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社区姑息治疗中的合理用药

Rational prescribing in community palliative care.

作者信息

Mitchell Geoffrey

出版信息

Aust Prescr. 2021 Apr;44(2):45-48. doi: 10.18773/austprescr.2021.001. Epub 2021 Apr 1.

Abstract

Palliative care is the province of everyone, particularly people managing older patients. Most people die of multimorbidity, frailty and dementia rather than cancer and will never see a palliative care specialist. People dying from non-malignant disease have symptoms and problems that are usually predictable. Common symptoms like pain and dyspnoea can be anticipated. Planning to prevent them, or for when they occur, is more effective than waiting until they happen. Deprescribing is an effective way of preventing morbidity in this group. Getting to know a few medicines well for each symptom is important when providing palliative care for patients. Starting at low doses and increasing slowly is also key.

摘要

姑息治疗是每个人的职责范围,尤其是负责照顾老年患者的人。大多数人死于多种疾病、身体虚弱和痴呆症,而非癌症,并且他们可能从未见过姑息治疗专科医生。死于非恶性疾病的人会出现通常可预测的症状和问题。像疼痛和呼吸困难这样的常见症状是可以预料到的。在症状出现之前就制定预防计划,或者在症状出现时进行应对,比等到症状出现后再处理更有效。减少不必要的药物治疗是预防这一群体发病的有效方法。在为患者提供姑息治疗时,熟悉针对每种症状的几种药物非常重要。从低剂量开始并缓慢增加剂量也是关键。

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本文引用的文献

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Deprescribing in older people.老年人的减药管理
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Prescribing in renal supportive care.肾脏支持治疗中的处方开具。
Aust Prescr. 2020 Apr;43(2):57-60. doi: 10.18773/austprescr.2020.004. Epub 2020 Apr 1.
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Megestrol acetate for treatment of anorexia-cachexia syndrome.醋酸甲地孕酮治疗恶病质综合征。
Cochrane Database Syst Rev. 2013 Mar 28;2013(3):CD004310. doi: 10.1002/14651858.CD004310.pub3.

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