Eggen A E, Andrew M
Institute of Community Medicine, University of Tromsø, Norway.
Eur J Clin Pharmacol. 1994;46(6):491-6. doi: 10.1007/BF00196103.
The prescribing of controlled analgesics (codeine, buprenorphine and pentazocine preparations) was studied, using prescriptions from the three pharmacies in the municipality of Tromsø, Norway. All prescriptions dispensed during one year were analysed. The study sample comprised 3083 women (58%) and 2223 men (42%) between 10 and 99 years of age. About 8% of the population had obtained one or more prescriptions of controlled analgesics. Combined codeine preparations were by far the most frequently prescribed subgroups, and the average amount purchased during 1 year was 30 defined daily doses (DDD). The sporadic users were in the majority. A few users had purchased high amounts of controlled analgesics. The prevalence of use, the mean number of defined daily doses of analgesics, and the proportion of 'weekly' drug users was higher in women than men. The prevalence increased significantly with age, from 0.7 to 22.3% in women and from 0.5 to 14.1% in men. The mean number of DDD during one year also increased with age, from 12.6 to 50.6 DDD in women, and from 6.6 to 40.6 DDD in men. The users of buprenorphine and pentazocine differed in several aspects from the codeine users. The highest use of combined codeine preparations was seen in elderly people especially in women. Use of lower codeine doses or intermittent treatment with other drugs e.g. plain paracetamol in adequate doses, may be appropriate alternatives reducing the risk of adverse drug reactions such as nausea and constipation. Monitoring of prescribing and use of controlled analgesics according to certain criteria may uncover possible misuse.
利用挪威特罗姆瑟市三家药店的处方，对管制类镇痛药（可待因、丁丙诺啡和喷他佐辛制剂）的处方情况进行了研究。分析了一年内配发的所有处方。研究样本包括3083名女性（58%）和2223名男性（42%），年龄在10至99岁之间。约8%的人口获得过一张或多张管制类镇痛药处方。复方可待因制剂是迄今为止最常被处方的亚组，一年内的平均购买量为30限定日剂量（DDD）。偶尔用药者占大多数。少数使用者购买了大量管制类镇痛药。女性在用药普及率、镇痛药限定日剂量平均数以及“每周”用药者比例方面高于男性。用药普及率随年龄显著增加，女性从0.7%增至22.3%，男性从0.5%增至14.1%。一年内的DDD平均数也随年龄增加，女性从12.6 DDD增至50.6 DDD，男性从6.6 DDD增至40.6 DDD。丁丙诺啡和喷他佐辛的使用者在几个方面与可待因使用者不同。复方可待因制剂的最高使用率见于老年人，尤其是女性。使用较低剂量的可待因或用其他药物（如适当剂量的普通对乙酰氨基酚）进行间歇治疗，可能是降低恶心和便秘等药物不良反应风险的合适替代方法。根据某些标准对管制类镇痛药的处方和使用情况进行监测，可能会发现潜在的滥用情况。
