奥兰扎与奎平对比:在重症患者中纠正QT变化
Kaden Shen1, Kevin M Dube1, Jeremy R DeGrado1
1Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA.
The Annals of pharmacotherapy
|October 17, 2024
概括
在重症患者中, olanzapine 和 quetiapine 对纠正的 QT (QTc) 间隔表现出类似的效果. 这项研究表明,在ICU中,这些抗精神病药物对QTc延长的安全性相当.
科学领域:
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
背景情况:
- 非典型的抗精神病药物 olanzapine 和 quetiapine 常用于重症患者.
- 它们对该人群中纠正的QT (QTc) 间隔的影响尚未得到充分证实.
研究的目的:
- 为了比较 olanzapine 与 quetiapine 在重症监护室 (ICU) 患者的 QTc 间隔变化的影响.
- 评估重症患者中与这些药物相关的QTc延长的发生率.
主要方法:
- 对接受 olanzapine 或 quetiapine 的成年ICU 患者的回顾性分析.
- 纳入标准:在48小时内服用≥2剂,并在开始后48小时内评估QTc.
- 主要终点:QTc延长的复合发病率 (QTc>500毫秒或从基线>60毫秒).
主要成果:
- 在复合的QTc延长终点上没有统计学上显著的差异在奥兰扎宾和奎蒂亚平组之间 (9.6%对14.7%,P = .28).
- QTc>500毫秒的发生率 (2.9%对4.7%,P = .25) 和从基线变化>60毫秒 (2.0%对4.0%,P = .26) 是相似的.
- 在这两组中都没有报告Torsades de Pointes或额外金字塔症状的病例.
结论:
- 奥兰沙平和奎蒂亚平似乎对重症患者的QTc延长有着相似的影响.
- 调查结果可能支持在ICU环境中为抗精神病药物作出明智的处方决定.
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