特别是安洛迪平,现在是CCB过量服用中最常见的药物.
- 过量服用迪尔提阿泽姆和维拉帕米尔与二皮里丁相比,与更严重的毒性和不同的管理要求有关.
- 临床管理应根据涉及过量服用的特定CCB剂量进行量身定制,以优化患者的治疗结果.
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