한국임상약학회지 (Korean Journal of Clinical Pharmacy)

  • 제30권2호
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  • Pages.92-101
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  • 2020
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  • 1226-6051(pISSN)
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  • 2508-786X(eISSN)
한국임상약학회 (Korean College Of Clinical Pharmacy)
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완화의료병동 암환자들의 섬망 치료를 위해 사용된 항정신병 약물의 효과 및 안전성 비교

Efficacy and Safety of Antipsychotics for Delirium Treatment in Cancer Patients Receiving Palliative Care

  • 오솔 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 금민정 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 김재송 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 손은선 (연세대학교 의과대학 세브란스병원 약무국) ;
  • 유윤미 (연세대학교 약학대학)
  • Oh, Sol (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Geum, Min Jung (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Kim, Jae Song (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Son, Eun Sun (Department of Pharmacy, Severance Hospital, College of Medicine, Yonsei University) ;
  • Yu, Yun Mi (Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University)
  • 투고 : 2020.02.21
  • 심사 : 2020.05.26
  • 발행 : 2020.06.30
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초록

Background: Delirium is a neuropsychiatric disorder characterized by sudden impairments in consciousness, attention, and perception. The evidence of successful pharmacological interventions for delirium is limited, and medication recommendations for managing delirium are not standardized. This study aimed to provide evidence of antipsychotics for symptomatic treatment of delirium in cancer patients receiving palliative care. Methods: We retrospectively reviewed adult cancer patients in palliative care who received antipsychotic delirium treatment at Severance Hospital between January 2016 and June 2019. The efficacy was evaluated primarily by resolution rates. The resolution of delirium was defined as neurological changes from drowsiness, confusion, stupor, sedation, or agitation to alertness or significant symptomatic improvements described in the medical records. The safety was studied primarily by adverse drug reaction incidence ratios. Results: Of the 63 enrolled patients, 60 patients were included in the statistical analysis and were divided into three groups based on which antipsychotic medication they were prescribed [quetiapine (n=27), haloperidol (n=25) and co-administration of quetiapine and haloperidol (n=8)]. The resolution ratio showed quetiapine to be more effective than haloperidol (p=0.001). No significant differences were seen in adverse drug reaction rates among the three groups (p=0.332). Conclusions: Quetiapine was considered the most effective medication for delirium, with no significant differences in adverse drug reaction rates. Therefore, quetiapine may be considered a first-line medication for treating delirium in cancer patients receiving palliative care. However, further studies comparing more diverse antipsychotics among larger populations are still needed.

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