局麻药介导的抽丝:意外的不良事件还是新的治疗指征?

IF 3.4 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Therapeutic Advances in Drug Safety Pub Date : 2025-04-21 eCollection Date: 2025-01-01 DOI:10.1177/20420986251332740
Homero Contreras-Salinas, Janet Cristina Vázquez-Beltrán, María Soledad Romero-López, Oscar Olvera-Montaño, Lourdes Yolotzin Rodríguez-Herrera
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引用次数: 0

摘要

越来越多的超说明书用药需要一个强有力的药物警戒系统。考虑到可以用来确保产品安全的大量科学数据,这一点尤为重要。我们的回顾集中在说明书外使用局部麻醉剂,一种常见的做法,在局部和内窥镜应用。然而,正如产品特性的专著/摘要所指出的那样,蝇蛆病的发生是一种意想不到的不良事件。我们的目的是全面了解由局部麻醉剂引起的蛔虫病,包括意外不良事件和标签外使用,以加强药物警戒实践的重要性。我们从两个不同的角度对Medline/PubMed和谷歌Scholar进行了全面的搜索:检查局部麻醉剂作为不良事件和作为标签外使用时发生的瞳孔肿大。我们检索了14篇文章,这些文章报道了使用麻醉剂时出现的一种意想不到的不良事件,而牙科手术是导致这种事件的重要因素。此外,我们还发现了8篇文章,探讨了超说明书使用局部麻醉剂诱导蛔虫的情况,其中最常见的给药方法是肠腔内注射。这些发现强调了我们的研究在理解蛔虫意外不良事件和超说明书使用局部麻醉剂的可能性方面的重要性。它们还强调了在这一领域继续参与和保持警惕的必要性,因为我们对这些现象的理解在不断发展,进一步的调查至关重要。使用局部麻醉剂治疗瞳孔肿大具有重要的前景,特别是在眼科手术中。这种方法可能潜在地减轻与传统心肌炎相关的不良事件,提供更有效和更安全的替代方案。此外,使用单一药物治疗肌动症、麻醉和抽丝可以显著提高手术的效率和便利性。另一方面,通过风险最小化活动(例如,包括专著/产品特性总结)来扩展蛔虫病与麻醉关联的知识是至关重要的,以便与使用局部麻醉剂的蛔虫病风险进行沟通。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mydriasis mediated by local anesthetics: an unexpected adverse event or new therapeutic indication?

The increasing off-label use of medications needs a robust pharmacovigilance system. This is particularly crucial given the abundance of scientific data that can be harnessed to ensure a product's safety. Our review focuses on the off-label use of local anesthetics, a common practice in topical and intracameral applications. However, the occurrence of mydriasis, as indicated in the monographs/summaries of product characteristics, is an unexpected adverse event. Our aim is to provide a comprehensive understanding of mydriasis caused by local anesthetics, both as an unexpected adverse event and as an off-label use, to reinforce the importance of pharmacovigilance practices. We conducted a comprehensive search in Medline/PubMed and Google Scholar from two distinct perspectives: examining the occurrence of mydriasis with the use of local anesthetic as an adverse event and as an off-label use. Our search yielded 14 articles that reported mydriasis as an unexpected adverse event with the use of anesthetics, with dental procedures being a significant contributor to this type of event. Also, we identified eight articles that explored the off-label use of local anesthetics to induce mydriasis, with the most common method of drug administration being intracameral injection. These findings underscore the importance of our research in understanding the unexpected adverse event of mydriasis and the potential for off-label use of local anesthetics. They also highlight the need for continued involvement and vigilance in this area, as our understanding of these phenomena continues to evolve and further investigation is crucial. The use of local anesthetics for mydriasis holds significant promise, particularly in ophthalmological surgeries. This approach could potentially mitigate the adverse events associated with conventional mydriatics, offering a more efficient and safer alternative. Furthermore, using a single medication for akinesia, anesthesia, and mydriasis could significantly enhance the efficiency and convenience of surgical procedures. On the other hand, it is crucial to extend the knowledge of the mydriasis-anesthesia association through risk minimization activities (e.g., the inclusion of monographs/summary of product characteristics) to communicate the risk of mydriasis with the use of local anesthetics.

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来源期刊
Therapeutic Advances in Drug Safety
Therapeutic Advances in Drug Safety Medicine-Pharmacology (medical)
CiteScore
6.70
自引率
4.50%
发文量
31
审稿时长
9 weeks
期刊介绍: Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.
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