迪戈辛加载剂量和血清迪戈辛度用于控制重症患者心房律乱的速率
Tania Ahuja1,2, Raghad Saadi3, John Papadopoulos1
1Department of Pharmacy, NYU Langone Health, New York, NY; and.
Journal of cardiovascular pharmacology
|November 12, 2024
概括
在患有心房失常症的重症患者中,静脉输入的迪戈辛加载剂达到1.3 ng/mL的中位数血清度. 虽然60%的人达到目标心率,但36%的人具有超治疗水平,这表明需要谨慎的剂量.
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.
- 关键护理医学 关键护理医学
背景情况:
- 静脉注射 (IV) 迪戈辛加载剂量 (LD) 建议在患有心房失常症的重症患者中控制速率尚未确立.
- 目前的指导方针建议针对心房动/心房动 (AF/AFL) 的血清狄戈辛度 (SDC) 达到0.8-1.5 ng/mL.
研究的目的:
- 为了评估IV消毒素LD在重症患者中控制AF/AFL的安全性和有效性.
- 评估在这个患者群体中,在迪戈辛LD后获得的SDC.
主要方法:
- 单中心回顾性队列研究,涉及92名急性病患者,这些患者接受了静脉注射的迪戈辛,并进行了SDC绘制.
- 主要终点:中位数SDC后LD. 二次结局:SDC发病率≥1.5 ng/mL和心率控制 (<110 bpm在24小时内).
主要成果:
- 总LD的中位数为11μg/kg (750μg),其中61%的患者接受了6小时的分剂.
- 获得的中位数SDC为1.3 ng/mL (范围:0.9-1.7 ng/mL).
- 超治疗性SDC (≥1.5 ng/mL) 在36%的患者中发生. 目标心率达到了60%.
结论:
- 在重病AF/AFL患者的急性速率控制中,可以考虑将迪戈辛总LD的中位数为750μg,目标是SDC<1.5 ng/mL.
- 仔细考虑药物相互作用至关重要,特别是在心脏重症监护病房.
- 需要进一步的研究来验证这些发现.
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