アブストラクト
Japanese
| Title | 緩和ケア・精神科リエゾンにおける抗精神病薬の使い方のコツ |
|---|---|
| Subtitle | 第65回日本心身医学会総会ならびに学術講演会 ワークショップ : 緩和ケア・精神科リエゾンチームに役立つ向精神薬使い方のコツ |
| Authors | 菊地未紗子* |
| Authors (kana) | |
| Organization | *済生会小樽病院精神科, **同 腫瘍精神科・緩和ケア内科 |
| Journal | 心身医学 |
| Volume | 65 |
| Number | 3 |
| Page | 213-219 |
| Year/Month | 2025 / |
| Article | 報告 |
| Publisher | 日本心身医学会 |
| Abstract | 抄録: 緩和ケア・精神科リエゾン領域において, せん妄をはじめ, 認知症に伴う易怒性, 興奮, 拒否などの行動・心理症状, 不眠, 嘔気などの症状緩和を目的に抗精神病薬を使用する機会は多い. 特にせん妄は臨床現場で遭遇する機会が多いものの, せん妄を適応症とするのはいまだtiaprideのみである. せん妄は脳内の神経伝達物質の不均衡による意識障害が一因であり, 抗ドパミン作用を有する抗精神病薬を中心に対症的薬物療法を行う. 現時点で薬剤の選択や用量設定に強いエビデンスがないため適用外使用の薬剤を使用せざるを得ず, 抗精神病薬の使い方に悩むことも多い. また, がん終末期やイレウスなど内服が困難な場面も多く注射薬や貼付剤が必要となることも多い. しかし注射, 貼付剤, 舌下錠といった投与方法に選択の幅があるのは向精神薬の中でも抗精神病薬の特徴ともいえる. 臨床場面において薬理学的観点からどのような症例にどの抗精神病薬の選択が好ましいかを解説する. |
| Practice | 臨床医学：内科系 |
| Keywords | せん妄, 抗精神病薬, リエゾン, 緩和ケア, delirium, antipsychotics, liaison, palliative care |
English
| Title | Tips for Using Antipsychotics in Palliative Care and Psychiatric Liaison |
|---|---|
| Subtitle | Workshop / Medication Usage Tips for Palliative Care and Psychiatric Liaison Teams |
| Authors | Misako Kikuchi* |
| Authors (kana) | |
| Organization | *Department of Psychiatry, Saiseikai Otaru Hospital, **Department of Psycho-Oncology/Palliative Care Medicine, ditto |
| Journal | Japanese Journal of Psychosomatic Medicine(Tokyo) |
| Volume | 65 |
| Number | 3 |
| Page | 213-219 |
| Year/Month | 2025 / |
| Article | Report |
| Publisher | Japanese Society of Psychosomatic Medicine |
| Abstract | [Abstract] Many opportunities exist in the field of palliative care and psychiatric liaison to use antipsychotics for delirium as well as the behavioral and psychological symptoms associated with dementia, such as irritability, excitement, refusal, insomnia, and nausea. Delirium is often encountered in clinical practice; however, tiapride is the only drug covered by insurance for delirium. Delirium is partly caused by impaired consciousness due to an imbalance of neurotransmitters in the brain. Symptomatic drug therapy mainly involves the administration of antipsychotics that have antidopaminergic effects. Presently, no strong evidence exists for the selection of drugs and dosage settings, and patients are often forced to use drugs off-label, hindering the use of antipsychotics. In addition, oral administration is difficult in many situations, such as in the terminal stages of cancer and ileus; as such, injections and patches are often required. A wide range of methods, such as injections, patches, and sublingual tablets, can be used to administer antipsychotics among the psychotropic drugs. This article explains the optimal selection of antipsychotics in clinical situations from a pharmacological perspective. |
| Practice | Clinical internal medicine |
| Keywords | delirium, antipsychotics, liaison, palliative care |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
