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新的电子处方规定可能会增加苯二氮䓬类或非苯二氮䓬类催眠药物依赖患者出现急性戒断综合征的风险。

New regulations regarding e-prescriptions may increase the risk of acute withdrawal syndromes in patients dependent on benzodiazepines or non-benzodiazepine hypnotics.

机构信息

Instytut Psychiatrii i Neurologii w Warszawie.

出版信息

Psychiatr Pol. 2020 Apr 30;54(2):351-358. doi: 10.12740/PP/115555.

Abstract

The implementation of solutions in the area of e-health and use of electronically issued prescription obligations meets the modern requirements of the healthcare system. Adigital record of theissued prescriptions aims atpreventing prescriptions from being traded without a physician's name in patient medical records. Access to the system may in turn reveal doctors' bad practices, and fear of the professional and legal consequences may force achange in the prescription of benzodiazepines or non-benzodiazepine hypnotics. The effect of these activities may be the disclosure of many cases of 'hidden' dependence and adverse phenomena and increase in the number of effects of cases of sudden dose reduction or discontinuation of benzodiazepines or non-benzodiazepine hypnotics. It is recommended to develop integrated, central information and train Emergency Department staff. Awareness of the phenomenon and appropriate diagnostic and therapeutic procedures can significantly increase the chance of improving the quality and safety of services provided in the acute intervention mode (Emergency Department). Arational solution may be to urgently develop standards of conduct in cases of acute withdrawal syndromes from benzodiazepines or non-benzodiazepine hypnotics. Itseems reasonable to introduce preventative programs enabling early recognition and treatment of cases where large and very large doses of drugs have been taken (high dose tolerance). Under no circumstances should medication be stopped abruptly. An information campaign, raising awareness also among the personnel of psychiatric wards, may increase the chances of systemic preparation for admission of the currently unknown population of patients at risk.

摘要

电子健康领域解决方案的实施和电子处方的使用符合医疗保健系统的现代要求。签发处方的电子记录旨在防止处方在患者病历中没有医生姓名的情况下进行交易。访问该系统反过来又可能揭示医生的不良做法,对专业和法律后果的恐惧可能迫使改变苯二氮䓬类或非苯二氮䓬类催眠药物的处方。这些活动的效果可能是揭示许多“隐藏”的依赖和不良现象,并增加因突然减少或停止苯二氮䓬类或非苯二氮䓬类催眠药物剂量而产生的病例的数量。建议开发综合的、中央的信息系统,并培训急诊部门的工作人员。对该现象的认识以及适当的诊断和治疗程序可以显著增加提高急性干预模式(急诊室)所提供服务的质量和安全性的机会。一个合理的解决方案可能是紧急制定苯二氮䓬类或非苯二氮䓬类催眠药物急性戒断综合征的行为标准。引入预防性计划以尽早识别和治疗大剂量和超大剂量药物的情况(高剂量耐受性)似乎是合理的。在任何情况下都不应突然停药。信息宣传活动,包括提高精神病病房工作人员的认识,可能会增加为目前未知的高危患者人群入院进行系统准备的机会。

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