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関連する概念動画

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Bioavailability Study Design: Healthy Subjects Versus Patients01:15

Bioavailability Study Design: Healthy Subjects Versus Patients

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Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
248
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

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Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
259
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

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Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
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Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

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A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
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Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration
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初等医療におけるメタドンのメンテナンス:ランダム化制御試験

D A Fiellin1, P G O'Connor, M Chawarski

  • 1Yale University School of Medicine, 333 Cedar St, PO Box 208025, New Haven, CT 06520-8025, USA. david.fiellin@yale.edu

JAMA
|October 12, 2001
PubMed
まとめ

安定したオピオイド依存患者のオフィスベースのメタドン維持は,実行可能で有効です. プライマリケア医は,この治療を提供することができ,患者は従来の麻薬治療プログラム (NTP) に比べて,より高い満足度を示しています.

科学分野:

  • 依存症医学 薬物中毒医学
  • プライマリーケア (プライマリーケア)
  • 公衆衛生は公衆衛生である.

背景:

  • メタドン維持は,オピオイド依存症の実証された治療法です.
  • 現在の治療は,連邦政府が認可した麻薬治療プログラム (NTP) に限定されています.
  • 安定した患者のためのオフィスベースのケアは,制御された試験データを必要とする有望な代替手段です.

研究 の 目的:

  • オフィスでのメタドン維持の可行性と有効性を評価する.
  • 安定したオピオイド依存症患者のための従来のNTPケアとプライマリケア医師主導の治療を比較する.

主な方法:

  • 6ヶ月のランダム化制御されたオープン臨床試験です.
  • 47人の安定したオピオイド依存症患者は,訓練されたプライマリーケア医師によるオフィスベースのケア,またはNTPでの通常のケアにランダムに割り当てられました.
  • 結果には,違法薬物使用,臨床的不安定性,患者/臨床医の満足度,およびサービスの利用が含まれていました.

主要な成果:

  • オフィスベースのグループとNTPグループの間で,違法なオピエット使用または臨床的不安定さの有意な違いはありません.
  • オフィスベースのケアを受けた患者は,ケア品質に対する満足度が著しく高かった (73%対13%) と報告しています.

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  • 機能的な状態や医療,法律,または社会サービスの利用において,違いは認められなかった.

    • 結論:

    • 安定したオピオイド依存症の患者をメタドン維持のために主治医の診療所に移すことは,実行可能で効果的です.
    • このアプローチは,患者の満足度を高めます.
    • 患者の選択と臨床モニタリングのガイドラインが提案されています.