[他类药物不耐受-他类药物耐受性]
1Stoffwechselambulanz, Lipoprotein-Apherese, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Ziemssenstr. 5, 80336, München, Deutschland. anja.vogt@med.uni-muenchen.de.
Innere Medizin (Heidelberg, Germany)
|June 15, 2023
概括
大多数他类药物的副作用不是药物本身造成的. 解决患者的担忧和沟通策略可以改善他类药物的坚持和心血管健康结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 患者护理 患者护理
背景情况:
- 类药物是降低低密度脂蛋白 (LDL) 胆固醇的主要治疗方法.
- 尽管有效性已被证明,但由于药物不耐受,LDL胆固醇的目标往往无法实现.
- 组合疗法存在,但患者的耐受性仍然是一个挑战.
研究的目的:
- 审查他类药物的耐受性,并探索管理不耐受性的策略.
- 要突出nocebo效应对他类药物坚持的影响.
- 为个性化患者管理提供指导.
主要方法:
- 审查关于他类药物治疗的国际建议.
- 从专门的脂质门诊诊所的临床经验分析.
- 讨论患者沟通策略,以减轻nocebo效应.
主要成果:
- 随机试验中的不良反应很少发生,类似于安慰剂.
- 在临床实践中,患者报告的投诉,特别是肌肉症状,更为常见.
- 诺塞博效应显著导致感知到的他类药物不耐受性,导致不坚持.
- 不坚持导致低于最佳的LDL胆固醇降低和心血管风险增加.
结论:
- 许多归因于他类药物的不良反应不是药物诱导的.
- 识别和解决非他类药物相关的症状原因至关重要.
- 个性化,以患者为中心的沟通可以减少nocebo效应并改善治疗结果.
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