Failure of lorazepam to treat alprazolam withdrawal in a critically ill patient  

作　　者：Gaurav Sachdev Gail Gesin A Britton Christmas Ronald F Sing 

机构地区：[1]The F H Sammy Ross, Jr Trauma Center, Department of Pharmacy, Carolinas Medical Center, Charlotte, NC 28023, United States [2]Department of Surgery/MEB 601, Carolinas Medical Center, Charlotte, NC 28203, United States

出　　处：《World Journal of Critical Care Medicine》2014年第1期42-44,共3页世界重症医学杂志

摘　　要：Management of sedation in the critical care unit is an ongoing challenge. Benzodiazepines have been commonly used as sedatives in critically ill patients. The pharmacokinetic and pharmacodynamic properties that make benzodiazepines effective and safe in critical care sedation include rapid onset of action and decreased respiratory depression. Alprazolam is a commonly used benzodiazepine that is prescribed for anxiety and panic disorders. It is frequently prescribed in the outpatient setting. Its use has been reported to result in a relatively high rate of dependence and subsequent withdrawal symptoms. Symptoms of alprazolam withdrawal can be difficult to recognize and treat in the critical care setting. In addition, other benzodiazepines may also be ineffective in treating alprazolam withdrawal. We present a case of alprazolam withdrawal in a critically ill trauma patient who failed treatment with lorazepam and haloperidol. Subsequent replacement with alprazolam resulted in significant improvement in the patient's medication use and clinical status.Management of sedation in the critical care unit is an ongoing challenge. Benzodiazepines have been commonly used as sedatives in critically ill patients. The pharmacokinetic and pharmacodynamic properties that make benzodiazepines effective and safe in critical care sedation include rapid onset of action and decreased respiratory depression. Alprazolam is a commonly used benzodiazepine that is prescribed for anxiety and panic disorders. It is frequently prescribed in the outpatient setting. Its use has been reported to result in a relatively high rate of dependence and subsequent withdrawal symptoms. Symptoms of alprazolam withdrawal can be difficult to recognize and treat in the critical care setting. In addition, other benzodiazepines may also be ineffective in treating alprazolam withdrawal. We present a case of alprazolam withdrawal in a critically ill trauma patient who failed treatment with lorazepam and haloperidol. Subsequent replacement with alprazolam resulted in significant improvement in the patient's medication use and clinical status.

关 键 词：Alpralazom LORAZEPAM WITHDRAWAL PHARMACOKINETICS PHARMACODYNAMICS 

分 类 号：R96[医药卫生—药理学]