随着与新的持续性阿片类药物使用相关的激进切除术后的阿片类药物处方
Muhannad Alsyouf1, Ala'a Farkouh2, Erika L Wood3
1Department of Urology, Loma Linda University Health, Loma Linda, CA; Department of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Department of Urology, Riverside University Health System, Moreno Valley, CA.
Urologic oncology
|August 3, 2024
概括
由于丸癌的激进整形术后,术后的阿片类药物处方增加了持续使用阿片类药物的风险. 接受阿片类药物治疗的十分之一的年轻人发展出长期依赖,突出了非阿片类药物疼痛管理的必要性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 阿片类药物依赖是一个重大的公共卫生问题.
- 在门诊泌尿外科手术后也可能使用阿片类药物.
研究的目的:
- 为了评估丸癌症激进切除术后持续使用阿片类药物的风险.
主要方法:
- 使用TriNetX研究网络确定了一组15-45岁的男性,这些男性因丸癌而接受了激进切除术.
- 患有晚期疾病,先前使用阿片类药物或接受化疗,放射治疗或逆皮节淋巴结解剖的患者被排除在外.
- 新的持续性阿片类药物使用被定义为手术后3至15个月之间的处方,比较曾经服用过阿片类药物的患者,接受了手术后阿片类药物与没有接受的患者.
主要成果:
- 在2,911名男性中,89.8%接受了骨架切除术后的阿片类药物. 在倾向分数匹配后,分析了592名患者 (296人接受了阿片类药物,296人没有).
- 没有接受术后阿片类药物治疗的患者出现持续的阿片类药物使用.
- 接受术后阿片类药物治疗的患者中有10.5%出现了新的持续性阿片类药物使用,这是统计学上显著的增加 (风险差异:10.5%;P<0.01).
结论:
- 术后的阿片类药物处方在彻底整形术后与开发新的持续阿片类药物使用密切相关.
- 约有10分之一的年轻人为此程序处方阿片类药物经历了长期阿片类药物使用.
- 应强调非阿片类药物治疗的疼痛管理策略,用于进行激进管切除术的患者.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
258
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
258
Opioid Analgesics: Morphine and Other Natural Cogeners
206
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
206
Analgesia and Pain Management
555
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...
555
Prescription, Nonprescription and Orphan Drugs
711
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
711
Opioid Receptors: Overview
639
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
639
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
186
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
186


