降低长期处方阿片类药物使用的药理学策略:系统性审查
Hannah Ellerbroek1,2, Gerard A Kalkman3, Cornelis Kramers3,4
1Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Journal of clinical medicine
|January 8, 2025
概括
减少长期处方阿片类药物的使用可以通过逐渐减少或阿片类激素治疗 (OAT) 来实现. 这两种策略都有好处和缺点,OAT改善了临床结果,并逐渐减少了阿片类药物剂量.
科学领域:
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
- 疼痛管理 疼痛管理
背景情况:
- 长期使用处方阿片类药物与增加的健康风险有关.
- 关于降低阿片类药物的研究主要集中在海洛因上,而不是处方阿片类药物.
- 了解药理学策略来减少处方阿片类药物的使用至关重要.
研究的目的:
- 审查减少处方阿片类药物使用的药理学策略.
- 评估长期处方阿片类药物使用或阿片类药物使用障碍患者的临床结果.
主要方法:
- 在PubMed,Embase,CINAHL和Cochrane图书馆的系统文献搜索.
- 包括随机对照试验和观察性研究.
- 评估结果,如剂量减少,疼痛,成和生活质量.
主要成果:
- 确定了13项研究,检查了阿片类药物逐渐减少和阿片类激动剂治疗 (OAT).
- 紧缩降低了阿片类药物的剂量,但对疼痛和成有混合作用.
- OAT (布普伦诺芬/甲) 改善了疼痛和生活质量,在延续治疗中对甲的偏好不显著.
结论:
- 逐渐缩减和OAT都是处方阿片类药物管理的可行策略.
- 缓冲降低了阿片类药物的剂量,但对疼痛和潜在的不良事件有不同的影响.
- OAT改善了临床结果,提供了一个合适的替代品,当逐渐缩小是不可行的.
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