急诊科肥胖患者激动药物的处方实践。

IF 1.3 4区 医学 Q3 PSYCHIATRY
Connie Kang, Andrew Williams, Niyati Butala
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引用次数: 0

摘要

引言:体重是影响许多药物剂量的一个因素,尽管没有临床研究评估肥胖人群使用激动药物的这一因素。本研究的目的是评估躁动患者服用抗精神病药物和苯二氮卓类药物时是否需要考虑体重,并评估躁动患者的处方模式。方法:这项回顾性队列研究比较了肥胖和非肥胖成年患者的结果,这些患者在急诊科接受了至少一次抗精神病药物或苯二氮卓类药物的胃肠外给药。主要结果是24小时内抗精神病药物和苯二氮卓类药物的总剂量(分别为氯丙嗪当量和劳拉西泮当量)。关键的次要结果包括首次给药时使用的抗精神病药物和苯二氮卓类药物剂量、24小时内重复紧急给药的发生率、下次给药的时间以及24小时内的重复给药次数。结果:该研究调查了研究中每个患者队列中115名患者的遭遇。两个研究队列的基线特征相似。两组24小时平均抗精神病药物使用量相似[272.7氯丙嗪当量(非肥胖队列),313.5氯丙嗪等价物(肥胖队列);P=0.157]和24小时平均苯二氮卓类药物使用量[0.9劳拉西泮当量(两组);P=0.750]。研究组之间在所有次要结果上的差异也没有统计学意义(P>0.05)研究并没有发现肥胖人群和非肥胖人群相比使用更高剂量的激动药物。未来的前瞻性试验,可能侧重于个别药物、躁动的具体病因或病态肥胖,需要证实这一发现或阐明肥胖人群最佳药物剂量的潜在差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prescribing Practices for Agitation Medication in Obese Patients Admitted to the Emergency Department.

Introduction: Weight is a factor that influences the dosages of many medications, although no clinical studies have evaluated this factor in the use of agitation medications in the obese population. The objectives of this study were to assess the need for weight considerations in dosing antipsychotics and benzodiazepines for patients with agitation and to assess prescribing patterns in agitated patients.

Methods: This retrospective cohort study compared outcomes between obese and nonobese adult patients who received at least one parenteral administration of an antipsychotic or benzodiazepine for agitation in the emergency department. The primary outcomes were total antipsychotic and benzodiazepine doses within 24 hours (in chlorpromazine equivalents and lorazepam equivalents, respectively). Key secondary outcomes included antipsychotic and benzodiazepine doses used for first administration, incidence of repeat emergency medication administration within 24 hours, time to next administration, and number of repeat administrations within 24 hours.

Results: The study examined 115 patient encounters in each cohort of patients in the study. The baseline characteristics of the 2 study cohorts were similar. Both groups had similar mean 24-hour antipsychotic usage [272.7 chlorpromazine equivalents (nonobese cohort), 313.5 chlorpromazine equivalents (obese cohort); P=0.157] and mean 24-hour benzodiazepine usage [0.9 lorazepam equivalents (both cohorts); P=0.750]. Differences between the study cohorts on all of the secondary outcomes were also not statistically significant (P>0.05).

Discussion: This study did not find the use of higher dosages of agitation medication in the obese compared with the nonobese population. Future prospective trials, with possible emphasis on individual medications, specific etiologies of agitation, or morbid obesity, are required to confirm this finding or to elucidate potential differences in optimal medication dosages for the obese population.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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