已发表的磺酰脲毒性报告中奥曲肽剂量的变化:1988年至今的系统综述。

IF 2.5 4区 医学 Q3 TOXICOLOGY
Erin Ryan, William Rushton
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引用次数: 0

摘要

背景:奥曲肽通常用于治疗磺脲毒性引起的低血糖,但该适应症的最佳剂量尚未明确。方法:我们对医学文献中使用奥曲肽治疗磺脲中毒的病例进行了系统回顾。回顾了奥曲肽于1988年10月21日获FDA批准至2024年8月15日期间发表的关于奥曲肽和磺脲类药物的文献。结果:来自61个来源的80例独特病例(66例成人/青少年和14例儿科患者)被纳入最终分析。其中包括41种不同剂量、频率和/或给药途径的奥曲肽给药策略。皮下给药,主要是50-100微克/次,频率为每6-8小时,是成人中最常见的方案,而静脉给药1微克/公斤在儿科中最普遍。间歇皮下给药和静脉给药的成人奥曲肽的治疗时间和总剂量没有显著差异。在所有给药途径中,低血糖的治疗和血糖的维持是相似的。输注奥曲肽的持续时间相似,但总剂量更高。较高的间歇给药剂量与较短的治疗时间相关。故意暴露与奥曲肽的高剂量和较长的治疗时间有关。报告了3例奥曲肽不良反应。除2例外,所有患者均存活,无长期并发症。结论:尽管奥曲肽的剂量和给药存在广泛的差异,但我们的报告显示,不同的奥曲肽给药方法具有相似的疗效和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Variations in Octreotide Dosing in Published Reports of Sulfonylurea Toxicity: A Systematic Review, 1988-Present.

Background: Octreotide is commonly used to treat hypoglycemia due to sulfonylurea toxicity, but optimal dosing for this indication is not well defined.

Methods: We performed a systematic review to identify cases in the medical literature of octreotide use for sulfonylurea poisoning. Literature published on octreotide and sulfonylureas between octreotide's FDA approval on 10/21/1988 and 8/15/2024 was reviewed.

Results: Eighty unique patient cases (66 adults/adolescents and 14 pediatric patients) from 61 sources were included in the final analysis. These included 41 octreotide dosing strategies that differed in dose, frequency, and/or route of administration. Subcutaneous dosing, primarily within the range of 50-100 mcg per dose at a frequency of every 6-8 h, was the most common regimen in adults while intravenous dosing of 1 mcg/kg was most prevalent in pediatrics. There were no significant differences in duration of therapy or total dose of octreotide in adults with intermittent subcutaneous vs intravenous dosing. Treatment of hypoglycemia and maintenance of euglycemia was similar among all routes of administration. Infusions had similar durations but higher total doses of octreotide. Higher intermittent bolus doses were associated with shorter durations of therapy. Intentional exposures were associated with higher doses and longer duration of treatment with octreotide. Three adverse reactions to octreotide were reported. Except for 2 cases, all patients survived without any long-term complications.

Conclusion: Despite widespread variation in octreotide dosing and administration, our report showed similar efficacy and safety with various octreotide dosing practices.

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来源期刊
CiteScore
5.40
自引率
10.30%
发文量
46
期刊介绍: Journal of Medical Toxicology (JMT) is a peer-reviewed medical journal dedicated to advances in clinical toxicology, focusing on the diagnosis, management, and prevention of poisoning and other adverse health effects resulting from medications, chemicals, occupational and environmental substances, and biological hazards. As the official journal of the American College of Medical Toxicology (ACMT), JMT is managed by an editorial board of clinicians as well as scientists and thus publishes research that is relevant to medical toxicologists, emergency physicians, critical care specialists, pediatricians, pre-hospital providers, occupational physicians, substance abuse experts, veterinary toxicologists, and policy makers.       JMT articles generate considerable interest in the lay media, with 2016 JMT articles cited by various social media sites, the Boston Globe, and the Washington Post among others.     For questions or comments about the journal, please contact jmtinfo@acmt.net.    For questions or comments about the journal, please contact jmtinfo@acmt.net.
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