アブストラクト
| Title | 第1回 てんかん重積状態 |
|---|---|
| Subtitle | 新連載 迷わず判断デキる! フローチャート薬物治療 |
| Authors | 佐野邦明 |
| Authors (kana) | |
| Organization | 獨協医科大学埼玉医療センター薬剤部 |
| Journal | 月刊薬事 |
| Volume | 64 |
| Number | 7 |
| Page | 1425-1431 |
| Year/Month | 2022 / 5 |
| Article | 報告 |
| Publisher | じほう |
| Abstract | 「はじめに」てんかん重積状態(status epilepticus;SE)は救急外来だけでなく病棟でも遭遇する. 速やかな薬剤投与の実施には治療フローチャートの活用が有用で, 適切な薬剤投与のアドバイスが必要である. プロトコルと治療フローチャートの作成はSEに対する適切な介入を可能にすること, また薬剤投与までの時間の短縮は, けいれん頓挫までの時間も短くすると報告がある. そのため, 筆者もフローチャートを作成し, 日常の診療補助に役立てている. 今回は, SEに対して薬剤選択, 用量の提案が可能となるようなフローチャートを紹介していく. 「まえちしき」「1 用語」●てんかん:大脳の神経細胞の電気的な活動の調和が乱れ, 過剰に神経細胞が興奮し発作が反復する脳の慢性的な疾患. ●てんかん重積状態(SE):発作を停止させる機構の破綻, もしくは異常に遷延する発作を引き起こす機構が惹起された状態. |
| 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) Xie Y, et al : A computerized standard protocol order entry for pediatric inpatient acute seizure emergencies reduces time to treatment. J Child Neurol, 29 : 162-166, 2014[PMID : 23392562]
- 2) Pavitt S, et al : A standardized protocol to improve acute seizure management in hospitalized pediatric patients. Hosp Pediatr, 11 : 389-395, 2021[PMID : 33685859]
- 3) 日本神経学会・監 : てんかん診療ガイドライン2018. 医学書院, 2018
- 4) Fisher RS, et al : Operational classification of seizure types by the International League Against Epilepsy : Position paper of the ILAE commission for classification and terminology. Epilepsia, 58 : 522-530, 2017[PMID : 28276060]
- 5) Trinka E, et al : A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia, 56 : 1515-1523, 2015[PMID : 26336950]
残りの31件を表示する
- 6) Hanada T : Ionotropic glutamate receptors in epilepsy : A review focusing on AMPA and NMDA receptors. Biomolecules, 10 : 464, 2020[PMID : 32197322]
- 7) Betjemann JP, at al : Status epilepticus in adults. Lancet Neurol, 14 : 615-624, 2015[PMID : 25908090]
- 8) Chen JW, et al : Advances in the pathophysiology of status epilepticus. Acta Neurol Scand, 115 : 7-15, 2007[PMID : 17362270]
- 9) Lowenstein DH, et al : It's time to revise the definition of status epilepticus. Epilepsia, 40 : 120-122, 1999[PMID : 9924914]
- 10) Lu M, et al : Epidemiology of status epilepticus in the United States : A systematic review. Epilepsy Behav, 112 : 107459, 2020[PMID : 33181886]
- 11) Leitinger M, et al : Epidemiology of status epilepticus in adults : A population-based study on incidence, causes, and outcomes. Epilepsia, 60 : 53-62, 2019[PMID : 30478910]
- 12) Walker MC : Pathophysiology of status epilepticus. Neurosci Lett, 667 : 84-91, 2018[PMID : 28011391]
- 13) Glauser T, et al : Evidence-based guideline : Treatment of convulsive status epilepticus in children and adults : Report of the guideline committee of the American Epilepsy Society. Epilepsy Curr, 16 : 48-61, 2016[PMID : 26900382]
- 14) Rosenow F, et al : S2k-Leitlinie : Status Epilepticus im Erwachsenenalter : Leitlinie der Deutschen Gesellschaft fur Neurologie. Nervenarzt, 92 : 1002-1030, 2021[PMID : 33751150]
- 15) Hill CE, et al : Timing is everything : Where status epilepticus treatment fails. Ann Neurol, 82 : 155-165, 2017[PMID : 28681473]
- 16) Nardone R, et al : Acute symptomatic seizures caused by electrolyte disturbances. J Clin Neurol, 12 : 21-33, 2016[PMID : 26754778]
- 17) Silbergleit R, et al : Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med, 366 : 591-600, 2012[PMID : 22335736]
