Respiratory aspiration during treatment with benzodiazepines, antiepileptic and antidepressant drugs in the pharmacovigilance database from VigiBase.

IF 3.9 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Expert Opinion on Drug Metabolism & Toxicology Pub Date : 2022-09-01 Epub Date: 2022-09-13 DOI:10.1080/17425255.2022.2122813

Carlos De Las Cuevas, Emilio J Sanz, Jose de Leon

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引用次数: 1

Abstract

Introduction: Three psychotropic drug classes, benzodiazepines, antiepileptic drugs (AEDs) and antidepressants (ADs), whether used in treatment or overdose, may be associated with respiratory aspiration. Polypharmacy was defined by counting suspected drugs from these classes or two others, antipsychotics and opioids. The confounding effects of polypharmacy were considered in this study.

Areas covered: VigiBase records of respiratory aspiration associated with benzodiazepines, AEDs, and/or ADs from inception until 5 September 2021, were reviewed. VigiBase, the World Health Organization's global pharmacovigilance database, uses a statistical signal for associations called the information component (IC).

Expert opinion: The ICs (and IC₀₂₅) were benzodiazepines 2.8 (and 2.6), AEDs 1.6 (and 1.5), and ADs 1.4 (and 1.3). The cases of respiratory aspiration associated with at least one drug from these 3 classes included: 1) 553 cases absent any known overdose (2.8 ± 1.7 drugs) and 2) 347 overdose cases (2.9 ± 1.8 drugs). Little support for the association of respiratory aspiration and benzodiazepine, AED or AD monotherapy in therapeutic dosages was found. Studies of the association between benzodiazepine monotherapy and respiration aspiration are needed in geriatric patients. ADs added to other medications increased lethality in all cases of respiratory aspiration including those associated with overdose, polypharmacy and/or major medical problems.

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VigiBase药物警戒数据库中苯二氮卓类药物、抗癫痫药物和抗抑郁药物治疗期间的呼吸误吸。

三种精神药物:苯二氮卓类药物、抗癫痫药(aed)和抗抑郁药(ADs)，无论是用于治疗还是过量使用，都可能与呼吸道误吸有关。多重药物的定义是将这类药物或其他两类药物(抗精神病药和阿片类药物)中的可疑药物进行计数。本研究考虑了多种药物的混杂效应。涵盖领域:回顾了VigiBase从创建到2021年9月5日期间与苯二氮卓类药物、aed和/或ADs相关的呼吸吸入记录。VigiBase是世界卫生组织的全球药物警戒数据库，为协会使用一种称为信息成分(IC)的统计信号。专家意见:ICs(和IC025)为苯二氮卓类2.8(和2.6)，aed 1.6(和1.5)，ADs 1.4(和1.3)。3类药物中至少有一种与呼吸道误吸相关的病例包括:1)553例无已知过量用药(2.8±1.7种药物);2)347例过量用药(2.9±1.8种药物)。在治疗剂量上，呼吸吸入与苯二氮卓类药物、AED或AD单药治疗之间的关联很少得到支持。在老年患者中，需要研究苯二氮卓类药物单药治疗与呼吸吸入之间的关系。在其他药物中加入ADs增加了所有呼吸道吸入病例的致死率，包括那些与过量、多药和/或重大医疗问题有关的病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Drug Metabolism & Toxicology 医学-生化与分子生物学

CiteScore

7.90

自引率

2.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Opinion on Drug Metabolism & Toxicology (ISSN 1742-5255 [print], 1744-7607 [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of ADME-Tox. Each article is structured to incorporate the author’s own expert opinion on the scope for future development. The Editors welcome: Reviews covering metabolic, pharmacokinetic and toxicological issues relating to specific drugs, drug-drug interactions, drug classes or their use in specific populations; issues relating to enzymes involved in the metabolism, disposition and excretion of drugs; techniques involved in the study of drug metabolism and toxicology; novel technologies for obtaining ADME-Tox data. Drug Evaluations reviewing the clinical, toxicological and pharmacokinetic data on a particular drug. The audience consists of scientists and managers in the pharmaceutical industry, pharmacologists, clinical toxicologists and related professionals.