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題 名 | Olanzapine和Clotiapine引起跌倒後的省思=Reflection after Falls Caused by Olanzapine and Clotiapine |
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作 者 | 李芷葶; 羅育光; 黃雯鈺; | 書刊名 | 藥學雜誌 |
卷 期 | 35:4=141 2019.12[民108.12] |
頁 次 | 頁83-89 |
分類號 | 418.21 |
關鍵詞 | 跌倒; 精神作用藥; 安非他命; Fall; Hypnotics; |
語 文 | 中文(Chinese) |
中文摘要 | 大多數跌倒都是由多種風險因素所造成,但是本文並沒有涵蓋所有因素,例如步 態評價、力量訓練、環境評估和變化,本文焦點在介紹如何改善藥物治療管理這一 限制因素,進而降低跌倒風險。本文引用併用9 種精神科藥品個案,因 olanzapine 和 clotiapine 誘發姿態性低血壓引起跌倒後,藥師介入藥物治療管理並提出一些建言。 像:一、併用多種精神科藥品處理原則,應先評估是否需要用藥,若可以以每週降低 10-25%劑量方式逐步停用與跌倒相關藥品,用以降低中樞神經系統負擔為目標,並 以不會引起因停藥所導致之不良反應為原則。二、長效和短效 benzodiazepines 類藥物 都會增加跌倒風險,若能改變日間睡眠方式,服用時間不早於11:00 pm,應能減少服 用種類及服用量,也可降低跌倒風險。三、最後,促進鈣吸收,同時補充足夠維生素 D以提高骨密度,降低跌倒相關骨折風險。 |
英文摘要 | While most falls are caused by multiple risk factors, this paper does not cover all factors, such as tread evaluation, power training, environmental valuation, and changes. This paper mainly introduces how to improve the limitation factors–meaning pharmaceutical administration, in order to reduce the risk of falls. A case where 9 psychotropic substances are used simultaneously is mentioned in this paper. After the fall, as caused by orthostatic hypotension induced by olanzapine and clotiapine, the pharmacist intervened in the pharmaceutical administration, and puts forward some suggestions: (1) In terms of the handling principle of the combined use of multiple psychotropic substances, patients should firstly evaluate whether it is necessary to take the medicine, and then, reduce the dosage by10-25% every week to gradually stop using the drugs related to falls, which reduces the burden of the central nervous system as the goal, and with no adverse reaction caused by the drug discontinuance as the principle. (2) Both long-acting and short-acting Benzodiazepines drugs will increase the risk of falls. If the daytime sleeping schedule can be changed, and the drug administration time is not earlier than 11:00 pm, it can reduce the drug species and dosage, and thus, reduce the risk of falls. (3) Finally, calcium absorption should be promoted, and sufficient vitamin D should be supplemented, in order to increase bone density to reduce the fracture risk related to falls. |
本系統中英文摘要資訊取自各篇刊載內容。