追逐摆摆:阿片类药物和老年人的过去,现在和未来
1SSM Health/Saint Louis University School of Medicine, Family and Community Medicine, St. Louis, Missouri, USA.
Innovation in aging
|June 27, 2025
概括
管理老年人的疼痛包括平衡有效的阿片类药物治疗急性和癌症疼痛的风险和慢性非癌症疼痛的风险. 本综述探讨了历史上的转变,老年人群的挑战以及安全,以患者为中心的疼痛管理策略.
科学领域:
- 老年病的医生 老年病的医生
- 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:
- 阿片类药物治疗对急性和癌症疼痛有效,但对老年人慢性非癌症疼痛有争议.
- 增加的阿片类药物处方与越来越多的滥用,成和过量死亡相关,需要对实践进行仔细审查.
- 老年人面临着独特的挑战,包括对不良反应和多药的脆弱性.
研究的目的:
- 追踪阿片类药物政策和疼痛管理实践的历史演变.
- 检查老年人阿片类药物使用的具体挑战.
- 探索最佳实践和新兴的平衡疼痛管理策略.
主要方法:
- 对阿片类药物政策和处方趋势的历史审查.
- 分析老年成人群体面临的挑战和脆弱性.
- 探索当前的辩论和新兴的治疗方法.
主要成果:
- 老年人使用阿片类药物治疗慢性非癌症疼痛仍然是一个复杂的问题,存在严重的安全问题.
- 老年人对不良药物事件和相互作用的敏感性增加.
- 一个转向以患者为中心的护理和整合非阿片类药物治疗的转变正在出现.
结论:
- 一个平衡的,基于证据的框架对于管理老年人的疼痛至关重要.
- 解决疼痛缓解需求和减少社会伤害至关重要.
- 整合非阿片类药物治疗和以患者为中心的方法可以优化结果.
相关概念视频
Opioid Analgesics: Morphine and Other Natural Cogeners
381
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
381
Analgesia and Pain Management
817
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...
817
Opioid Analgesics: Synthetic and Semisynthetic Opioids
446
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...
446
Opioid Receptors: Overview
2.0K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
2.0K
Prescription, Nonprescription and Orphan Drugs
857
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
857
Drug Abuse and Addiction: Pharmacological Phenomena
659
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
659