- 18) Brigo F, et al : Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus : A systematic review with meta-analysis. Epilepsy Behav, 49 : 325-336, 2015[PMID : 25817929]
- 19) McTague A, at al : Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev, 1 : CD001905, 2018[PMID : 29320603]
- 20) Kapur J, at el : Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med, 381 : 2103-2113, 2019[PMID : 31774955]
- 21) Chamberlain JM, et al : Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group(ESETT) : a double-blind, responsive-adaptive, randomised controlled trial. Lancet, 395 : 1217-1224, 2020[PMID : 32203691]
- 22) Nakamura K, et al : Efficacy of levetiracetam versus fosphenytoin for the recurrence of seizures after status epilepticus. Medicine(Baltimore), 96 : e7206, 2017[PMID : 28640109]
- 23) Nakamura K, et al : Fosphenytoin for second-line treatment of status epilepticus : propensity score matching analysis using a nationwide inpatient database. Front Neurol, 11 : 615, 2020[PMID : 32719650]
- 24) Gujjar AR, et al : Intravenous levetiracetam vs phenytoin for status epilepticus and cluster seizures : A prospective, randomized study. Seizure, 49 : 8-12, 2017[PMID : 28528211]
- 25) Nevitt SJ, et al : Antiepileptic drug monotherapy for epilepsy : a network meta-analysis of individual participant data. Cochrane Database Syst Rev, 6 : CD011412, 2017[PMID : 28661008]
- 26) Boon P, et al : Recommendations for the treatment of epilepsy in adult and pediatric patients in Belgium : 2020 update. Acta Neurol Belg, 121 : 241-257, 2021[PMID : 33048338]
- 27) Marson A, et al : The SANAD II study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy : an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial. Lancet, 397 : 1375-1386, 2021[PMID : 33838758]
- 28) Hocker S, et al : Parenteral phenobarbital in status epilepticus revisited : Mayo Clinic experience. Epilepsia, 59 Suppl 2 : 193-197, 2018[PMID : 30159873]
- 29) Madzar D, et al : Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus. Crit Care, 22 : 317, 2018[PMID : 30463604]
- 30) Ferlisi M, et al : The anesthetic drug treatment of refractory and super-refractory status epilepticus around the world : Results from a global audit. Epilepsy Behav, 101 : 106449, 2019[PMID : 31420291]
- 31) Masapu D, et al al : A comparative study of midazolam and target-controlled propofol Infusion in the treatment of refractory status epilepticus. Indian J Crit Care Med, 22 : 441-448, 2018[PMID : 29962746]
- 32) Zhang Q, et al : Systematic review and meta-analysis of propofol versus barbiturates for controlling refractory status epilepticus. BMC Neurol, 19 : 55, 2019[PMID : 30954065]
- 33) Muhlhofer WG, et al : Duration of therapeutic coma and outcome of refractory status epilepticus. Epilepsia, 60 : 921-934, 2019[PMID : 30957219]
- 34) Santamarina E, et al : Intravenous lacosamide[LCM) in status epilepticus[SE) : Weight-adjusted dose and efficacy. Epilepsy Behav, 84 : 93-98, 2018[PMID : 29758445]
- 35) Strzelczyk A, et al : Perampanel for treatment of status epilepticus in Austria, Finland, Germany, and Spain. Acta Neurol Scand, 139 : 369-376, 2019[PMID : 30613951]
- 36) Fechner A, et al : Treatment of refractory and superrefractory status epilepticus with topiramate : A cohort study of 106 patients and a review of the literature. Epilepsia, 60 : 2448-2458, 2019[PMID : 31713232]
