Vadivelu Nalini, Chen Isabel L, Kodumudi Vijay, Ortigosa Esperanza, Gudin Maria Teresa
Department of Anesthesiology, University, Yale University School of Medicine, 333 Ceder Street, New Haven, CT 06510, USA.
Curr Drug Saf. 2010 Jul 2;5(3):267-70. doi: 10.2174/157488610791698361.
In the treatment of pain management, physicians employ a variety of drugs, ranging from low-impact to highly potent, and to maximize patient health, urine toxicology analyses can significantly improve the delivery of pain treatment. Drugs such as opioids that are used for pain management are peculiar in that they provide effective pain relief and have a high risk of addiction. The use of illicit drugs in the general population has been on the rise; however, self-reporting and close monitoring of patient behavior are insufficient means to detect drug abuse and confirm compliance. Therefore, in order to create more effective drug treatment plans, physicians must understand and account for the implications of patient drug use history. Urine toxicology analysis is an important tool for pain physicians because it is more sensitive than most alternative blood tests, more efficient and cost-effective. Urine testing in addition to improving patient pain management also has forensic and legal implications. There are however limitations to urine toxicology methods as they can produce false-positive and false-negative results and are prone to human error and sample contamination There is also a need for more specific and rapid urine drug testing. Healthcare professionals should therefore be familiar with the limitations of various urine drug testing methods, and possess skills necessary to properly interpret these results. This review suggests that the overall benefits incurred by both the patient's short-term and long-term health support the routine integration of urine toxicology analysis in routine clinical care. In addition to improving health care and patient health, it has a strong potential to improve patient-physician relationships and protects the interest of involved healthcare practitioners.
在疼痛管理治疗中,医生会使用各种药物,从低效力到高效力不等。为了使患者健康最大化,尿液毒理学分析能够显著改善疼痛治疗的效果。用于疼痛管理的药物,如阿片类药物,其特殊之处在于它们能有效缓解疼痛,但成瘾风险很高。普通人群中非法药物的使用呈上升趋势;然而,自我报告和密切监测患者行为对于检测药物滥用和确认依从性而言是不够的手段。因此,为了制定更有效的药物治疗方案,医生必须了解并考虑患者用药史的影响。尿液毒理学分析对疼痛科医生来说是一项重要工具,因为它比大多数其他血液检测更敏感,更高效且更具成本效益。尿液检测除了能改善患者的疼痛管理外,还具有法医学和法律方面的意义。然而,尿液毒理学方法存在局限性,因为它们可能产生假阳性和假阴性结果,并且容易出现人为误差和样本污染。此外,还需要更特异、快速的尿液药物检测方法。因此,医疗保健专业人员应熟悉各种尿液药物检测方法的局限性,并具备正确解读这些结果所需的技能。本综述表明,患者短期和长期健康所带来的总体益处支持在常规临床护理中常规纳入尿液毒理学分析。除了改善医疗保健和患者健康外,它还有很大潜力改善医患关系,并保护相关医疗从业者的利益。