The Study Of Correlation Analysis Between Blood Concentration And Side Effects When BPSD Were Treated By Quetiapine

Objective: With the aging of the world’s population,a significant increase in the absolute number of older people with Alzheimer’s disease(AD)and other dementias is now occurring.Dementia is associated with progressive cognitive decline,a high prevalence of behavioral and psychological symptoms of dementia(BPSD)such as agitation,depression and psychosis,stress in caregivers,and costly care.Treatment of BPSD offers the best chance to alleviate suffering,reduce family burden,and lower societal costs in patients with dementia.In general,non-pharmacological approaches are first-line treatment for behavioral and psychological symptoms of dementia(BPSD).Medication is indicated for BPSD that are moderate to severe and that impact on a patient’s or caregiver’s quality of life,functioning,or that pose a safety concern,often in conjunction with non-pharmacological interventions.Atypical antipsychotics are preferred over typical antipsychotics for BPSD.6 Now quetiapine was used frequently to treat BPSD.However,due to its pharmacological characteristics,its side effects were often reported,especially in elderly patients,the incidence was significantly higher than that of young people,to bring much trouble to clinical medical workers.To evaluate the safety of this drug,we design this study of correlation analysis between blood concentration and side effects.Methods:90 patients of Alzheimer’s disease with BPSD were treated by quetiapine.These patients were evaluated by TESS and tested for electrocardiogram at the regions of 1≤100ng/ml,2:100-200 ng/ml,3:200-300 ng/ml,4>300ng/ml.Then we made the correlation analysis between blood concentration and side effects.Results: It showed that there was a negative correlation between drowsiness and blood concentration.When the blood concentration of quetiapine ≤100ng/ml,the incidence of drowsiness was significantly higher.But with the increment of blood concentration,the incidence of drowsiness was reduced.And postural hypotension was positive correlated with blood concentration.When the blood concentration of quetiapine >300ng/ml,the incidence of postural hypotension was significantly higher.There were no relations between other side effects and blood concentration.Conclusions: In clinical work,patients with Alzheimer’s disease is a very special group.This kind of people,the metabolism function was lower,the complications was more,and they were more sensitive to the side effect of the medicine.If the medical staff ignored the particularity of these people,there was no corresponding personalized treatment and regularly assess and monitor the use of the drug,but only routine treatment,patients were more likely to have serious side effects,such as orthostatic hypotension,falling fractures,and even sudden death.If this happened,not only will caused serious adverse consequences for patients,but also increased the occurrence of medical complaints.For the families of patients,medical staff,hospitals and the community were negatively affected.In general,when we choosed quetiapine to treat BPSD,we should start with low doses,slowly increasing the dose.Drowsiness is a common side effect for patients with BPSD who were treated by quetiapine.But it would be less risky when the dose of quetiapine was increased.On the other side,we need to focus on the postural hypotension.This side effect would be more dangerous when the dose was added.So before we decide to use quetiapine to treat patients with BPSD,we should assess the situation of patient thoroughly.And we should do some thing to prevent the side effects.