乳糖与纳洛对抗在重症监护室中阿片类药物引起的便秘
Mitra Rahimi1, Maral Ramezani2, Shahin Shadnia1
1Shahid Beheshti University of Medical Sciences Faculty of Medicine, Toxicological Research Center, Excellence Center and Department of Clinical Toxicology, Tehran, Iran.
Turkish journal of pharmaceutical sciences
|January 13, 2025
概括
乳糖是比纳洛更有效的治疗阿片类药物引起的便秘 (OIC) 在严重中毒的患者. 乳糖可避免戒断综合征和治疗失败,使其成为更安全的选择.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 阿片类药物引起的便秘 (OIC) 是严重中毒患者的常见并发症,可能导致长时间住院治疗.
- 严重的OIC可能会导致严重的并发症,包括肠道穿孔.
研究的目的:
- 为了比较乳糖与纳洛的安全性和有效性,用于治疗重症监护室 (ICU) 中的OIC中毒患者.
- 评估与每种治疗方法相关的治疗结果和不良事件.
主要方法:
- 一个随机的,双盲的临床试验进行了14个月.
- 患有阿片类药物中毒和便秘的患者随机分配给接受乳糖 (30厘米每天) 或纳洛 (8毫克每天三次).
- 记录和分析了关键参数,包括年龄,性别,阿片类型,严重程度得分 (APACHE II,GCS),排便时间和实验室变量.
主要成果:
- 乳糖组的平均排便时间为25±11.5小时,纳洛组的平均排便时间为30.8±23.1小时.
- 在纳洛组中,15%的患者出现治疗失败.
- 在纳洛组中,大量患者 (39.5%) 经历了戒断综合征症状.
结论:
- 在这种患者群体中,乳糖在治疗OIC方面表现出卓越的疗效.
- 乳糖是一种更安全的替代品,因为它不会诱导戒断综合征或导致治疗无效.
- 乳糖糖被推作为OIC在严重中毒患者的首选治疗方法.
相关概念视频
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
174
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
174
01:21Drugs for Treatment of Constipation-Predominant IBS
131
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
131
01:17Drugs for Treatment of Diarrhea-Predominant IBS
146
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
146
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
216
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...
216
01:20Drugs Affecting GI Tract Motility: Other Laxatives
164
Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
164
01:22Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives
184
Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This...
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This...
184