頁籤選單縮合
題 名 | 重積性癲癇之藥物治療=Management of Status Epilepticus |
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作 者 | 鄭雅芳; 林傳敏; 蔡慈貞; | 書刊名 | 藥學雜誌 |
卷 期 | 36:1=142 2020.03[民109.03] |
頁 次 | 頁31-37 |
分類號 | 418.21 |
關鍵詞 | 重積性癲癇; 抗癲癇藥物; 治療指引; |
語 文 | 中文(Chinese) |
中文摘要 | 重積性癲癇是常見神經重症之一,需快速辨識診斷及即早控制以避免後續腦部受損或死亡。目前治療的困境包括:缺乏高品質及證據等級足夠的隨機分派試驗提供臨床應用、近1/3 的病人需以兩種或以上的藥物避免治療失敗的問題及藥物的選擇需考量副作用及藥物交互作用而影響療效等。老一代抗癲癇藥物的使用經驗,因副作用、藥物交互作用及需進行血中濃度監測而限制使用。新一代抗癲癇藥物使用上相對安全,但對於重積性癲癇的療效,仍缺乏顯著的療效影響。因此重積性癲癇的治療在缺乏高品質證據建議的情況下,臨床醫生應考量各藥物之藥理學特性、副作用及不同藥物動力學產生潛在的交互作用下,為病人制訂不同的治療策略。 |
英文摘要 | Status epilepticus (SE) is one of the most frequent neurological emergencies. Rapid recognition and control of SE are advocated to prevent further brain damage or mortality. Selection of the most effective antiepileptic drugs (AEDs) with the least adverse events, however, can often be challenging. Older AEDs such as phenytoin, valproic acid, and phenobarbital are often used by clinicians due to intravenous formulations, and availability of evidence in certain clinical scenarios. However, adverse effects of these agents, drug-drug interactions, and the need for therapeutic drug monitoring (TDM) may limit their use. Newer agents such as levetiracetam and lacosamide are gaining popularity due to their relatively safe AEDs profile, fewer drug-drug interactions, and lack of need for TDM. But newer antiepileptic drugs show no significant beneficial impact on outcome has yet been demonstrated in SE. As no high-quality evidence is available for choosing one medication over another, prescription of AEDs in SE should be tailored to each patient considering the efficacy spectrum, potential of adverse events and pharmacokinetic interactions. |
本系統中英文摘要資訊取自各篇刊載內容。