用一种创新的治疗方法对患有双相情感障碍和慢性肾脏疾病的老年人给予锂离子治疗的案例研究

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL
R. Burns
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引用次数: 0

摘要

该病例是在对一名患有双相情感障碍和慢性肾脏疾病(CKD)的73至83岁妇女进行治疗后发生的。在研究期间,eGFR从43下降到20以下。最初的治疗是相当标准的,但强调了在发生不希望的情绪变化之前知道何时减少锂剂量的困难。在治疗的第二阶段,常规的每月血清测试与每月运行平均eGFR的新概念相结合,以决定何时减少锂剂量。一种新的管理锂的方法被创造出来,当病人每天的锂剂量达到300毫克时使用。代替固定的每日锂剂量,在短周期内使用固定的平均每日锂剂量。每日剂量在可重复的周期内变化,但由于锂的长半衰期而趋于平缓。新方法允许少量减少锂剂量,低于北美使用的150mg胶囊或欧洲使用的100mg片剂的最低强度。该方法已成功使用数年,患者情绪稳定,锂中毒避免。该患者目前的平均日剂量为187mg /天,eGFR小于20。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case Study of Administering Lithium to a Senior Who is Bipolar and Who Also has Chronic Kidney Disease Using an Innovative Treatment Method
The case follows the treatment of a woman from age 73 to age 83 who was bipolar and who also had Chronic Kidney Disease (CKD). During the study, the eGFR dropped from 43 to below 20. Initially the treatment was fairly standard but highlighted the difficulty of knowing when to reduce the lithium dose before undesired mood changes occurred. In phase 2 of the treatment, the usual monthly blood serum test is combined with a new concept of a monthly running average eGFR to decide when to reduce the lithium dose. A new way of administering lithium was created which was used when the patient’s daily dose of lithium reached 300mg a day. In place of a fixed daily dose of lithium, a fixed average daily dose of lithium over a short cyclic pattern was used. The daily dose varies within the repeatable cycle but is smoothed out by the long half-life of lithium. The new method allows for the reduction of the lithium dose by small amounts, less than the minimum strength 150mg capsule used in North America or the 100mg tablet used in Europe. The method has been successfully used for several years with the patient’s moods stable and lithium toxicity avoided. The patient is currently on an average daily dose of 187mg a day with an eGFR less than 20.
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来源期刊
Canadian Journal of Rural Medicine
Canadian Journal of Rural Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
18.20%
发文量
38
期刊介绍: The Canadian Journal of Rural Medicine (CJRM) is a quarterly peer-reviewed journal available in print form and on the Internet. It is the first rural medical journal in the world indexed in Index Medicus, as well as MEDLINE/PubMed databases. CJRM seeks to promote research into rural health issues, promote the health of rural and remote communities, support and inform rural practitioners, provide a forum for debate and discussion of rural medicine, provide practical clinical information to rural practitioners and influence rural health policy by publishing articles that inform decision-makers.
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