阿片类药物与酒精戒断的同步管理
Concurrent opioid and alcohol withdrawal management.
作者信息
Colvard Michelle
出版信息
Ment Health Clin. 2023 Dec 1;13(6):268-275. doi: 10.9740/mhc.2023.12.268. eCollection 2023 Dec.
Abstract
Concurrent alcohol and opioid withdrawal syndrome is a common and challenging clinical scenario with little published evidence or guidance to inform pharmacotherapy strategies. Concurrent use of benzodiazepines and opioid agonists, which are considered first-line agents for management of each withdrawal syndrome independently, is controversial and often avoided in clinical practice. Strategies to provide effective, simultaneous medication treatment of alcohol and opioid withdrawal while optimizing patient safety are demonstrated through 3 patient cases.
摘要
酒精和阿片类药物戒断综合征并发是一种常见且具有挑战性的临床情况，几乎没有公开的证据或指导意见可用于指导药物治疗策略。苯二氮䓬类药物和阿片类激动剂同时使用，这两种药物分别被认为是治疗每种戒断综合征的一线药物，但这种联合使用存在争议，在临床实践中常被避免。通过3个患者病例展示了在优化患者安全性的同时，为酒精和阿片类药物戒断提供有效、同步药物治疗的策略。
相似文献
1
Concurrent opioid and alcohol withdrawal management.阿片类药物与酒精戒断的同步管理
Ment Health Clin. 2023 Dec 1;13(6):268-275. doi: 10.9740/mhc.2023.12.268. eCollection 2023 Dec.
2
New Australian guidelines for the treatment of alcohol problems: an overview of recommendations.澳大利亚新的酒精问题治疗指南：推荐意见概述。
Med J Aust. 2021 Oct 4;215 Suppl 7:S3-S32. doi: 10.5694/mja2.51254.
3
Treatment of opioid and alcohol withdrawal in a cohort of emergency department patients.治疗一组急诊科患者的阿片类药物和酒精戒断。
Am J Emerg Med. 2021 May;43:17-20. doi: 10.1016/j.ajem.2020.12.074. Epub 2021 Jan 2.
4
Management of opioid withdrawal and initiation of medications for opioid use disorder in the hospital setting.医院环境中阿片类药物戒断的管理和阿片类药物使用障碍药物的启用。
Hosp Pract (1995). 2022 Oct;50(4):251-258. doi: 10.1080/21548331.2022.2102776. Epub 2022 Jul 22.
5
Management of Acute Alcohol Withdrawal Syndrome in Critically Ill Patients.危重症患者急性酒精戒断综合征的管理
Pharmacotherapy. 2016 Jul;36(7):797-822. doi: 10.1002/phar.1770. Epub 2016 Jun 30.
6
Case Report: Concurrent Clonidine Abuse and Opioid Use Disorder.病例报告：可乐定滥用与阿片类药物使用障碍并存。
J Psychoactive Drugs. 2021 Sep-Oct;53(4):373-377. doi: 10.1080/02791072.2021.1908644. Epub 2021 Apr 5.
7
[Assessment of alcohol withdrawal syndrome: new perspectives].[酒精戒断综合征的评估：新视角]
Orv Hetil. 2023 Sep 24;164(38):1487-1496. doi: 10.1556/650.2023.32847.
8
Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond.酒精戒断综合征：苯二氮䓬类药物及其他治疗方法
J Clin Diagn Res. 2015 Sep;9(9):VE01-VE07. doi: 10.7860/JCDR/2015/13407.6538. Epub 2015 Sep 1.
9
Management of precipitated opiate withdrawal syndrome induced by nalmefene mistakenly prescribed in opiate-dependent patients: a review for clinicians.纳美芬误用于阿片类药物依赖患者引发的戒断综合征的处理：临床医生的综述。
Expert Opin Drug Metab Toxicol. 2017 Jun;13(6):669-677. doi: 10.1080/17425255.2017.1312340. Epub 2017 Apr 3.
10
Pharmacotherapeutic management of acute alcohol withdrawal syndrome in critically Ill patients.危重症患者急性酒精戒断综合征的药物治疗管理。
Expert Opin Pharmacother. 2020 Jun;21(9):1083-1092. doi: 10.1080/14656566.2020.1746271. Epub 2020 Apr 13.
本文引用的文献
1
CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.美国疾病预防控制中心 2022 年《疼痛阿片类药物处方临床实践指南》。
MMWR Recomm Rep. 2022 Nov 4;71(3):1-95. doi: 10.15585/mmwr.rr7103a1.
2
Alcohol-Related Deaths During the COVID-19 Pandemic.新冠大流行期间与酒精相关的死亡。
JAMA. 2022 May 3;327(17):1704-1706. doi: 10.1001/jama.2022.4308.
3
Clinical guideline highlights for the hospitalist: 2020 American Society of Addiction Medicine clinical practice guideline on alcohol withdrawal management.临床指南亮点：2020 年美国成瘾医学学会酒精戒断管理临床实践指南。
J Hosp Med. 2022 Jan;17(1):47-49. doi: 10.12788/jhm.3729.
4
Is extended release naltrexone superior to buprenorphine-naloxone to reduce drinking among outpatients receiving treatment for opioid use disorder? A secondary analysis of the CTN X:BOT trial.在接受阿片类药物使用障碍治疗的门诊患者中，缓释纳曲酮是否优于丁丙诺啡-纳洛酮减少饮酒？CTN X:BOT 试验的二次分析。
Alcohol Clin Exp Res. 2021 Dec;45(12):2569-2578. doi: 10.1111/acer.14729. Epub 2021 Nov 23.
5
An examination between treatment type and treatment retention in persons with opioid and co-occurring alcohol use disorders.对患有阿片类药物使用障碍并同时存在酒精使用障碍的人群进行治疗类型与治疗持续率之间的调查。
Drug Alcohol Depend. 2021 Sep 1;226:108886. doi: 10.1016/j.drugalcdep.2021.108886. Epub 2021 Jun 25.
6
Impact of Implementing an Academic Detailing Program on Opioid-Benzodiazepine Co-Prescribing Trends at the U.S. Department of Veterans Affairs.实施学术细化项目对美国退伍军人事务部阿片类药物-苯二氮䓬类药物共同处方趋势的影响。
Pain Med. 2021 Jun 4;22(6):1426-1434. doi: 10.1093/pm/pnaa475.
7
Association of Opioid Use Disorder Treatment With Alcohol-Related Acute Events.阿片类药物使用障碍治疗与酒精相关的急性事件的关联。
JAMA Netw Open. 2021 Feb 1;4(2):e210061. doi: 10.1001/jamanetworkopen.2021.0061.
8
Treatment of opioid and alcohol withdrawal in a cohort of emergency department patients.治疗一组急诊科患者的阿片类药物和酒精戒断。
Am J Emerg Med. 2021 May;43:17-20. doi: 10.1016/j.ajem.2020.12.074. Epub 2021 Jan 2.
9
Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial.加巴喷丁治疗伴有酒精戒断症状的酒精使用障碍患者的疗效：一项随机临床试验。
JAMA Intern Med. 2020 May 1;180(5):728-736. doi: 10.1001/jamainternmed.2020.0249.
10
Pharmacotherapeutic management of co-morbid alcohol and opioid use.共病酒精和阿片类药物使用的药物治疗管理。
Expert Opin Pharmacother. 2020 May;21(7):823-839. doi: 10.1080/14656566.2020.1732349. Epub 2020 Feb 27.
Zotero 插件