Tune L E, Bylsma F W
Department of Psychiatry and Behavioral Sciences, John Hopkins School of Medicine, Baltimore, Maryland.
Int Psychogeriatr. 1991 Winter;3(2):397-408. doi: 10.1017/s1041610291000832.
Encompassing the range from subtle cognitive impairments to frank delirium, toxicity due to benzodiazepines and to anticholinergic-containing compounds is reviewed. For benzodiazepines, an extensive literature suggests that they impair immediate and delayed memory, psychomotor performance, and subjective complaints of station. This, in several studies, results in increased patient morbidity (e.g., increasing risk of hip fractures). Anticholinergic compounds are widely utilized in managing elderly patients, particularly nursing home residents. Toxicity from anticholinergic compounds, detected by anticholinergic drug levels, is significantly correlated with the presence and severity of delirium in a number of settings including postoperative patients and elderly nursing home residents. Possible means of identifying the syndrome by prediction of dose and type of medication, as well as by quantitative EEG, are reviewed.
本文综述了苯二氮䓬类药物和含抗胆碱能化合物导致的毒性，其涵盖了从轻微认知障碍到明显谵妄的范围。对于苯二氮䓬类药物，大量文献表明它们会损害即时和延迟记忆、精神运动表现以及体位的主观不适。在多项研究中，这会导致患者发病率增加（例如髋部骨折风险增加）。抗胆碱能化合物广泛用于老年患者的管理，尤其是疗养院居民。通过抗胆碱能药物水平检测到的抗胆碱能化合物毒性，在包括术后患者和老年疗养院居民在内的多种情况下，与谵妄的存在和严重程度显著相关。本文还综述了通过预测药物剂量和类型以及定量脑电图来识别该综合征的可能方法。
