老年人的药理性疼痛治疗方法
Gisèle Pickering1, Aleksandra Kotlińska-Lemieszek2, Nevenka Krcevski Skvarc3
1Clinical Pharmacology Department, PIC/CIC Inserm 1405-University Hospital CHU and Faculty of Medicine, Université Clermont Auvergne, Clermont-Ferrand, France. gisele.pickering@uca.fr.
Drugs & aging
|October 28, 2024
概括
老年人药理性疼痛管理需要仔细考虑并发症和多药性药物,以尽量减少不良影响. 根据个体患者的因素量身定制止痛药的选择和剂量对于有效的止痛至关重要.
科学领域:
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 老年人经常出现复杂的疼痛状况,包括痛感和神经病痛.
- 在这个人群中,并发症和多种药物显著增加了不良药物事件和相互作用的风险.
研究的目的:
- 为老年人急性和慢性疼痛的药理管理提供专家建议.
- 突出优化疼痛治疗的策略,同时减轻与衰老和多种药物相关的风险.
主要方法:
- 一个多学科的欧洲专家小组审查了目前用于疼痛管理的药理选择.
- 在考虑药物有效性,安全性和老年病的具体考虑方面,制定了指导方针.
主要成果:
- 非阿片类药物 (白醇,NSAIDs) 是轻度至中度疼痛的第一线治疗;阿片类药物是为中度至重度疼痛保留的.
- 神经病变性疼痛管理涉及联合止痛药,如 gabapentinoids 和抗抑郁药,并提供局部选择.
- 药物选择必须考虑到患者的并发病,器官功能和并发药物.
结论:
- 优化老年人疼痛管理需要全面的老年病学评估和功能系统评估.
- 建议采取谨慎的方法,包括低初始剂量,逐渐定位,定期重新评估和患者/家庭参与.
- 将药理学策略与非药理学干预相结合,对于整体疼痛治疗至关重要.
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