与长期阿片类药物治疗相关的阿片类药物相关的神经认知症状的发生
Casey León1, Minhee L Sung2,3, Joel I Reisman4
1Department of Public Health and Center for Health Statistics, University of Massachusetts Lowell, Lowell, MA.
The Clinical journal of pain
|December 17, 2024
概括
与阿片类药物相关的神经认知症状 (NCS) 在长期阿片类药物治疗 (LOT) 期间最常见. 监测这些症状对于减轻LOT患者的阿片类药物相关伤害至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
背景情况:
- 神经认知症状 (NCS) 可以表明与阿片类药物相关的危害.
- 识别这些症状对于患者的安全至关重要.
研究的目的:
- 评估长期服用阿片类药物治疗 (LOT) 的患者中NCS的发生率和阿片类药物归因.
- 使用自然语言处理 (NLP) 来从电子健康记录 (EHR) 中提取数据.
主要方法:
- 在55,652名患者的回顾性队列研究中,在2018年处方了LOT.
- 从临床笔记中确定了NCS在三个时期的临床笔记:LOT前,LOT期间和LOT后停药.
- 计算的发病率和危险比率来评估NCS发生率和阿片类药物归因.
主要成果:
- 3.1%的患者经历了与阿片类药物相关的NCS,在LOT期间发生率最高.
- 在老年人,亚洲患者和有药物使用障碍史的人群中,NCS患病率更高.
- 亚洲种族,痴呆症,抑郁症,PTSD,SUD,心血管疾病,COPD,肝硬化,CKD和TBI与增加NCS可能性有关.
结论:
- 与阿片类药物相关的NCS最有可能发生在LOT期间,这表明与阿片类药物使用的时间联系.
- 对LOT患者的NCS监测对于降低危害策略至关重要.
- 研究结果强调需要对接受长期阿片类药物治疗的患者认知功能进行警评估.
相关概念视频
Opioid Analgesics: Morphine and Other Natural Cogeners
179
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...
179
Analgesia and Pain Management
496
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...
496
Opioid Analgesics: Synthetic and Semisynthetic Opioids
219
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...
219
Long-term Potentiation
54.8K
Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre- and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
54.8K
Opioid Receptors: Overview
510
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,...
510
Long-term Depression
2.5K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over...
Calcium Ion Concentration Mechanism
If over...
2.5K


