Mo Yoonsun, Yam Felix K
1 Critical Care, Western New England University College of Pharmacy, Springfield, MA, USA.
2 Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, La Jolla, San Diego, CA, USA.
J Pharm Pract. 2017 Feb;30(1):121-129. doi: 10.1177/0897190015585763. Epub 2016 Jul 9.
Delirium, described as an acute neuropsychiatric syndrome, occurs commonly in critically ill patients and leads to many negative outcomes including increased mortality and long-term cognitive deficits. Despite the lack of clinical data supporting the use of antipsychotics for the management of intensive care unit (ICU) delirium, pharmacological interventions are often needed to control acutely agitated patients. Given that the most current guidelines do not advocate the use of haloperidol for either the prevention or treatment of ICU delirium due to a lack of evidence, second-generation antipsychotics (SGAs) have been commonly used as alternatives to haloperidol for ICU patients with delirium. Nonetheless, the evidence supporting the use of SGAs to treat ICU delirium remains limited. This review is designed to assess the available clinical evidence and highlights the different neuropharmacological and safety properties of SGAs in order to guide the rational use of SGAs for the treatment of ICU delirium.
谵妄被描述为一种急性神经精神综合征，在重症患者中很常见，并会导致许多负面后果，包括死亡率增加和长期认知缺陷。尽管缺乏临床数据支持使用抗精神病药物来管理重症监护病房（ICU）谵妄，但通常仍需要药物干预来控制急性躁动的患者。鉴于目前最新的指南因缺乏证据而不主张使用氟哌啶醇预防或治疗ICU谵妄，第二代抗精神病药物（SGA）已普遍被用作氟哌啶醇的替代品，用于治疗患有谵妄的ICU患者。尽管如此，支持使用SGA治疗ICU谵妄的证据仍然有限。本综述旨在评估现有的临床证据，并强调SGA的不同神经药理学和安全性特性，以指导合理使用SGA治疗ICU谵妄。
