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gabapentinoids:一个治疗性审查
Akshay Athavale1,2,3, Bridin Murnion1,2,3
1MQ Health, Macquarie University, Sydney.
Australian prescriber
|December 28, 2023
概括
加巴类药物是用于和神经疼痛的,但通常用于非标签. 非医疗用途可能导致依赖,戒断和中毒增加,需要谨慎的处方和降低处方.
科学领域:
- 药理学 药理学 是一个学科.
- 临床治疗学 临床治疗学
- 公共卫生 公共卫生
背景情况:
- 在澳大利亚, gabapentinoids 已被批准用于耐火焦和神经病痛.
- 非标签的 gabapentinoids 处方是普遍存在的,特别是慢性非特异性背痛和非根性腿痛,尽管支持证据有限.
- gabapentinoids 具有诸如高兴和镇静等特性,可能会鼓励非医疗用途.
研究的目的:
- 审查关于非标签 gabapentinoid 使用的证据.
- 突出与非医学性 gabapentinoid 使用相关的风险,包括依赖,戒断和中毒.
- 提供关于加巴类药物的安全处方和停止处方实践的指导.
主要方法:
- 对 gabapentinoid 使用和不良事件的文献综述.
- 对已批准的适应症与常见的临床实践进行分析.
- 检查导致非医疗用途和潜在危害的因素.
主要成果:
- 在未经批准的指示之外大量使用 gabapentinoids,特别是在肌肉骨疼痛.
- 与广泛的非医疗用途相关的意外和故意中毒的发生率增加.
- 潜在的依赖和戒断症状在突然停止;风险在患有脏疾病的患者中升高.
结论:
- 临床医生在开药时必须仔细考虑适应症,患者因素和危害益处概况.
- 建议在不确定继续使用时逐渐减小剂量.
- 意识到脆弱人群 (如功能障碍患者) 的伤害风险增加至关重要.
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