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Antipsychotics up risk of acute respiratory failure in adults

22 Nov 2020

Use of antipsychotics results in an elevated risk of acute respiratory failure (ARF) in adult patients, results of a recent study have shown. This risk is dose-dependent and significantly greater with current use of antipsychotics agents at doses of 1 defined daily dose and above.

“Physicians should be vigilant about any respiratory symptoms in patients currently receiving antipsychotics at such dose,” the authors cautioned.

Only one population-based study has examined the safety issue of antipsychotics in chronic obstructive pulmonary disease patients despite the drugs being prescribed off-label in adults frequently. To determine whether antipsychotic use carried an increased ARF risk among adult patients, this nested case–control study was conducted.

A total of 716,493 adults aged ≥20 years were identified from the Taiwan nationwide healthcare claims records between January 2000 and December 2013. Of these, 7,084 adults with ARF and 12,785 disease risk score-matched randomly selected controls were analysed. Odds ratios of ARF with antipsychotic drugs were estimated through multivariable logistic regression models.

Compared with nonuse, current use was associated with a 2.33-fold (95 percent confidence interval [CI], 2.06–2.64) increased risk of ARF, while recent and past use correlated with a 1.79-fold (95 percent CI, 1.43–2.25) and 1.41-fold (95 percent CI, 1.20–1.66) risk increase, respectively. On the other hand, antipsychotics discontinued >90 days posed no risk.

There was a dose-dependent association with current therapy of antipsychotics (test for trend, p<0.001), wherein antipsychotic use at >1 defined daily dose generated the highest risk of 6.53-fold (95 percent CI, 3.33–12.79). The findings were robust to using carbamazepine as an active comparator, according to the authors.

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Most Read Articles
10 Jan 2021
Regular practice of yoga postures confers benefits for glucose control, oxidative stress, inflammatory response, and sleep quality in patients with type 2 diabetes, a study has found.
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Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
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