长效注射抗精神病药物的功能障碍和剂量调整:我们是否正确? 一个案例报告
Colette Raphaël1, Gary Remington1, Ofer Agid1
1Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
概括
通过低估计的球过率 (eGFR) 表示的功能障碍会影响药物的有效性和安全性. 了解eGFR对于调整药物剂量至关重要,特别是在服用抗精神病药物的精神病患者中.
科学领域:
- 腎病學和藥理學 腎病學和藥理學
- 精神病药物剂量和功能
背景情况:
- 功能障碍被定义为估计的膜过率 (eGFR) <60毫升/分钟/1.73米2,可能影响药物的疗效和安全.
- 血清肌素是估计功能的主要生物标志物,是eGFR计算的组成部分.
- 由于脏分泌量下降,药物积累可能会引起药物效应的改变,包括毒性.
研究的目的:
- 突出EGFR在优化脏分泌药物的药物剂量的关键作用.
- 为了解决认知功能障碍和准确解释eGFR方程的挑战.
- 探索eGFR在精神病患者中的意义,特别是关于长效抗精神病剂的剂量.
主要方法:
- 对功能障碍定义及其对药物药理动力学影响的审查.
- 作为生物标志物用于估计膜过率 (eGFR) 的肌素分析.
- 病例报告侧重于精神病患者的eGFR和长效抗精神病药物管理.
主要成果:
- 由于潜在的药物积累和毒性,功能障碍需要进行治疗调整.
- 准确的eGFR解释对于适当的药物剂量至关重要,特别是对于通过脏清除的药物.
- 在临床识别和管理先前存在的功能障碍方面仍然存在挑战.
结论:
- 估计的淋巴细胞过率 (eGFR) 是调整药物剂量的关键决定因素.
- 对eGFR的正确理解和应用对于安全有效的药物治疗至关重要,特别是在脆弱的患者群体中.
- 本案例报告强调了在接受长期抗精神病药物治疗的精神病患者考虑eGFR的重要性.
相关概念视频
Renal Failure: Dose Adjustments
64
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
64
Insulin: Dosing Regimen and Adverse Effects
145
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
145
Drug Therapy
39
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
39
Factors Affecting Drug Response: Overview
1.9K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.9K
Psychosis: Goals of Pharmacotherapy
104
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
104
Factors Affecting Renal Clearance: Renal Impairment
54
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
54


