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首页> 外文期刊>Drugs and aging >Withholding, discontinuing and withdrawing medications in dementia patients at the end of life: a neglected problem in the disadvantaged dying?
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Withholding, discontinuing and withdrawing medications in dementia patients at the end of life: a neglected problem in the disadvantaged dying?

机译：老年痴呆症患者在生命终了时停药，停药和停药：在处境不利者中被忽视的问题？

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摘要

Recent years have seen a growing recognition that dementia is a terminal illness and that patients with advanced dementia nearing the end of life do not currently receive adequate palliative care. However, research into palliative care for these patients has thus far been limited. Furthermore, there has been little discussion in the literature regarding medication use in patients with advanced dementia who are nearing the end of life, and discontinuation of medication has not been well studied despite its potential to reduce the burden on the patient and to improve quality of life. There is limited, and sometimes contradictory, evidence available in the literature to guide evidence-based discontinuation of drugs such as acetylcholinesterase inhibitors, antipsychotic agents, HMG-CoA reductase inhibitors (statins), antibacterials, antihypertensives, antihyperglycaemic drugs and anticoagulants. Furthermore, end-of-life care of patients with advanced dementia may be complicated by difficulties in accurately estimating life expectancy, ethical considerations regarding withholding or withdrawing treatment, and the wishes of the patient and/or their family. Significant research must be undertaken in the area of medication discontinuation in patients with advanced dementia nearing the end of life to determine how physicians currently decide whether medications should be discontinued, and also to develop the evidence base and provide guidance on systematic medication discontinuation.
机译：近年来，人们越来越认识到痴呆症是一种绝症，并且接近生命晚期的晚期痴呆症患者目前没有得到足够的姑息治疗。但是，到目前为止，对这些患者的姑息治疗的研究一直很有限。此外，关于在生命快要结束的晚期痴呆患者中使用药物的文献报道很少，尽管对减轻药物负担可能减轻患者负担并改善其质量也没有很好的研究。生活。文献中仅有很少的证据，有时甚至是相互矛盾的证据来指导药物的循证停用，例如乙酰胆碱酯酶抑制剂，抗精神病药，HMG-CoA还原酶抑制剂（他汀类药物），抗菌药，抗高血压药，抗高血糖药和抗凝药。此外，患有晚期痴呆的患者的临终护理可能会因难以准确估计预期寿命，有关停药或退出治疗的道德考量以及患者和/或其家人的意愿而变得复杂。必须在生命快要结束的晚期痴呆患者中停止用药领域进行重大研究，以确定医生当前如何决定是否应停止用药，并建立证据基础并为系统用药停顿提供指导。

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