clozapine-induced低血压的治疗策略:一个系统的复习。

文章的细节

引用

复制到剪贴板

Tanzer TD, Brouard T, Pra SD,沃伦·N,彭M, Kisely年代,布鲁克斯E, Siskind D

clozapine-induced低血压的治疗策略:一个系统的复习。

睡觉Psychopharmacol。2022年5月24日,12:20451253221092931。doi: 10.1177 / 20451253221092931。eCollection 2022。

PubMed ID

35633931 (在PubMed

]

文摘

背景:氯氮平是最有效的药物治疗难以精神分裂症但与重要药物不良影响,包括低血压、眩晕,对生活质量产生负面影响和治疗依从性。现有证据管理clozapine-induced低血压是不足。目的:由于有限的指导药物治疗的安全性和有效性clozapine-induced低血压,我们系统地回顾和评估的证据clozapine-induced低血压的管理和指导临床医生、患者和护理人员。设计:我们进行了一个系统的安全性和有效性的审查干预clozapine-induced低血压由于现有证据有限。数据源和方法:PubMed、Embase PsycINFO, CINAHL, Cochrane试验注册表搜索从开始到2021年11月对文学clozapine-induced低血压的治疗策略使用预普洛斯彼罗的搜索策略和眩晕。直立性低血压,我们开发了一个管理框架,协助选择干预。结果:我们确定了9个案例研究和四个案例系列描述干预15例。低血压的干预措施包括临时氯氮平剂量减少,后备治疗和药物治疗。米多君,氟氢可的松,moclobemide和肉汁((R))的组合,和etilefrine与改善相关症状或减少直立性低血压。血管紧张素ⅱ、精氨酸加压素和去甲肾上腺素成功地恢复和维护在重症监护的情况下平均动脉压。 A paradoxical reaction of severe hypotension was reported with adrenaline use. CONCLUSION: Orthostatic hypotension is a common side effect during clozapine titration. Following an assessment of the titration schedule, salt and fluid intake, and review of hypertensive and nonselective alpha1-adrenergic agents, first-line treatment should be a temporary reduction in clozapine dose or non-pharmacological interventions. If orthostatic hypotension persists, fludrocortisone should be trialled with monitoring of potassium levels and sodium and fluid intake. Midodrine may be considered second-line or where fludrocortisone is contraindicated or poorly tolerated. For patients on clozapine with hypotension in critical care settings, the use of adrenaline to maintain mean arterial pressure should be avoided. REGISTRATION: PROSPERO (Registration No. CRD42020191530).

beplay体育安全吗DrugBank数据引用了这篇文章

药物

氯氮平