向具有延长QT间隔的高风险患者引入口服甲:一项回顾性研究
Miho Takemura1, Kazuyuki Niki2, Yoshiaki Okamoto3
1Department of Clinical Pharmacy Research and Education, Osaka University Graduate School of Pharmaceutical Sciences, Suita, Osaka; Department of Pharmacy, Ashiya Municipal Hospital, Ashiya, Hyogo, Japan. ORCID: https://orcid.org/0000-0002-7170-6938.
甲可以安全地用于晚期癌症疼痛,即使在患有心脏问题或延长QTc的患者中. 谨慎的低剂量启动和药物管理可以预防心脏不良事件.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 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:
- 甲对难以治疗的癌症疼痛是有效的,但具有纠正QT (QTc) 延长的风险.
- 患有晚期癌症的患者往往患有诸如心脏病之类的并发症,增加了QTc延长的风险.
- 评估高风险人群中的甲安全性对于有效的疼痛管理至关重要.
研究的目的:
- 评估在高风险的QTc延长患者的癌症疼痛开始口服甲的安全性和有效性.
- 为了比较高风险和低风险群体之间的甲剂量,QTc延长.
主要方法:
- 追溯的,单中心的队列研究.
- 招募了64名癌症患者开始服用口服甲治疗疼痛.
- 在基线和启动后1-2周监测12导电心电图 (ECG).
主要成果:
- 没有患者经历了临床显著的甲诱导的QTc延长或心脏毒性.
- 50%的患者有先前存在的心脏病或延长的QTc.
- 高风险患者先前接受较低的阿片类药物剂量,并以较低的剂量开始服用甲.
结论:
- 甲可以安全地给心脏病患者或基线延长QTc.c.的患者服用.
- 以低剂量的甲开始使用,特别是当之前的阿片类药物剂量低时,这是关键.
- 调整可能与甲相互作用的并发药物可以提高安全性.
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