drugs & dysphagia
TRANSCRIPT
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Drugs&Dysphagia
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-01
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vs
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PMDA 18,0002631
383 6,268 93 3,466 2,839 2,989
031700617317
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-04
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-05
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-06
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-07
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-03
.etc
.etc
Quality of LifePatient-Centered OutcomesInternational Classification of Functioning
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Melonpan
24
17
12
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Sun-rise
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-01
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-02
2013
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Medication-induced Dysphagia
2007910
-03
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-04
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1Anticholinergic Risk ScaleRudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The an
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-06
GER
CaLESGERD
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-07
GABA
v -fight-flight response
v
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-08
(lll)
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-09
+
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-10
80
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-11
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-12
1. 2. 3. 4. 5. 6. 7.
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-015
1.2.3.4.5.
Process Model (Hiiemae)
Stage Itransport
Processing
Stage transport Esophageal phase
hypopharyngeal transit time
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-02
-a
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-03
-b
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-04
-cp
p
p
p
POINT
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23115387071412
-05
-d
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-06
-e 104/127 (82%) 7/56 (13%) 42/48 (87%)
124 70 67 66 46 42 32 23
76 13 6 6 5 5
1-3 494-7 348 5
1-3 344-7 282 20 5 3
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-1)
2)
3)
4)
5)
ZZnn
NNSSAAIIDDss
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-07
-a
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-08
-b
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-09
-c
,,M
MAO ,,M
..
(
GABAA/CBR ,PBR Ca2+PLC ,IP3
, D2 , K+.
D- ,.
.
1274474532006
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-d
. 1-2
.
Ca2+,.
1274474532006
.
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-e 1274474532006
Zn
Zn
D- Zn
Zn
Zn
Zn
Zn
Zn
. .
.
,
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-12
-f
4
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-13
-g
Mg
-()()
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-1)
2)
3)
NNSSAAIIDDss
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-14
-a
Logemann J.A.Logemann
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-15
-b
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-16
-c
Logemann JA, Smith CH, Pauloski BR, et al. : Effects of xerostomia on perception and performance of swallow function. Head Neck. 2001 Apr;23(4):317-21.
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-16
-a
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-17
-bam
Campbell-Taylor I. Benzodiazepines and pneumonia or aspiration pneumonitis. Thorax. 2013 Jun;68(6):591.Sliwa JA1, Lis S. Drug-induced dysphagia. Arch Phys Med Rehabil. 1993 Apr;74(4):445-7.Sokoloff LG1, Pavlakovic R. Neuroleptic-induced dysphagia. Dysphagia. 1997 Fall;12(4):177-9.
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-18
-c1)2)3)
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-19
-a
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-20
-b1) 2) 3) 4) 5)
vNSAIDsvv
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-21
-c
v Cav v v v v v
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-22
1.
2. 3.
4.
5.
6.
7. 8.
9.
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-01
1Anticholinergic Risk ScaleRudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The an
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-02-b
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-03 -a
/
EPSACH
B/P
5~20mg +++ 0 ++++ + ++ 0/+ +
50~800mg ++ + ++++ +++ + 0 +
4~16mg + +/++ 0 +++ + 0 ++
15~30mg + + ++ + 0 0 +
30~800mg +++ ++ ++ +++ 0 +++ ++
12~64mg ++ ++ + + 0 0 +
1~15mg + +++ + + 0 0 0
1~10mg + +++ + + 0 0 ++
+++++++++++
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-04-b
, . .. Vol. 17 (2004-2005) No. 3 P 399-405
15.9, 665.6.10, , , , ., , 1.6., 8., , , ., .
n=14
n=10
0.670.480.380.170.440.38
0.240.090.240.110.210.06
p
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-05
40
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-06
1121
40