• 제목/요약/키워드: haloperidol

검색결과 104건 처리시간 0.024초

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;금민정;김재송;손은선;유윤미
    • 한국임상약학회지
    • /
    • 제30권2호
    • /
    • pp.92-101
    • /
    • 2020
  • 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.

흰쥐의 심장과 심근세포에서 dopaminergic 수용체 자극이 Mg2+ 조절에 미치는 영향 (Effects of dopaminergic receptor stimulation on Mg2+ regulation in the rat heart and isolated ventricular myocytes)

  • 강형섭;김종식;김진상
    • 대한수의학회지
    • /
    • 제39권3호
    • /
    • pp.463-471
    • /
    • 1999
  • Magnesium($Mg^{2+}$) is one of the most abundant intracellular divalent cation. Although recent studies demonstrate that adrenergic receptor stimulation evokes marked changes in $Mg^{2+}$ homeostasis, the regulation of $Mg^{2+}$ by dopaminergic receptor stimulation is not yet known. In this work, we used dopaminergic agents to identify which type(s) of receptors were involved in the mobilization of $Mg^{2+}$ by dopaminergic receptor stimulation in the perfused rat hearts, isolated myocytes and circulating blood. The $Mg^{2+}$ content was measured by atomic absorbance spectrophotometry. Dopamine(DA), apomorphine(APO) and pergolide stimulated $Mg^{2+}$ efflux in the perfused rat hearts and these effects were inhibited by haloperidol or fluphenazine, nonselective dopaminergic antagonists. SKF38393, a selective doparminergic agonist, increased $Mg^{2+}$ efflux from the perfused hearts in dose dependant manners and SKF38393-induced $Mg^{2+}$ efflux was blocked by haloperidol. However, dopaminergic agonists-induced $Mg^{2+}$ efflux was potentiated in the presence of sulpiride or eticlopride, $D_2$-selective antagonist, from the perfused hearts. This increase of $Mg^{2+}$ efflux was blocked by haloperidol or imipramine. DA or pergolide increased in circulating $Mg^{2+}$ from blood. By contrast, PPHT stimulated $Mg^{2+}$ influx(a decrease in efflux) from the perfused hearts and circulating blood. PPHT-induced $Mg^{2+}$ influx was blocked by fluphenazine in the perfused hearts. DA-stimulated $Mg^{2+}$ efflux was inhibited by dopaminergic antagoinst in the isolated myocytes. In conclusion, the flux of $Mg^{2+}$ is modulated by DA receptor activation in the rat hearts. The efflux of $Mg^{2+}$ can be increased by $D_1$-receptor stimulation and decreased by $D_2$-receptor stimulation, respectively.

  • PDF

Olanzapine이 백서의 Schedule-Induced Polydipsia에 미치는 영향 (Effects of Olanzapine on the Schedule-Induced Polydipsic Rats)

