...
首页> 外文期刊>JAMA: the Journal of the American Medical Association >Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal.
【24h】

Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal.

机译:戒酒的药理管理。荟萃分析和循证实践指南。美国戒毒协会戒酒药理管理工作组。

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       

摘要

OBJECTIVE: To provide an evidence-based practice guideline on the pharmacological management of alcohol withdrawal. DATA SOURCES: English-language articles published before July 1, 1995, identified through MEDLINE search on "substance withdrawal--ethyl alcohol" and review of references from identified articles. STUDY SELECTION: Articles with original data on human subjects. DATA ABSTRACTION: Structured review to determine study design, sample size, interventions used, and outcomes of withdrawal severity, delirium, seizures, completion of withdrawal, entry into rehabilitation, adverse effects, and costs. Data from prospective controlled trials with methodologically sound end points corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were abstracted by 2 independent reviewers and underwent meta-analysis. DATA SYNTHESIS: Benzodiazepines reduce withdrawal severity, reduce incidence of delirium (-4.9 cases per 100 patients; 95% confidence interval, -9.0 to -0.7; P=.04), and reduce seizures (-7.7 seizures per 100 patients; 95% confidence interval, -12.0 to -3.5; P=.003). Individualizing therapy with withdrawal scales results in administration of significantly less medication and shorter treatment (P<.001). beta-Blockers, clonidine, and carbamazepine ameliorate withdrawal severity, but evidence is inadequate to determine their effect on delirium and seizures. Phenothiazines ameliorate withdrawal but are less effective than benzodiazepines in reducing delirium (P=.002) or seizures (P<.001). CONCLUSIONS: Benzodiazepines are suitable agents for alcohol withdrawal, with choice among different agents guided by duration of action, rapidity of onset, and cost. Dosage should be individualized, based on withdrawal severity measured by withdrawal scales, comorbid illness, and history of withdrawal seizures. beta-Blockers, clonidine, carbamazepine, and neuroleptics may be used as adjunctive therapy but are not recommended as monotherapy.
机译:目的:为戒酒的药理管理提供循证实践指南。数据来源:1995年7月1日之前发布的英语文章,通过MEDLINE搜索“物质撤除-乙醇”并从已发现文章的参考文献中检索而确定。研究选择:带有人类受试者原始数据的文章。数据摘要:结构化审查,以确定研究设计,样本量,使用的干预措施以及戒断严重程度,del妄,癫痫发作,戒断完成,进入康复,不良反应和费用的结果。由2名独立审稿人对来自前瞻性对照试验的数据进行了合理的研究,其方法学上合理的终点与《精神疾病诊断和统计手册》第四版相对应,并进行了荟萃分析。数据合成:苯二氮卓类药物可降低戒断严重程度,减少reduce妄发生率(-每100例患者-4.9例; 95%置信区间,-9.0至-0.7; P = .04),并减少癫痫发作(每100例患者-7.7癫痫发作; 95%置信区间,-12.0到-3.5; P = .003)。用戒断量表进行个体化治疗可显着减少用药并缩短治疗时间(P <.001)。 β受体阻滞剂,可乐定和卡马西平改善了戒断的严重程度,但尚不足以确定其对del妄和癫痫发作的影响。吩噻嗪改善戒断作用,但在减少reducing妄(P = .002)或癫痫发作(P <.001)方面不如苯二氮卓类有效。结论:苯二氮卓类药物是戒断酒精的合适药物,可以根据作用时间,起效速度和费用来选择不同的药物。剂量应根据通过戒断量表,合并症和戒断发作史测得的戒断严重程度进行个体化。 β受体阻滞剂,可乐定,卡马西平和抗精神病药可以用作辅助治疗,但不建议作为单一疗法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号