相关实验视频
Updated: May 7, 2025

04:41
Knee Arthrocentesis in Adults
Published on: February 25, 2022
7.1K
凯托洛拉克与吗啡治疗状细胞疾病严重血管闭塞危机:一项开放式随机对照试验 (KISS研究)
Sai Pratap Reddy1, Sunil Natha Jondhale1, Santosh Kumar Rathia1
1Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Indian pediatrics
|January 4, 2025
概括
静脉注射凯托洛拉克在患有状细胞疾病的儿童中,可与静脉注射吗啡对严重血管闭塞危机提供可比的缓解疼痛. 这项研究表明,凯托洛拉克是治疗状细胞疼痛的可行替代品.
科学领域:
- 儿科血液学 儿科血液学
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 状细胞疾病 (SCD) 是一种遗传性血液疾病,其特征是严重的血管闭塞危机 (VOC).
- 在患有SCD的儿童中,管理严重的VOC疼痛通常涉及静脉注射 (IV) 像吗啡这样的阿片类药物.
- 需要使用替代止痛药来优化疼痛管理和安全性.
研究的目的:
- 为了比较IV凯托洛拉克与IV吗啡在儿童SCD患者中严重的VOC的疗效和安全性.
- 为了评估疼痛评分减少和不良事件在两个治疗组.
- 为了确定 ketorolac 是否可以作为吗啡的有效替代品.
主要方法:
- 一项开放的随机对照试验包括儿童 (3-15岁) 患有严重的VOC (疼痛评分>6).
- 参与者接受了IV凯托洛拉克或IV吗啡输液,如果疼痛持续,剂量升级.
- 疼痛评分每三小时评估一次,长达12小时.
主要成果:
- 凯托洛拉克和吗啡组在基线和整个12小时的研究期间 (P > 0.05) 显示了类似的平均疼痛得分.
- 在接受基托洛拉克的5名儿童和接受吗啡的11名儿童中报告了轻微的副作用 (P = 0.069).
- 只有凯托洛拉克组中的一个孩子和吗啡组中的两个孩子在12小时后持续严重疼痛 (P = 0.55).
结论:
- 静脉注射凯托洛拉克在治疗SCD儿童严重的VOC疼痛方面表现出与IV吗啡相似的疗效.
- 凯托洛拉克在这种人群中为治疗严重血管闭塞危机提供了一个潜在的有效和安全的替代方案.
- 进一步的研究可能会探索长期的结果和特定的患者亚组受益于 ketorolac.
相关概念视频
Opioid Analgesics: Morphine and Other Natural Cogeners
132
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...
132
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
82
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
82
Analgesia and Pain Management
390
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...
390
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
97
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
97
Opioid Analgesics: Synthetic and Semisynthetic Opioids
163
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...
163
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
96
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
96

