Summers William K
Alzheimer's Corporation, 6000 Uptown Blvd, Suite 308, Albuquerque, NM 87110-4148, USA.
J Alzheimers Dis. 2006 Mar;9(1):69-75. doi: 10.3233/jad-2006-9107.
Congress and the FDA have strongly suggested that tranquilizers and antipsychotics not be used in agitated demented frail elderly patients. The medical profession has not moved away from the tradition of antipsychotic sedation of such patients. Use of 'modern second generation low dose' antipsychotics continue to be the standard of care. Propranolol, a non-selective beta-blocker with good penetration of the CNS, is a reasonable and safe alternative to sedatives and antipsychotics. Anti-dementia drugs are complementary to propranolol. A case study which contrasts the two pharmacologic approaches is detailed. A method of estimating delirium-agitation risk in dementia patients (DRN method) is described.
国会和美国食品药品监督管理局强烈建议，不要在患有痴呆且烦躁不安的体弱老年患者中使用镇静剂和抗精神病药物。医学界并未摒弃对此类患者使用抗精神病药物进行镇静的传统做法。使用“现代第二代低剂量”抗精神病药物仍然是护理标准。普萘洛尔是一种能很好穿透中枢神经系统的非选择性β受体阻滞剂，是镇静剂和抗精神病药物合理且安全的替代品。抗痴呆药物与普萘洛尔具有互补性。详细介绍了一个对比这两种药理学方法的案例研究。描述了一种评估痴呆患者谵妄 - 激越风险的方法（DRN方法）。
