Burkhardt H, Wehling M
IV. Medizinische Klinik, Geriatrisches Zentrum, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland,
Schmerz. 2015 Aug;29(4):371-9. doi: 10.1007/s00482-015-0032-2.
Non-opioid analgesics are frequently used to control chronic pain in elderly patients; however some of these drugs show high rates of adverse drug reactions. Among these are significant clinical problems which impede an effective and safe pain control. This review provides recent data concerning non-steroidal anti-inflammatory drugs (NSAID), acetaminophen, metamizol and flupirtin. Due to their risk profile NSAIDs are less appropriate due to high incidence rates and drug-related risk patterns. Acetaminophen, metamizol and flupirtin may be recommended instead; however a shortcoming of acetaminophen in comparison to NSAIDs is its weaker action to control pain. Metamizol is still banned in some countries due to rare but potentially severe hematological side effects and flupirtin frequently causes unfavorable sedation.
非阿片类镇痛药常用于控制老年患者的慢性疼痛;然而,其中一些药物显示出较高的药物不良反应发生率。这些药物存在一些严重的临床问题,阻碍了有效且安全的疼痛控制。本综述提供了有关非甾体抗炎药(NSAID)、对乙酰氨基酚、安乃近和氟吡汀的最新数据。由于其风险特征,NSAIDs因高发生率和与药物相关的风险模式而不太适用。可推荐使用对乙酰氨基酚、安乃近和氟吡汀;然而,与NSAIDs相比,对乙酰氨基酚的一个缺点是其控制疼痛的作用较弱。安乃近由于罕见但可能严重的血液学副作用在一些国家仍被禁用,氟吡汀则经常导致不良的镇静作用。