アブストラクト
Japanese
| Title | ベンゾジアゼピン・非ベンゾジアゼピン系睡眠薬服用患者に対して置換法を併用しながら, レンボレキサント・トラゾドンへの変更に成功した1症例 |
|---|---|
| Subtitle | 症例報告 |
| Authors | 野島一眞1, 戸梶孝枝1, 山本盛雄2 |
| Authors (kana) | |
| Organization | 1高知県立あき総合病院薬剤科, 2高知県立あき総合病院外科 |
| Journal | 日本老年薬学会雑誌 |
| Volume | 7 |
| Number | 2 |
| Page | 52-57 |
| Year/Month | 2024 / |
| Article | 報告 |
| Publisher | 日本老年薬学会 |
| Abstract | 「緒言」 不眠症は臨床場面で最もよく遭遇する疾患の一つであり, 睡眠衛生指導などを行っても, 不眠症状が残存している場合に薬物療法の選択がなされる. 薬物療法として使用されるベンゾジアゼピン系睡眠薬には, 筋弛緩作用によるふらつきや転倒, 前向性健忘, 持ち越し効果による翌日の精神作業能力の低下, 身体依存による耐性や離脱症状などの報告があり, 高齢者では特に転倒や骨折が大きな問題となっている. また, 身体依存や退薬症候などの問題が生じている場合の漸減中止に関しては, 個々の患者の状況にあった治療計画を選択することが望ましいとされている. 漸減中止の方法としては, 漸減法や隔日法や置換法が従来から用いられており, 複数のベンゾジアゼピン系睡眠薬を服用している場合において, 単剤化していくことは有効な方法として推奨されている. 実際の臨床では, これらの方法を組み合わせながら減薬していくことが多く, 漸減法や隔日法が一般的に用いられており, 置換法については, あまり用いられていない. |
| Practice | 薬学 |
| Keywords | benzodiazepine sleeping pills, nonbenzodiazepine sleeping pills, substitution method, lemborexant, trazodone |
English
| Title | A Case of Successful Conversion to Lemborexant and Trazodone while Being Used as a Substitution Method for a Patient Taking Benzodiazepine and Nonbenzodiazepine Sleeping Pills |
|---|---|
| Subtitle | Case Report |
| Authors | Kazumasa Nojima1, Takae Tokaji1, Morio Yamamoto2 |
| Authors (kana) | |
| Organization | 1Department of Hospital Pharmacy, Kochi Prefectural Aki General Hospital, 2Department of surgery, Kochi Prefectural Aki General Hospital |
| Journal | Journal of Geriatric Pharmacy |
| Volume | 7 |
| Number | 2 |
| Page | 52-57 |
| Year/Month | 2024 / |
| Article | Report |
| Publisher | Japanese Society of Geriatric Pharmacy |
| Abstract | [Abstract] Adverse effects of benzodiazepines and nonbenzodiazepines include tolerance due to physical dependence, muscle relaxant effect, lightheadedness, and falls, which are particularly serious problems in the elderly. The conventional methods of discontinuation of these sleeping pills have been the tapering method, the every-other-day method, and the substitution method. However, there are few reports on the efficacy and safety of the substitution method in the elderly. Lemborexant, an orexin receptor antagonist, has attracted much attention because of the lack of adverse effects reported with benzodiazepines and nonbenzodiazepines. Trazodone has also been reported to reduce the frequency of awakenings and withdrawal symptoms. In the present study, we have conducted an outpatient analysis of an elderly patient on long-term benzodiazepine and nonbenzodiazepine sleeping pills who had been experiencing side effects such as periodic lightheadedness and carryover to the next day, and the patient was anxious about the side effects. Not only the conventional tapering method and the every-other-day method, but also the substitution method could be used without any side effects such as withdrawal symptoms and insomnia. The results also suggest that lemborexant and trazodone can be substitutes for benzodiazepines and nonbenzodiazepines without lowering sleep quality. |
| Practice | Pharmaceutical sciences |
| Keywords | benzodiazepine sleeping pills, nonbenzodiazepine sleeping pills, substitution method, lemborexant, trazodone |
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