在急诊室患者中启动延长释放布诺芬:一项回顾性队列研究
Louisa Marion-Bellemare1, Anita Srivastava2, Julie Samson1
1Northern Ontario School of Medicine, 935 Ramsey Lake Rd, Sudbury, ON P3E 2C6.
The American journal of emergency medicine
|April 25, 2025
概括
在急诊室治疗阿片类药物使用障碍 (OUD) 的高剂量布普伦诺芬治疗显著减少了过量服用,急救诊所访问和住院治疗. 这种方法在一年内改善了患者的治疗结果,并减少了医疗保健的使用率.
科学领域:
- 成 药物 药物 药物 药物
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
背景情况:
- 阿片类药物使用障碍 (OUD) 是一个重大的公共卫生挑战,通常需要急诊室 (ED) 的干预.
- 对于ED中OUD患者的有效管理策略对于改善长期结果至关重要.
研究的目的:
- 评估高剂量布普伦诺芬治疗与OUD患者的住院戒断管理相结合的有效性.
- 根据这种综合治疗方法,评估患者的结果,包括不良事件,治疗保留和医疗利用.
主要方法:
- 在ED环境中,对90名OUD患者进行了回顾性图表审查,这些患者接受了高剂量的舌下布普伦诺芬 (SL bup) 和延长释放布普伦诺芬 (ER bup) 治疗.
- 入住住院患者戒断管理单位 (WiMU) 是治疗方案的一部分.
主要成果:
- 在布普伦诺芬治疗方案中没有观察到任何不良事件,例如急性戒断.
- 在3,6个月和12个月的治疗持续率分别为58%,44%和36%.
- 与前一年相比,在治疗后的一年中,非致命的过量剂量 (21.9%),ED访问 (78.1%) 和住院 (77.1%) 显著减少.
结论:
- 涉及高剂量SL布诺芬,ER布诺芬和WiMU入院的治疗方案对OUD患者在社区ED.
- 这种综合方法使得关键医疗利用率和过量事件在一年内大幅减少.
相关概念视频
01:21Factors Affecting Drug Response: Overview
1.7K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.7K
01:19Depolarizing Blockers: Pharmocokinetics
289
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
289
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
396
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
396
01:25Analgesia and Pain Management
397
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...
397
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
171
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...
171
01:18Drug Delivery: Enteral Route
331
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
331