Meier P J, Ziegler W H
Ther Umsch. 1989 Aug;46(8):526-36.
Pain represents the most frequent complaint for which patients ask for medical help. Successful treatment of acute and chronic pain syndromes largely depends on the knowledge and the therapy of the underlying disease process and on the rational use of analgesics, such as the nonnarcotic analgesic-antipyretics, the anti-inflammatory agents and the opioid analgesics. In addition, so-called 'adjuvant' analgesics of different chemical structures can be used in special clinical conditions to increase the efficacy of the common analgesics. For optimal therapy, the selection and dosing of a specific agent has to be tailored to the individual needs of the patient. For this purpose it is important to follow some general principles of pain management and to consider the relevant pharmacokinetic and pharmacodynamic properties of the various analgesics. This overview summarizes the most important pharmacological properties of the widely used analgetic drugs, with special emphasis on their risk-benefit ratio in various clinical situations.
疼痛是患者寻求医疗帮助时最常见的主诉。急性和慢性疼痛综合征的成功治疗很大程度上取决于对潜在疾病过程的了解和治疗,以及对镇痛药的合理使用,如非麻醉性止痛退热药、抗炎药和阿片类镇痛药。此外,不同化学结构的所谓“辅助”镇痛药可在特殊临床情况下使用,以提高常用镇痛药的疗效。为了实现最佳治疗,必须根据患者的个体需求来选择特定药物并确定其剂量。为此,遵循一些疼痛管理的一般原则并考虑各种镇痛药相关的药代动力学和药效学特性非常重要。本综述总结了广泛使用的镇痛药的最重要药理特性,特别强调了它们在各种临床情况下的风险效益比。