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加巴丁类药物与阿片类药物相关的过量服用在住院环境中的关联:单中心回顾性病例控制研究
Shelby R Humpert1,2, Kelly R Reveles1,2, Kajal Bhakta1,2,3
1The University of Texas at Austin, Austin, TX, USA.
Hospital pharmacy
|March 7, 2024
概括
在医院同时使用 gabapentinoids 与阿片类药物显著增加了与阿片类药物相关的过量服用 (ORO) 的风险. 医疗保健提供者应仔细权衡这些药物一起处方时,益处与过量剂量增加的风险.
科学领域:
- 药理学和毒理学 药理学和毒理学
- 医院 医院 医疗 医疗 医疗 医疗
- 患者安全 患者安全
背景情况:
- 新出现的数据表明, gabapentinoid 和与阿片类药物相关的过量剂量 (ORO) 风险之间存在联系.
- 同时使用 gabapentinoid 和阿片类药物与 ORO 之间的关联尚未在医院环境中得到广泛研究.
研究的目的:
- 在接受阿片类药物治疗的住院患者中,与加巴类药物配合和不配合的ORO风险进行比较.
- 为了确定 gabapentinoid 使用和 ORO 在住院患者群体之间的独立关联.
主要方法:
- 从2020年1月1日到2021年12月31日,对成人住院患者进行了回顾性病例控制研究.
- 病例是接受纳洛>24小时后的患者;对照组是没有纳洛的阿片类药物患者,匹配1:1.
- 主要结局:同时在住院治疗中使用 gabapentinoid 的病例和对照人群的百分比;逻辑回归分析了 ORO 关联.
主要成果:
- 与对照组 (20.8%) 相比, gabapentinoid 暴露在病例中 (34.0%) 显著更高.
- 经历ORO的患者住院时间更长 (11 vs. 4天) 和死亡率更高 (19% vs. 5%).
- gabapentinoid 的使用独立地与 ORO (调整的 OR 4.91) 和血清激素药物暴露 (调整的 OR 4.31) 相关.
结论:
- 在住院治疗中同时使用 gabapentinoids 和 opioids 与 ORO 的风险增加有关.
- 在医院处方 combined gabapentinoid 和阿片类药物治疗的决定必须考虑过量剂量的增加潜力.
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