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중환자실 섬망의 약물요법Pharmacotherapy for Delirium in the Intensive Care Units

Other Titles
Pharmacotherapy for Delirium in the Intensive Care Units
Authors
이민정송예슬김현아
Issue Date
Feb-2016
Publisher
한국병원약사회
Keywords
Delirium; Haloperidol; Antipsychotic Agents; Dexmedetomidine
Citation
병원약사회지, v.33, no.1, pp 8 - 19
Pages
12
Journal Title
병원약사회지
Volume
33
Number
1
Start Page
8
End Page
19
URI
https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/3517
DOI
10.32429/jkshp.2016.33.1.001
ISSN
1226-640X
Abstract
Delirium is defined as an acute disturbance of consciousness with inattention difficulties, changes in cognition or perceptual disturbance, which can develop over hours to days. Delirium is common in the medical and surgical intensive care units (ICU) and associated with many negative outcomes such as increased mortality, ICU and hospital length of stay, and cognitive impairment. A large number of studies have been conducted on various nonpharmacologic and pharmacologic strategies for prevention or treatment of delirium. The purpose of this article was to review the nonpharmacologic and pharmacologic agents used for delirium and review current studies on each strategy. Nonpharmacologic delirium managements using early mobilization and spontaneous awakening trials/spontaneous breathing trials have been demonstrated to reduce the incidence or duration of delirium in ICU patients. Pharmacologic medications such as haloperidol, atypical antipsychotics (e.g., risperidone, olanzapine, quetiapine, ziprasidone), and dexmedetomidine can be used to treat delirium in the ICU, although there are limited data on when to treat and which agents to use. Haloperidol and atypical antipsychotics have the potential to cause QT prolongation and should be used cautiously in ICU patients.
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