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Title 周術期における精神症状
Subtitle 特集 向精神薬はどこから使う? どう使う? 入院患者の精神症状 悩ましい場面でのアプローチ
Authors 山田裕士
Authors (kana)
Organization 岡山大学病院精神科神経科
Journal 月刊薬事
Volume 65
Number 15
Page 3084-3088
Year/Month 2023 / 11
Article 報告
Publisher じほう
Abstract [Key Points] ●手術に関連した不安や抑うつを経験する患者は多く, 非薬物的介入が有効であり, 薬物的介入と比べて有害事象が少ない. ●術後せん妄は, 手術麻酔からの覚醒後, 多くは5日以内にみられる意識や注意の障害である. ●術後せん妄の評価方法は, ほかのせん妄と同様であるが, 集中治療室 (ICU) へ入室するケースではICDSCやCAM-ICUが有用である. ●術後せん妄では, せん妄のリスクや原因の除去などの非薬物治療が有効であり, 向精神薬による薬物治療はそうした非薬物治療でも改善がみられない症例に限ることが推奨されている. ●周術期における向精神薬の中止/継続の判断は, 薬物相互作用, 離脱症状のリスク, 精神症状の増悪リスクを考慮のうえで慎重に判断されるべきである.
Practice 薬学
Keywords
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