在老年患者中,经过下舌 dexmedetomidine 给药后发生严重的低血压
Zlatan Coralic1, Moujan Allai2, Calvin Hwang3
1Department of Clinical Pharmacy and Emergency Medicine, University of California San Francisco, San Francisco, CA, USA.
概括
舌下用德克斯梅德托米丁可以在老年患者中引起严重的低血压,特别是那些有现有健康状况的患者. 仔细监测和剂量调整对于在这个脆弱人群中安全使用至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 老年医学 老年医学
- 关键护理医学 关键护理医学
背景情况:
- 副语言德克斯梅德托米丁已被批准用于精神分裂症和双相情感障碍的激发.
- 对于其在临床试验之外的使用存在有限的安全数据.
- 伴随疾病的老年患者对药物安全性提出了独特的挑战.
研究的目的:
- 在老年患者中,报告下舌 dexmedetomidine 后严重低血压的病例.
- 为了突出在医学上复杂的老年人中,潜舌用德克斯梅德米丁的潜在风险.
- 强调在老年人群中需要谨慎使用和监测.
主要方法:
- 一个88岁的患者的病例报告,患有多种并发病症.
- 120μg的德克斯梅德托米丁在舌下进行调动.
- 血液动力学参数和实验室值的监测.
- 使用Naranjo尺度对药物不良反应的评估.
主要成果:
- 患者在1小时内出现严重的低血压 (血压从102/49mmHg下降到62/40mmHg).
- 血红蛋白显著下降,导致输血和调查出血.
- 确定了一种大型肌内血瘤,可能因抗凝血和抗血小板治疗而恶化.
- 纳兰乔评分表明了对德克斯米德米丁的可能不良药物反应.
结论:
- 在患有心血管并发症的老年患者中,口服德克斯梅德托米丁可以引起显著的低血压.
- 药物的低血压潜力在这个人群中是一个严重的问题.
- 谨慎的患者选择,剂量定位和警的监测对于老年人安全使用德克斯梅德托米丁至关重要.
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 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
Skeletal Muscle Relaxants: Adverse Effects
761
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
761
Parenteral Anesthetics: Overview
546
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
546
Alterations in Blood Pressure
1.9K
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.9K


