在门诊环境中通过微诱导从甲转换为布普伦诺芬
Farid Juya1, John Fredrik Askjer1, Linda Merete Kaaberg Dahl1
1Klinikk psykisk helse og avhengighet, Sykehuset i Vestfold, Tønsberg.
概括
从甲切换到布普伦诺芬可以在门诊环境中轻轻地完成. 这种微诱导方法避免了阿片类药物戒断症状,为阿片类药物维持疗法提供了一个患者友好的替代方案.
科学领域:
- 成 药物 药物 药物 药物
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类药物维持疗法 (OMT) 通常涉及甲.
- 从甲转换为布普伦诺芬可能具有挑战性,通常需要住院护理并导致戒断.
- 目前的方法往往需要一个无阿片类药物的一天,导致不适.
研究的目的:
- 描述一个温和的,门诊的方法,从美沙切换到布普伦诺芬.
- 为了评估微诱导在没有阿片类药物无天的情况下的可行性.
主要方法:
- 一名接受甲 (80毫克,降至50毫克) 的OMT治疗的患者经历了一周的切换到皮下布普伦诺芬 (16毫克).
- 在门诊环境中使用微诱导方法.
- 甲的服用量逐渐逐渐减少,避免了完全戒 opioid 的一天.
主要成果:
- 从甲转换为布普伦诺芬成功完成,没有阿片类药物戒断症状.
- 患者在过渡期间没有出现并发症.
- 微诱导方法被证明是一个流且对患者友好的过程.
结论:
- 微诱导提供了一个可行的,以患者为中心的策略,从完全阿片类药物激动剂 (甲) 过渡到部分激动剂 (布普伦诺芬).
- 这种门诊方法尽量减少戒断的不适.
- 建议进行进一步的随机对照试验,以系统地评估这种方法.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
251
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...
251
Phase II Reactions: Methylation Reactions
157
Methylation is a phase II biotransformation process involving the attachment of a methyl group to a substrate. Enzymes known as methyltransferases orchestrate this reaction.
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
157
Analgesia and Pain Management
552
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...
552
Pulmonary Tuberculosis V
172
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
172
Drug Abuse and Addiction: Pharmacological Phenomena
448
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
448
Drug Dependence
989
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
989