  • 이기철;이경규;장환일;이정호;김현우;하준명;정재현;정홍경
    • 생물정신의학
    • /
    • 제6권2호
    • /
    • pp.240-245
    • /
    • 1999
  • Object : This study was designed to evaluate the effects of olanzapine on the schedule-induced polydipsia(SIP) which is one of animal model of obsessive-compulsive disorder in rats. We administered olanzapine as a serotonin and dopamine blocking agent, fluoxetine as a selective serotonin reuptake inhibitor, and haloperidol for the dopamine antagonist to rats which showed schedule-induced polydipsic behavior. Methods : Spraque-Dawley rats weighing 200-250gm were individually housed and maintained and allowed free access to water. The rats were placed on a restricted diet. To induce polydipsia, rats were placed in the cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT-60s) feeding schedule over 150 minute test session per day. Water was available at all times in the cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). 5 groups of rats were administered olanzapine(3mg/kg, i.p), olanzapine(10mg/kg, i.p), fluoxetine(5mg/kg, i.p.), haloperidol(0.1mg/kg, i.p.), and vehicle(1cc/kg, i.p.) for 3 weeks. The rats were tested once a week to access schedule induced polydipsic behavior. Water bottles were weighed before and after the 150-minute test session. The chronic effects of administration of experimental drugs on schedule induced polydipsic behavior were analyzed with ANOVA and Scheffe test as a posthoc comparison. In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5gm) of food per day which maintained them at their average body weight. Results and Conclusion : The results were as follows ; 1) After 4 weeks of scheduled feeding procedure, the experimental group showed significant differences than the bolus control in the amount of water consumption as compared with their average water intakes for 4 weeks. At the same periods, there were no differences between the experimental group and the bolus control in the body weight. 2) The fluoxetine group showed significant decrease in the amount of water intake over the 3 weeks of drug treatment as compared with their average amount of polydipsic water intakes. The olanzapine 3mg group showed significant decrease in the amount of water intake at 3rd weeks of drug treatment as compared with their average amount of polydipsic water intakes. The olanzapine 10mg group showed significant decrease in the amount of water intake at 2nd and 3rd weeks of drug treatment as compared with their average amount of polydipsic water intakes. However, the haloperidol group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their average amount of polydipsic water intakes. 3) The fluoxetine group showed significantly lower amounts of water intake than the haloperidol group at 2nd weeks of drug treatment. And also the fluoxetine group showed significantly lower amounts of water intake than the haloperidol group and the vehicle control at 3rd weeks of drug treatment. The olanzapine 3mg group and the olanzapine 10mg group showed significantly lower amounts of water intake than the haloperidol group and the vehicle control at 3rd weeks of drug treatment. Above findings suggest that the fixed time feeding procedure for schedule-induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. The authors assume that the serotonin hypothesis and the serotonin-dopamine interaction hypothesis are preferred to the dopamine hypothesis in the biological etiology of obsessive-compulsive disorder.

  • PDF

남자 만성 정신분열병환자에서 Haloperidol과 Nimodipine의 병합사용이 혈장 HVA와 5-HIAA에 미치는 영향 (The Effects of the Combined Use of Haloperidol and Nimodipine on Plasma HVA, 5-HIAA in Male Chronic Schizophrenics)

  • 김형섭;최애경;지성학;김수동;박성덕;김광현
    • 생물정신의학
    • /
    • 제3권1호
    • /
    • pp.88-95
    • /
    • 1996
  • 본 연구는 난치성 만성 정신분열병 남자환자 20명을 대상으로 항정신병약물인 haloperidol 올 2주간 일정량으로 유지한후 중추신경계에 비교적 선택적으로 작용하는 칼슘차단제인 nimodipine을 5주간 병합투여하였고 BPRS, Simpson-Angus Scale Averse events-Somatic Symptoms 등을 이용하여 nimodipine투여전, 투여후 1주, 3주, 5주에 임상반응을 평가하고 혈장 HVA, 5-HIAA농도를 투여전과 투여후 1주, 3주, 5주에 측정하여 다음과 같은 결과를 얻었다. 1) Nimodipine과 haloperidol의 병합투여시 전체 BPRS점수 및 사고소검사점수, 편집성소검사점수는 용량에 관계없이 기간에 따라 감소하는 추세를 보였으나, 특히 nimodipine 90mg을 병용투여하는 군의 경우 nimodipine투여전과 비교하여 3, 5주째에서 통계적으로 의미있게 감소하는 결과를 나타냈다(p<0.05). 2) Nimodipine과 haloperidol의 병합투여에 따른 부작용등은 통계적으로 의미는 없었으나 기간에 따라 감소하는 추세를 보였고, 임상적으로 관찰된 소견상 추체외로증상, 안구동통, 정서적 불안정, 심혈관계 부작용 등의 심각한 부작용은 없었다. 3) Nimodipine의 투여량 및 기간에 따른 혈장 HVA와 5-HIAA의 농도변화는 없었다. 4) BPRS점수가 20% 이상 감소하는 경우를 호전된 것으로 간주했을때 호전군과 비호전군간의 혈장 HVA 및 5-HIAA는 차이를 나타내지 않았고, 각 군에서 측정시기에 따른 차이도 보이지 않았다. 상기 결과로 보아 nimodipine이 혈장 HVA와 5-HIAA의 농도변화에 영향을 미치지 않으나 임상적인 호전은 나타내는 바 난치성 정신분열병환자, 노인환자나 항정신병 약물에 대해 부작용이 심한 정신분열병환자에서 nimodipine 병합사용이 유용할 것으로 사료된다.

  • PDF