临床护理中的药物诱导的低血症
Buster Mannheimer1, Jonatan D Lindh2, Cecilia Bergh Fahlén1
1Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Södersjukhuset, Stockholm, Sweden.
European journal of internal medicine
|May 6, 2025
概括
药物诱导的低血症通常与新开始服用的药物,如 thiazide 利尿剂有关. 新的药物,包括SGLT2抑制剂和免疫检查点抑制剂,也需要进一步调查它们对平衡的影响.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 对低血症及其关联的理解有了很大的进步.
- 影响水平衡的新药类已经出现.
- 药物诱导的低血仍然是一个重要的临床问题.
研究的目的:
- 审查药物诱导的低血量现有证据.
- 为了总结药物和平衡之间的关联.
- 为了告知临床诊断和低血的管理.
主要方法:
- 在PubMed搜索"化学诱导"和"低血量和SIADH的诊断".
- 包括从2008年1月到2024年9月的文章.
- 复习2003年获取的文章和向后引用的追踪.
主要成果:
- 常见的罪祸首包括SSRI,抗精神病药物,抗药,PPI和 thiazide尿剂,通常在治疗开始后不久出现.
- 化物利尿剂的风险在早期达到顶峰,但长期仍然很高.
- 促进负水平衡的药物 (循环利尿剂,,SGLT2抑制剂) 可能会降低低血的风险.
- 免疫检查点抑制剂通过低体质炎/上腺炎和皮质醇缺乏增加风险.
结论:
- 大多数药物和低血症之间的因果关系与新的治疗开始有关.
- 对于新型药物,如SGLT2抑制剂和免疫检查点抑制剂,需要进一步的研究.
- 临床警对于管理药物诱导的低血症至关重要.
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