在接受透析的功能衰竭患者中服用抗发作药物:如何管理?
Oreste Marsico1, Angelo Pascarella1,2, Roberta Cutellè1
1Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy.
Expert review of clinical pharmacology
|July 5, 2025
概括
在末期病患者中治疗需要由于透析效应而仔细调整抗发作药物 (ASM). 本综述为血液透析和腹膜透析提供了指导,强调了需要个性化剂量策略的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種神經病學.
- 神经学 神经学
- 临床药理学 临床药理学
背景情况:
- 末期病 (ESKD) 中的治疗是复杂的,因为抗发作药物 (ASM) 的药理学发生了变化.
- 透析显著影响ASM清除,需要精确的剂量来平衡疗效和毒性.
研究的目的:
- 为在接受血液透析和腹腔透析的患者中提供ASM使用的最新概述.
- 为在透析患者中治疗提供实用临床指导.
主要方法:
- 在MEDLINE和谷歌学者中搜索文献,查找透析患者的ASM相关研究.
- 包含每个ASM的产品特性.
主要成果:
- 有限的证据存在,主要来自小型观察性研究和病例报告.
- 目前没有官方指导方针可用,强调需要个性化治疗.
- 低蛋白结合和脏排泄的ASM通常需要透析后调整剂量;治疗药物监测可能是有益的.
结论:
- 进一步的研究至关重要,特别是对于较新的ASM来说,以制定基于证据的建议.
- 个性化ASM剂量和仔细监测对于透析的患者至关重要.
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