治疗严重激动症的药物的比较安全性:老年急诊室指南2.0系统审查
Martin F Casey1, Natalie M Elder2, Alexander Fenn1
1Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Journal of the American Geriatrics Society
|April 24, 2025
概括
对老年人严重动荡的抗精神病和镇静药物有风险. 奔二胺的米达佐拉姆显著增加了不良事件,而他可能更安全.
科学领域:
- 老年医学 老年医学
- 紧急医疗 紧急医疗
- 临床药理学 临床药理学
背景情况:
- 在老年人中,严重的激动往往需要用抗精神病药物或镇静剂进行药理干预.
- 这些药物在老年人群中具有严重的不良事件风险.
- 对这些药物在老年人中的比较安全性数据是有限的.
研究的目的:
- 系统地审查对老年人严重动荡的药物的安全性进行的比较有效性研究.
- 在这个人口群体中识别和分析与抗精神病药物,二胺和胺相关的不良事件.
- 为了建立一个比较的安全概况,使用利作为参考.
主要方法:
- 在2024年2月之前对八个数据库 (PubMed,EMBASE,SCOPUS,Cochrane,CINAHL,Proquest,Ageline,PsycInfo) 进行系统审查.
- 包括检查第一代抗精神病药物,第二代抗精神病药物,二胺或胺的研究.
- 提取有关呼吸系统事件 (呼吸暂停,低氧化,输管) 和其他不良事件 (心律失常,低血压,妄想,心脏骤停,死亡率) 的数据;计算几率比率 (ORs).
主要成果:
- 分析了8项观察性研究和1项随机临床试验,涉及838名老年人.
- 总体不良事件发生在16.8%的患者中.
- 与哈洛佩里多尔相比,米达佐拉姆的不良事件风险明显高 (OR 5.25) ,其中53%的人经历了不良事件.
- 奎蒂亚平与较低的不良事件频率相关 (OR 0.27).
结论:
- 药物不良反应在老年人中经常发生,老年人因严重动荡而接受治疗.
- 二甲类药物,特别是米达佐拉姆,在这个患者群体中具有较高的风险概况.
- 奎蒂亚平可能为老年人管理严重动荡提供更安全的替代方案.
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