阿片类药物处方的基本概念以及阿片类药物对驾驶影响的当前概念。
Basic concepts in opioid prescribing and current concepts of opioid-mediated effects on driving.
作者信息
Kaye Adam M, Kaye Alan D, Lofton Elise C
机构信息
Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA.
Departments of Anesthesiology and Pharmacology, Louisiana State University School of Medicine, New Orleans, LA.
出版信息
Ochsner J. 2013 Winter;13(4):525-32.
BACKGROUND
Many patients with chronic pain receive substandard analgesic therapy. Incomplete or inadequate care often stems from physician fears of patient addiction and/or drug toxicity. As a result, many chronic pain patients are undertreated and have unrelieved pain that tempts them to overuse or to abuse prescribed pharmacologic treatments. In the last few years, educational efforts have targeted physicians who treat chronic, nonmalignant pain with information to improve prescribing strategies and to appreciate side effects. Additionally, opioid prescribing guidelines and educational programs, including World Health Organization-published guidelines for the management of cancer pain in 1986 and the American Pain Society's promotion of pain as the 5(th) vital sign, have increased the propensity of pharmacists, physicians, and pain specialists to dispense pain treatments.
METHODS
Controversial and evolving consequences from this explosion of prescription opioid use have emerged and are discussed in this review, including prescribing principles, opioid analgesic side effects, and driving concerns.
CONCLUSION
With additional appreciation for the untoward effects of chronic analgesia and a better understanding of opioid pharmacology, physicians can utilize pain management treatments in a safer and more effective manner.
背景
许多慢性疼痛患者接受的镇痛治疗不达标。护理不完整或不充分往往源于医生对患者成瘾和/或药物毒性的担忧。因此，许多慢性疼痛患者治疗不足，疼痛未得到缓解，这促使他们过度使用或滥用处方药物治疗。在过去几年中，教育工作针对治疗慢性非恶性疼痛的医生，提供信息以改善处方策略并认识副作用。此外，阿片类药物处方指南和教育项目，包括世界卫生组织1986年发布的癌症疼痛管理指南以及美国疼痛协会将疼痛提升为第五生命体征的推广，增加了药剂师、医生和疼痛专家开具疼痛治疗药物的倾向。
方法
本文综述讨论了处方阿片类药物使用激增带来的有争议且不断演变的后果，包括处方原则、阿片类镇痛药副作用以及驾驶方面的问题。
结论
随着对慢性镇痛不良影响的进一步认识以及对阿片类药物药理学的更好理解，医生可以更安全、有效地使用疼痛管理治疗方法。
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