The Study Of The Relationship Between Dose Of In Quetiapine And Adverse Reactions Treatment Of BPSD

Objective: The population aging problem in our country is worsening.In recent years,there has been a significant increase in the number of the elderly suffering from dementia with Alzheimer’s disease(AD).Dementia leads to a progressive generalized decline in cognitive function,coupled with a higher incidence of dementia patients with psychiatric symptoms such as anxiety,depression,agitation and psychotic symptoms(Behavioral and psychological symptoms of dementia,BPSD),making caregiver pressure This has greatly increased the cost of care and treatment for families and the community.At present,the internationally accepted goal of treatment and rehabilitation of BPSD is to minimize the pain caused by disease in patients,which is also one of the best strategies to reduce the social burden.Often,non-drug approaches are the preferred treatment and rehabilitation modalities for BPSD.Medication interventions are generally used to treat moderate-to-severe BPSD,especially when BPSD affects the social functioning,quality of life,or safety risk of a patient or caregiver.In terms of drug selection,atypical antipsychotics performed better than the typical antipsychotics in terms of efficacy and safety.In the actual clinical work,most of the treatment of BPSD will use quetiapine.However,quetiapine due to its pharmacological characteristics of neurotransmitter receptors,so its side effects are more,especially in poor physical condition in elderly patients,the incidence of side effects caused by quetiapine was significantly higher than that of young People,increase medical risks and make patients less tolerant.At present,there are few studies on the side effects of quetiapine in the treatment of elderly BPSD patients.In order to standardize the medication and prevent serious adverse reactions,the present study was conducted on the correlation between plasma concentration of quetiapine and drug side effects in elderly BPSD patients system Research.Methods: The diagnostic criteria of Alzheimer’s disease dementia conforming to the third edition(CCMD-3)of Chinese mental disorders classification and diagnostic criteria were randomly selected,with mental and behavioral problems associated with anxiety,depression,agitation or psychotic symptoms,and age Sixty-six hospitalized patients with BPSD over 60 years old were treated with quetiapine orally in four groups: group 1: <200mg / day,group 2: 200-300 mg / day,group 3: 300-400 mg / day,group 4:> 400 mg / day,24 cases in each group.The data used were SPSS 13.0 statistical software for spearman correlation analysis of the correlation between drug dose and adverse reaction.Results: After statistical analysis,the level of drug dose was negatively correlated with the occurrence of narcolepsy in adverse reactions.The smaller the dosage,the higher the incidence of lethargy,the result was statistically significant(p <0.05);while the dose level And adverse reactions in the incidence of orthostatic hypotension symptoms are positively correlated,and with statistical significance(p <0.01),that when the dose> 400 mg / day,the higher the incidence of orthostatic hypotension.Other side effects of drugs such as dizziness,fatigue,QT prolongation,no significant correlation with plasma concentration.Conclusion: Alzheimer’s patients are very common and very special groups in psychiatric work.If the medical staff ignore these particularities,do not have a good personalized treatment and timely prevention,and there is no regular drug risk assessment and monitoring,then patients are most likely to have more serious adverse drug reactions.Therefore,when psychiatrists choose to treat patients with Alzheimer’s disease with quetiapine BPSD symptoms,must be at a lower dose(initial drug or plasma concentration is low)need to pay attention to the occurrence of lethargy,timely prevention and treatment;Higher doses(or higher blood concentration)need to pay attention to the occurrence of orthostatic hypotension,and timely prevention and intervention.To sum up,with quetiapine in the treatment of BPSD,clinicians and nursing staff must pay attention to possible adverse drug reactions at different dosage levels to improve clinical safety and advance communication and informed consent with patients and their families to establish Good doctor-patient relationship.