Subcutaneous Olanzapine for Hyperactive or Mixed Delirium in Patients with Advanced Cancer A Preliminary Study
Subcutaneous Olanzapine for Hyperactive or Mixed Delirium in Patients with Advanced Cancer A Preliminary Study
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DOI：
10.1016/j.jpainsymman.2010.02.017
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发表时间：
2010-11-01
影响因子：
4.7
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
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作者：
Elsayem, Ahmed;Bush, Shirley H.;Bruera, Eduardo
背景口服奥氮平可有效控制谵妄患者的激越，但通常需要胃肠外给药。肌内注射奥氮平被批准用于治疗精神分裂症患者的激越，但这种途径不适合晚期病人。目的：本初步研究的目的是确定皮下注射（SC）的安全性和耐受性。奥氮平治疗晚期癌症患者多动性或混合性谵妄的临床研究（里士满躁动镇静量表[RASS]评分>=+1）在24小时内对10 mg或更高剂量的胃肠外氟哌啶醇没有反应的患者接受奥氮平5 mg SC，每8小时一次，持续3天，并继续氟哌啶醇治疗爆发性激越。超过8毫克的补救氟哌啶醇每日，奥氮平剂量增加到10毫克SC每8小时注射部位，全身毒性，和疗效（RASS评分
Context Oral olanzapine is effective in controlling agitation in patients with delirium, but often, parenteral administration is necessary Intramuscular (IM) olanzapine is approved for managing agitation in schizophrenia, but this route is inappropriate for terminally ill patientsObjectives The purpose of this pilot study was to determine the safety and tolerability of subcutaneous (SC) olanzapine in the management of hyperactive or mixed delirium in patients with advanced cancerMethods We conducted a prospective open-label study in patients with advanced cancer who had agitated delirium (Richmond Agitation Sedation Scale [RASS] score >=+1) that had not responded to a 10 mg or higher dose of parenteral haloperidol over 24 hours Patients received olanzapine 5 mg SC every eight hours for three days and continued haloperidol for breakthrough agitation For patients requiring more than 8 mg of rescue haloperidol daily, the olanzapine dose was increased to 10 mg SC every eight hours Injection site, systemic toxicity, and efficacy (RASS score