一个老年患者的Cefepime诱导的神经毒性:一个病例报告
Miguel Herrera1, Carlos F Caballero1, Brian J Robles1
1Internal Medicine, Hospital Gustavo Nelson Collado, Chitre, PAN.
Cureus
|December 1, 2025
概括
塞费皮姆 (第四代塞法洛斯波林) 可以在患有脏疾病的患者中引起神经毒性. 及时识别和管理这种不良影响对于患者的康复至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 神经学 神经学
背景情况:
- 塞菲皮姆是第四代塞法洛斯波林,与潜在的神经毒性有关.
- 老年患者和功能障碍患者有更高的药物不良反应风险.
研究的目的:
- 在患有慢性病 (CKD) 的老年患者中报告塞费皮姆诱导的神经毒性 (CIN) 的病例.
- 突出在脆弱患者群体中识别和管理CIN的重要性.
主要方法:
- 一份病例报告显示,一名81岁的男性患有慢性病,因肺炎而接受了静脉注射塞费皮姆治疗.
- 在服用塞费皮姆后,对神经状态变化的临床观察.
- 停止服用塞费皮姆并开始替代性抗生素治疗 (皮佩拉西林-塔扎巴克坦).
主要成果:
- 患者在接受了五天的塞费皮姆治疗后出现了急性混乱和意识减弱.
- 实验室和成像结果没有表明神经衰退的其他原因.
- 神经状态在停止服用塞费皮姆后48小时内完全恢复.
结论:
- 应考虑Cefepime诱导的神经毒性老年患者的功能障碍呈现改变精神状态.
- 及时识别和干预,如剂量调整或药物停用,对于有利的结果至关重要.
- 这一案例强调了对风险人群中塞费皮姆治疗的警监测的必要性.
相关概念视频
Drug Dosing: Geriatric Patients
212
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
212
Pharmacodynamics in Geriatric Patients: Effects of Age
180
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
180
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
221
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
221
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
183
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
183
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
216
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
216
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
212
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
212

