对接受手术的青少年进行术后阿片类药物处方填充和补充的评估
Rabab M Barq1, Shadassa Ourshalimian2, Laura Houshmand2
1Division of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, United States; Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St #514, Los Angeles, CA 90033, United States.
Journal of pediatric surgery
|October 31, 2024
概括
处方药监测计划 (PDMP) 在追踪手术后青少年阿片类药物处方时显示不准确. 多个数据源对于准确监测儿科患者的受控物质至关重要.
科学领域:
- 儿科手术 儿科手术
- 药物监督 药物监督 药物监督
- 医疗信息学 医疗信息学
背景情况:
- 处方药监测计划 (PDMP) 对于追踪受控物质至关重要.
- 在接受术后阿片类药物处方的青少年中,PDMPs的准确性在很大程度上是未知的.
- 青少年群体在药物坚持和监测方面存在独特的挑战.
研究的目的:
- 评估处方药监测计划 (PDMPs) 在跟踪接受手术的青少年阿片类药物处方时的准确性.
- 将PDMP的数据与其他来源比较,例如电子医疗记录 (EMR) 和患者/家长调查.
- 为了识别处方阿片类药物发放和补充数据中的差异.
主要方法:
- 在高等儿童医院进行的前性队列研究 (2019-2020).
- 招募的青少年 (13-20岁) 接受了需要阿片类药物处方的选择性手术.
- 使用EMR,诊所笔记,PDMP和调查测量处方阿片类药物填充和补充;分析的数据与UpSet图表重叠.
主要成果:
- 在42名EMR阿片类处方的青少年中,EMR和PDMP显示92.9%的重叠,但只有19%的填充在所有五个来源中被捕获.
- 在PDMP中发现了两名没有处方阿片类药物的患者 (EMR/调查).
- 在调查中发现的8个 (9.5%) 的阿片类药物处方补充中,PDMP仅捕获了4个.
结论:
- 在EMR,PDMP和青少年术后阿片类药物分发和补充调查数据之间存在重大差异.
- 准确跟踪处方阿片类药物开放需要整合多个数据源.
- 显然需要提高儿童手术患者处方药监测计划的准确性和完整性.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
232
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...
232
Opioid Analgesics: Morphine and Other Natural Cogeners
186
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...
186
Prescription, Nonprescription and Orphan Drugs
698
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...
698
Analgesia and Pain Management
525
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...
525
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
53
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
53
Parenteral Anesthetics: Overview
102
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
102


