吗啡对慢性喘息的危害与剂量,持续时间和定位阶段有关
Magnus Ekström1, Fatima Alameri1, Sungwon Chang2
1Respiratory Medicine (M.E., F.A.), Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Sweden.
Journal of pain and symptom management
|February 27, 2025
概括
持续释放口服吗啡对慢性COPD患者呼吸困难的不良事件 (AE) 的风险在治疗的第一周是最高的. 大多数副作用都是轻微的,并且没有调整剂量就消失了.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 在COPD患者中,严重的慢性喘息可以用吗啡治疗.
- 吗啡使用可能会增加不良事件 (AE) 的风险.
研究的目的:
- 评估与定期,低剂量持续释放 (SR) 口服吗啡相关的副作用的风险,用于COPD患者的慢性呼吸困难.
- 评估AE与吗啡剂量,治疗持续时间和定位阶段之间的关系.
主要方法:
- 一项双盲随机试验的二次分析,该试验涉及COPD患者的SR吗啡定位 (0-32毫克/天超过三个星期).
- 使用多变量通用估计方程 (GEE) 模型,根据吗啡剂量,持续时间和定位阶段 (启动,稳定剂量,上升定位) 来分析AE风险.
主要成果:
- 在156名参与者中,64%的人在第1周经历了AE.
- 吗啡治疗的第一周内AE风险最高,在第2周和第3周显著下降.
- 在增加吗啡剂量 (8-32毫克/天) 或在不同的定位阶段时,没有观察到AE风险的统计学显著趋势.
结论:
- 在慢性慢性肺炎患者的慢性呼吸困难中,SR口服吗啡治疗的最初一周发生了最高的副作用风险.
- 根据定位阶段或每日吗啡剂量 (8-32毫克) 的不同,AE风险没有显著差异.
- 大多数AE是可以管理的,并在滴定期结束时得到解决.
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