Department of Cardiology, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
Department of Clinical Pharmacy, Isala, Zwolle, The Netherlands.
Drug Saf. 2018 Dec;41(12):1303-1308. doi: 10.1007/s40264-018-0710-y.
Although opioids are recommended and frequently used in the acute phase of ST-elevation myocardial infarction (STEMI), their use is accompanied by serious side effects. In particular, gastrointestinal adverse effects may disturb absorption of essential oral medication like platelet inhibitors. This may cause suboptimal platelet inhibition and increased risk of acute stent thrombosis. Some clinical studies have already demonstrated these negative results. Alternative strategies to optimize platelet inhibition and pain relief in STEMI are being investigated. Clinicians should become more aware of the potential side effects of opioids in STEMI.
虽然阿片类药物在 ST 段抬高型心肌梗死(STEMI)的急性期被推荐并经常使用,但它们的使用伴随着严重的副作用。特别是,胃肠道不良反应可能会干扰血小板抑制剂等必需口服药物的吸收。这可能导致血小板抑制不足和急性支架血栓形成的风险增加。一些临床研究已经证明了这些负面结果。目前正在研究优化 STEMI 中血小板抑制和缓解疼痛的替代策略。临床医生应该更加意识到阿片类药物在 STEMI 中的潜在副作用。