Possibility of Influence of Midazolam Sedation on the Diagnosis of Brain Death: Concentrations of Active Metabolites after Cessation of Midazolam
スポンサーリンク
概要
- 論文の詳細を見る
Midazolam and its active metabolites have a depressant effect on respiration and consciousness level, and therefore their effects should be considered in all patients for whom brain death testing is contemplated. The concentrations of midazolam and its active metabolites were measured in critically ill patients on a ventilator during and after continuous intravenous infusion of midazolam. Three days after cessation of midazolam infusion, the concentrations of midazolam and 1-hydroxymidazolam decreased to below the therapeutic range (100-1000 ng/ml) in all patients, although the concentrations of 1-hydroxymidazolam glucuronide remained extremely high in a patient who showed deteriorating renal function. The concentrations of l-hydroxymidazolam glucuronide (19,497-29,761 ng/ml) were measured in this patient. When it is impossible to confirm factors consistent with irreversible brain death, such as the lack of cerebral blood flow, until 3 days after cessation of midazolam infusion, monitoring of the concentration of these substances should be carried out in all patients in whom suspicion exists prior to the evaluation of brain death. It is particularly imperative that monitoring of the 1-hydroxymidazolam glucuronide concentration be carried out in patients with poor renal function.
- 社団法人日本薬学会の論文
- 2003-09-01
著者
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松本 宜明
日本大・薬
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清水 万紀子
昭和薬大
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平田 清貴
Department of Pharmacy, Nippon Medical School Hospital
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松本 宜明
Department of Clinical Pharmacokinetics, College of Pharmacy, Nihon University
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山本 保博
Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital
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山本 保博
日本医科大学付属病院高度救命救急センター
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黒川 顕
日本医科大学附属多摩永山病院 精神神経科
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黒川 顕
日本医科大学付属多摩永山病院救命救急センター
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黒川 顕
日本医科大学武蔵小杉病院 救命救急センター
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松本 宜明
昭和薬科大学薬物動態学
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福岡 正道
昭和薬科大学薬物動態学
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松本 宜明
日本大学薬学部臨床薬物動態学ユニット
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松本 宜明
浦川会勝田病院 薬局
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黒川 顕
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tama Nagayama Hospital
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恩田 美穂
Department of Clinical Pharmacology and Toxicology, Showa Pharmaceutical University
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清水 万紀子
Department of Clinical Pharmacology and Toxicology, Showa Pharmaceutical University
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福岡 正道
Department of Clinical Pharmacology and Toxicology, Showa Pharmaceutical University
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平野 正晟
Department of Pharmacy, Nippon Medical School Hospital
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Matsumoto Y
Department Of Clinical Pharmacology And Toxicology Showa Pharmaceutical University
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黒川 顕
日本医科大学附属第二病院
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平野 正晟
Department Of Pharmacy Nippon Medical School Hospital
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恩田 美穂
Department Of Clinical Pharmacology And Toxicology Showa Pharmaceutical University
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松本 宣明
Division Of Applied Life Science Graduate School Of Engineering Sojo University
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松本 宜明
Department Of Clinical Pharmacokinetics College Of Pharmacy Nihon University
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山本 保博
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School
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