预测纳尔特雷克松处方酒精使用障碍的预测者来自急诊室
Jacob A Lebin1, Colin Hensen2, Zhixin Lun2
1Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Alcohol, clinical & experimental research
|September 29, 2025
概括
紧急部门对酒精使用障碍 (AUD) 处方纳尔德是罕见的,只有0.5%的符合条件的患者获得处方. 然而,近一半被处方纳尔德的人补充了它,这表明ED启动的AUD治疗的潜力.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度饮酒是美国主要可预防的死亡原因之一.
- 紧急诊所 (ED) 是干预酒精使用障碍 (AUD) 的关键点.
- 目前的指导方针建议使用药物治疗AUD (MAUD),如纳尔特雷,但ED的处方并不常见.
研究的目的:
- 分析对ED中危险饮酒或AUD患者的纳尔特雷克松处方模式.
- 为了确定患者和遭遇因素预测在ED出院时的纳尔特雷克松处方.
- 为了评估对纳尔特雷的处方填充率,在ED开始.
主要方法:
- 在12家医院对成年人ED遭遇的回顾性队列研究 (2022-2024年).
- 包括有阳性AUDIT-C查的患者和没有对纳尔特雷的禁忌.
- 使用GEE的多变量逻辑回归来确定处方和填充的预测因素.
主要成果:
- 在52,701名符合条件的ED患者中,只有0.5%的患者获得了纳尔特雷的处方.
- 处方在年轻男性,具有较高AUDIT-C分数的男性,与酒精有关的投诉和学术EDS中较高.
- 学术环境,戒酒诊断和更高的滥用酒精严重程度预测了处方的增加; 45%的处方被填补.
结论:
- 纳尔特雷克松在ED中对AUD的处方特别罕见.
- 很大一部分 (45%) 的纳尔特雷克森处方被填写,显示ED启动治疗的希望.
- 需要有系统的策略来克服障碍,并在ED环境中加强MAUD启动.
更多相关视频
05:40The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans
Published on: April 28, 2022
3.4K
08:05A Prediction Error-driven Retrieval Procedure for Destabilizing and Rewriting Maladaptive Reward Memories in Hazardous Drinkers
Published on: January 5, 2018
10.1K
相关概念视频
01:27CNS Depressants: Alcohol and Nicotine
978
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
978
01:15Drug Abuse and Addiction: Pharmacological Phenomena
1.1K
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...
1.1K
01:17Drug Dependence
1.5K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.5K
01:29Therapeutic Drug Monitoring: Affecting Factors
163
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
163
01:28Depressants
361
Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
361
01:21Factors Affecting Drug Response: Overview
2.8K
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...
2.8K