尿液药物检测的可靠性在服用布普伦诺芬透皮贴片的患者中
Jaya Amaram-Davila1, Akhila Reddy1, Matthew D Clark2
1Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Palliative & supportive care
|August 1, 2023
概括
低剂量的布普伦诺芬贴片可能会导致尿液药物测试 (UDT) 的虚假阴性,因为代谢物不足. 除了UDT之外,对患者进行全面的评估对于管理慢性阿片类药物治疗 (COT) 至关重要.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 临床毒理学 临床毒理学
背景情况:
- 尿液药物检测 (UDT) 对于监测慢性阿片类药物治疗 (COT) 患者至关重要.
- UDT可能不一致,可能产生误导性的结果.
- 这一案例突出了使用布普伦诺芬贴片的患者的虚假阴性UDT.
研究的目的:
- 在服用低剂量布普伦诺芬贴片的患者中呈现虚假阴性UDT病例.
- 讨论这些结果对患者监测的影响.
- 强调综合性评估在疼痛管理中的重要性.
主要方法:
- 一个女性患者的病例报告,患有转移性乳腺癌和不受控制的疼痛.
- 由于对其他阿片类药物的不良反应,处方5μg/h布普伦诺芬补丁.
- 在临床访问期间进行的UDT导致布普伦诺芬及其代谢物的假阴性.
- 关于低剂量布普伦诺芬贴片虚假阴性UDT的文献综述.
主要成果:
- 患者通过布普伦诺芬贴片获得了很好的疼痛控制.
- 对于布普伦诺芬及其代谢物,UDT结果是负的.
- 文献表明,虚假阴性UDT在低剂量布普伦诺芬贴片中很常见.
结论:
- 低剂量的布普伦诺芬可能不会产生足够的尿路代谢物来检测,导致虚假阴性.
- 假负的UDT结果可能会影响患者和医生的信任.
- 综合评估包括病史,体检,PDMP审查和理解阿片类药物代谢对于有效的疼痛管理至关重要.
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