著者
渡邊 美智留 三田 恭平 中村 春世 田中 恒明 三原 潔 小野 秀樹
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.40, no.12, pp.726-733, 2014-12-10 (Released:2015-12-10)
参考文献数
9

Pregabalin, a useful drug for neuropathic pain, has a high incidence of dizziness and somnolence as side effects. In the present study, the incidence of both side effects and the risk factors were retrospectively investigated in hospitalized patients who were administered pregabalin after their admission. In 65 patients (median 68 years old), 34 cancer patients and 18 opioid users were included. Items studied were cancer/non-cancer, opioid user/non-user, fall/nonfall, age, sex, weight, daily dose of opioids, the number of the drugs that may cause dizziness and somnolence, daily dose of pregabalin, and the ratio of creatinine clearance to daily dose of pregabalin. Fourteen (21.5%) and 21 (23.3%) patients developed dizziness and somnolence, respectively, and 4 (6.1%) patients developed fall. In the case of opioid combination, 7 (38.9%) and 10 (55.6%) patients developed dizziness and somnolence, respectively. A logistic-regression analysis showed that opioid use is a significant augmenting risk factor for dizziness (P = 0.026) and somnolence (P = 0.016) of pregabalin. The ratios of daily dose of pregabalin to creatinine clearance did not show any relation to the incidence of dizziness and somnolence; both side effects were observed in some patients whose renal functions were normal. It is suggested that attention is necessary to the incidence of dizziness and somnolence regardless of renal function, and that particular attention is required when opioids, which have similar side effects, are combined with pregabalin.
著者
益戸 智香子 小川 ゆかり 山下 直美 三原 潔
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.139, no.1, pp.113-122, 2019-01-01 (Released:2019-01-01)
参考文献数
41
被引用文献数
6

Benzodiazepine receptor agonists (BZDRAs) have been associated with an increased risk of falls in the elderly. However, the association between the elimination half-life (t1/2) of BZDRAs and the difference between benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs) has not been clarified. By conducting a meta-analysis of observational studies, we compared the risk of falls with respect to 1) short-acting BZDRAs (t1/2<12 h) vs. long-acting BZDRAs (t1/2≥12 h) and 2) BZDs vs. Z-drugs in elderly patients. Data were retrieved from MEDLINE, the Cochrane Library, and Igaku Chuo Zasshi. In total, 13 observational studies from 12 articles were included in our study (short-acting BZDRAs, n=12; long-acting BZDRAs, n=9; BZDs, n=13; Z-drugs, n=7). The risk of falls was significantly increased by the use of short-acting BZDRAs [Odds ratio (OR) (95% Confidence interval (CI)): 2.00 (1.46-2.73)], long-acting BZDRAs [OR (95%CI): 2.16 (1.61-2.89)], BZDs [OR (95%CI): 1.67 (1.31-2.13)], and Z-drugs [OR (95%CI): 2.42 (1.35-4.34)] compared to the risk in BZDRAs non-users. The increased risk of falls in elderly patients was similar in each group and unrelated to t1/2. This study suggested that all BZDRAs including Z-drugs should be avoided in elderly patients.