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过去二十年开发的降血糖剂及其经手术影响
Basavana Goudra1, Geno J Merli2, Michael Green3,4
1Jefferson Surgical Center Endoscopy, Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Pharmaceuticals (Basel, Switzerland)
|January 25, 2025
概括
像GLP-1RA和SGLT-2这样的新型糖尿病药物提供了好处,但带来了外科手术期间的风险. 医生必须管理这些风险,包括来自GLP-1RA的吸收和来自SGLT-2is的酸性疾病,以确保安全的患者护理.
科学领域:
- 内分泌学 在内分泌学.
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 糖尿病治疗的近期进展包括双类化酶-4抑制剂 (DPP-4is),类似葡萄糖类1受体激动剂 (GLP-1RAs) 和-葡萄糖共运输体2抑制剂 (SGLT-2is).
- 这些药物,特别是GLP-1RAs和SGLT-2is,已经扩大了糖尿病以外的治疗应用,包括心力衰竭和肥胖管理.
- 糖尿病药物治疗的不断变化需要对其对外科手术期间护理的影响进行审查.
研究的目的:
- 要突出与GLP-1RAs和SGLT-2is.相关的特定外科手术期间的担忧.
- 告知外科医生有关风险,如吸血和euglycemic酸性脂肪酸症.
- 讨论糖尿病管理中的当前建议和新兴治疗选择.
主要方法:
- 关于GLP-1RAs和SGLT-2患者的术后管理的当前文献和指导方针的审查.
- 对麻醉和手术相关的药理动力学和药理动力学特性进行分析.
- 探索新兴的糖尿病治疗方法及其潜在的术后影响.
主要成果:
- GLP-1RAs与延迟胃排空有关,增加吸入风险,需要扣留药物,胃超声波或修改麻醉技术.
- SGLT-2增加了euglycemic ketoacidosis的风险,需要仔细的术后监测和管理.
- 像Imeglimin,Icodec和IcoSema这样的新药正在接受调查,为外科手术期间的护理提出了未来的考虑.
结论:
- 周围手术的医生必须意识到现代糖尿病药物 (如GLP-1RA和SGLT-2is) 所带来的独特风险.
- 遵守指导方针和个性化患者评估对于缓解术后并发症至关重要.
- 对新型糖尿病治疗的持续研究需要在外科手术期间管理策略的持续更新.
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