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右美托咪定的安全性评估:来自美国食品药品监督管理局不良事件报告系统公共仪表盘的真实世界不良事件分析。

Safety assessment of dexmedetomidine: Real-world adverse event analysis from the Food and Drug Administration Adverse Events Reporting System public dashboard.

作者信息

Yin Yi, Jiang Jie, Jin Youpeng

机构信息

Department of Pediatric Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

出版信息

Indian J Pharmacol. 2025 Sep 1;57(5):344-349. doi: 10.4103/ijp.ijp_688_24. Epub 2025 Aug 22.

Abstract

Dexmedetomidine (DEX), as a widely used medication for sedation, its usage has increased significantly. The concerns about its side effects remain, making a thorough safety evaluation necessary. Data on adverse drug events related to DEX from the first quarter of 2004 to the fourth quarter of 2023 were collected from the US Food and Drug Administration. Signal quantification techniques were used for the analysis, including reporting odds ratios (RORs), proportional reporting ratios, Bayesian confidence propagation neural network and empirical Bayes geometric mean. An analysis of 20,629,811 adverse event (AE) reports identified 1977 cases of DEX-related AEs, covering 24 system organ classes and 344 preferred terms (PTs). The most common PTs were bradycardia (n = 263), cardiac arrest (n = 150), and hypotension (n = 141). Based on the ROR algorithm, the top three were: transcranial electrical motor evoked potential monitoring abnorma, acute motor axonal neuropathy, and trigemino-cardiac reflex. In addition, this study identified the adverse effects such as diabetes insipidus, coronary arteriospasm, and intestinal pseudo-obstruction, which were not previously mentioned in the instructions. It is essential to monitor, identify, and address these adverse reactions effectively.

摘要

右美托咪定(DEX)作为一种广泛使用的镇静药物,其使用量显著增加。对其副作用的担忧依然存在,因此有必要进行全面的安全性评估。从美国食品药品监督管理局收集了2004年第一季度至2023年第四季度与DEX相关的药物不良事件数据。采用信号量化技术进行分析,包括报告比值比(ROR)、比例报告比值、贝叶斯置信传播神经网络和经验贝叶斯几何均值。对20,629,811份不良事件(AE)报告的分析确定了1977例与DEX相关的AE,涵盖24个系统器官类别和344个首选术语(PT)。最常见的PT是心动过缓(n = 263)、心脏骤停(n = 150)和低血压(n = 141)。基于ROR算法,排名前三的是:经颅电运动诱发电位监测异常、急性运动轴索性神经病和三叉神经心脏反射。此外,本研究还发现了如尿崩症、冠状动脉痉挛和肠道假性梗阻等不良反应,这些不良反应在说明书中此前未被提及。有效监测、识别和处理这些不良反应至关重要。

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Probable Dexmedetomidine Induced Diabetes Insipidus: A Case Review.疑似右美托咪定诱发的尿崩症:病例回顾
J Pharm Pract. 2023 Jun;36(3):685-688. doi: 10.1177/08971900211053261. Epub 2021 Oct 20.

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