アブストラクト
| Title | せん妄リスク患者の不眠にはどう対応するか |
|---|---|
| Subtitle | 特集 悩ましい局面で薬をどう使う? せん妄薬物療法のリスク・ベネフィット [せん妄薬物療法のグッド・プラクティス] |
| Authors | 八田耕太郎 |
| Authors (kana) | |
| Organization | 順天堂大学医学部附属練馬病院メンタルクリニック |
| Journal | 月刊薬事 |
| Volume | 62 |
| Number | 8 |
| Page | 1541-1545 |
| Year/Month | 2020 / 6 |
| Article | 報告 |
| Publisher | じほう |
| Abstract | [Points] ●せん妄リスク患者の不眠には, 不眠症に適応をもつメラトニン受容体作動薬およびオレキシン受容体拮抗薬が第一選択である. ●不眠症に適応外であるが, 一部の抗うつ薬, 一部の抗ヒスタミン薬, ガバペンチノイド, 抗精神病薬もしばしば用いる. ●せん妄リスク因子であるベンゾジアゼピン受容体作動薬は可能な限り中止する. ●せん妄予防の非薬物的介入を併行する. |
| Practice | 薬学 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に803円(税込) です。
参考文献
- 1) Sultan SS: Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly. Saudi J Anaesth, 3:169-173, 2010
- 2) Al-Aama T, et al: Melatonin decreases delirium in elderly patients: A randomized, placebo-controlled trial. Int J Geriatr Psychiatry, 26:687-694, 2011
- 3) de Jonghe A, et al: Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial. CMAJ, 186:E547-556, 2014
- 4) DELIRIA-J GROUP: Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA Psychiatry, 71:397-403, 2014
- 5) DELIRIA-J GROUP: Ramelteon for delirium in hospitalized patients. JAMA, 314:1071-1072, 2015
残りの10件を表示する
- 6) Nishikimi M, et al: Effect of administration of ramelteon, a melatonin receptor agonist, on the duration of stay in the ICU: a single-center randomized placebo-controlled trial. Crit Care Med, 46:1099-1105, 2018
- 7) Hatta K, et al: Real-world effectiveness of ramelteon and suvorexant for delirium prevention in 948 patients with delirium risk factors. J Clin Psychiatry, 81:19m12865, 2019
- 8) DELIRIA-J GROUP: Preventive effects of suvorexant on delirium: a randomized placebo-controlled trial. J Clin Psychiatry, 78:e970-e979, 2017
- 9) Azuma K, et al: Ability of suvorexant to prevent delirium in patients in the intensive care unit: a randomized controlled trial. Acute Med Surg, 5:362-368, 2018
- 10) Ma J, et al: Electroencephalographic power spectral density profile of the orexin receptor antagonist suvorexant in patients with primary insomnia and healthy subjects. Sleep, 37:1609-1619, 2014
- 11) Kubo N, et al: Antimuscarinic effects of antihistamines: quantitative evaluation by receptor-binding assay. Jpn J Pharmacol, 43:277-282, 1987
- 12) Atkin T, et al: Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery. Pharmacol Rev, 70:197-245, 2018
- 13) Molero Y, et al: Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden. BMJ, 365:l2147, 2019
- 14) Devlin JW, et al: Efficacy and safety of quetiapine in critically ill patients with delirium: A prospective, multicenter, randomized, double-blind, placebo-controlled pilot study. Crit Care Med, 38:419-427, 2010
- 15) Tahir TA, et al: A randomized controlled trial of quetiapine versus placebo in the treatment of delirium. J Psychosom Res, 69:485-490, 2010
