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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Psychiatric side effects of indomethacin in parturients: (Les effets secondaires psychiatriques de l'indomethacine chez les parturientes).
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Psychiatric side effects of indomethacin in parturients: (Les effets secondaires psychiatriques de l'indomethacine chez les parturientes).

机译：消炎痛在产妇中的精神病副作用：（消炎痛在产妇中的精神病副作用）。

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PURPOSE: To examine the central nervous system side effects of the non-steroidal anti-inflammatory drug (NSAID) indomethacin in a case-series of obstetric patients. METHODS: The hospital records of patients experiencing any postpartum complication between 1994 and 1999 were reviewed for adverse drug reactions (ADR) attributed to indomethacin. Additional cases of indomethacin-induced adverse effects were identified through reports to the nursing administration and the Saskatchewan ADR reporting program. The Naranjo ADR probability scale was applied to all cases. RESULTS: Thirty-two patients experienced a psychiatric reaction after receiving indomethacin for postpartum pain. The symptoms were often severe and included dizziness, anxiety, fear, agitation, affective lability, depersonalization, paranoia, and hallucinations. There was no past psychiatric history documented in any of the cases. CONCLUSION: This study identifies a possible ADR to indomethacin occurring in postpartum patients. Whether the vulnerability to these neuropsychiatric reactions is randomly distributed or if parturients are at increased risk is yet to be determined. Proposed mechanisms of these side effects include a postpartum dopamine supersensitivity exacerbated by prostaglandin inhibition as well as a structural similarity between serotonin and indomethacin. The severity of the reactions to indomethacin in parturients and the potential for these disturbing psychiatric side effects to compromise the safety of both mother and infant have led to the use of alternative analgesics including different classes of NSAIDs for this population at our institution.
机译：目的：检查非甾体类消炎药（NSAID）消炎痛在一系列产科患者中的中枢神经系统副作用。方法：回顾性分析了1994年至1999年间发生过任何产后并发症的患者的医院记录，归因于消炎痛的不良药物反应（ADR）。通过向护理管理部门报告和萨斯喀彻温省ADR报告计划报告，确定了消炎痛引起的其他不良反应。 Naranjo ADR概率量表适用于所有情况。结果：32例患者在接受吲哚美辛治疗产后疼痛后出现了精神病反应。这些症状通常很严重，包括头晕，焦虑，恐惧，激动，情绪不稳，人格解体，偏执狂和幻觉。在任何情况下都没有记录过的精神病史。结论：本研究确定了产后患者发生吲哚美辛的可能的ADR。这些神经精神反应的脆弱性是否是随机分布的，还是产妇处于增加的风险中，尚待确定。这些副作用的拟议机制包括，由于前列腺素的抑制而加剧的产后多巴胺超敏性以及5-羟色胺和消炎痛之间的结构相似性。产妇对吲哚美辛反应的严重性以及这些令人不安的精神副作用损害母亲和婴儿安全的潜力，导致我们机构对该人群使用了其他镇痛药，包括不同种类的非甾体抗炎药。

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