评估肾功能减退的住院患者使用加巴喷丁和普瑞巴林的情况

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Gwendolyn M. Knowles, Grace E. LaFleur, Mariann D. Churchwell
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引用次数: 0

摘要

背景:加巴喷丁和普瑞巴林是耐受性良好的药物,主要由肾脏清除。接受较高剂量加巴喷丁且肾功能下降的患者发生不良反应(AEs)的风险可能会增加,但目前评估这类人群加巴喷丁剂量和 AEs 的证据有限。目的确定肌酐清除率(CrCl)降低的患者在入院时是否会出现与加巴喷丁胺剂量相关的更高频率的不良反应。方法: 单中心回顾性队列研究单中心回顾性队列研究,对象为开具加巴喷丁类药物处方且入院时有血清肌酐测量记录的成人。主要结果是根据入院时的 CrCl(按 CrCl ≥60 mL/min、<60 mL/min、15-29 mL/min 和 <15 mL/min 分层)确定加巴喷丁胺处方的适当性。次要结果包括与加巴喷丁类药物相关的AEs发生率以及阿片类药物和精神科处方的并发症发生率。研究结果本研究共纳入 286 例患者(加巴喷丁 n = 234 例,普瑞巴林 n = 52 例)。CrCl<60毫升/分钟且剂量高于制造商推荐值的患者被处方加巴喷丁(34%)和普瑞巴林(22.7%)。在 CrCl 为 15 至 29 毫升/分钟和小于 15 毫升/分钟的患者组中,加巴喷丁(48.8%)和普瑞巴林(45%)的处方剂量过高。在 CrCl <60 毫升/分钟的患者中,记录到的跌倒次数明显增加 ( P = 0.029)。同时服用阿片类药物和精神类药物会导致更高的 AEs 发生率,与 CrCl 无关。结论CrCl<60毫升/分钟的患者经常被处方不适当的高剂量加巴喷丁类药物。加巴喷丁类药物剂量、肾功能和入院时加巴喷丁类药物相关不良反应发生率之间的关系需要进行更大规模的多中心研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Gabapentin and Pregabalin Use in Hospitalized Patients With Decreased Kidney Function
Background: Gabapentin and pregabalin are well-tolerated medications primarily cleared by the kidney. Patients receiving higher gabapentinoid doses with decreased kidney function may be at an increased risk of adverse effects (AEs), but limited evidence exists evaluating gabapentinoid dosing and AEs in this population. Objective: To determine whether patients with decreased creatinine clearance (CrCl) experienced increased frequency of AEs related to gabapentinoid dose at hospital admission. Methods: Single-center retrospective cohort study in adults with a gabapentinoid prescription and serum creatinine measurement documented on hospital admission. The primary outcome was the appropriateness of gabapentinoid prescription based on CrCl (stratified by CrCl ≥60 mL/min, <60 mL/min, 15-29 mL/min, and <15 mL/min) at admission. Secondary outcomes included the incidence of AEs related to gabapentinoids and concomitant opioid and psychiatric prescriptions. Results: A total of 286 patients were included in this study (gabapentin n = 234, pregabalin n = 52). Patients with a CrCl <60 mL/min and doses above the manufacturer’s recommendation were prescribed gabapentin (34%) and pregabalin (22.7%). For patients with a CrCl of 15 to 29 mL/min and <15 mL/min groups, inappropriately high doses were prescribed for gabapentin (48.8%) and pregabalin (45%). A significant increase in recorded falls ( P = 0.029) was identified in patients with a CrCl <60 mL/min. Concomitant opioid and psychiatric medications contributed to a higher prevalence of AEs regardless of CrCl. Conclusions: Patients with a CrCl <60 mL/min were frequently prescribed inappropriately high doses of gabapentinoids. The relationship between gabapentinoid dosing, kidney function, and the incidence of gabapentinoid-related AEs at hospital admission requires larger, multicentre studies.
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来源期刊
Journal of Pharmacy Technology
Journal of Pharmacy Technology PHARMACOLOGY & PHARMACY-
CiteScore
1.50
自引率
0.00%
发文量
49
期刊介绍: For both pharmacists and technicians, jPT provides valuable information for those interested in the entire body of pharmacy practice. jPT covers new drugs, products, and equipment; therapeutic trends; organizational, legal, and educational activities; drug distribution and administration; and includes continuing education articles.
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