Practice and experience in the participant of the clinical pharmacist in the treatment of cancer pain with renal insufficiency
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摘要: 目的 探讨临床药师在止痛治疗中的作用,促进镇痛药更加规范的使用。 方法 临床药师通过参与癌痛伴肾功能不全患者止痛方案的制定,从药物的选择、给药剂量以及不良反应预计等方面,提出药学观点。 结果 医师采用了临床药师的建议,首日使用盐酸吗啡片进行快速滴定,次日起使用羟考酮缓释片控制背景疼痛,小剂量盐酸吗啡片控制爆发痛,在疼痛控制稳定后,改用芬太尼贴剂以减轻肾功能损害。 结论 临床药师参与到重度癌痛患者的治疗方案制定中,能提高患者用药安全性、合理性,提高临床治疗效果。Abstract: Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs. Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection, dosage and adverse reaction monitoring. Results Physicians accepted suggestions from clinical pharmacists.The first day, the morphine hydrochloride tablets were used for rapid titration. The next day doxycodone were used, adding the morphine hydrochloride tablets when required. After the pain was controlled stability, the transdermal fentanyl was used to alleviate the damage of kidney. Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treatment.
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Key words:
- cancer pain /
- opioids /
- renal insufficiency
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[1] 李小梅,董艳娟,李慧莉,等. 阿片耐受与慢性癌痛的阿片类药物治疗[J]. 中国疼痛医学杂志,2012,18(9):561-565. [2] Dhingra L, Lam K,Homel P,et al. Pain in underserved community-dwelling Chinese American cancer patients: demographic andmedical correlates[J].Oncologist,2011,16(4):523-533. [3] 刘 芳,付 平. 恶性肿瘤肾损害[J]. 中国实用内科杂志,2011,31(2):100-101. [4] 王雅琦,王美鉴,邱志敏,等. 芬太尼透皮贴在肾功能不全的癌痛患者中的应用[J].实用癌症杂志,2012,27(5):529-530. [5] Boger RH. Renal impairment: a challenge for opioid treatment? The role of buprenorphine[J].Palliat Med, 2006,20(1):17-23. [6] 任玉娥,段红光,倪家骧. 芬太尼缓释透皮贴剂的临床药理学[J]. 中国疼痛医学杂志, 2002, 8(3):169-172. [7] 程 熠,于世英. 阿片类药物在肝肾功能不全癌痛患者中的选择应用[J].中国肿瘤,2011,20(4):278-282. [8] 周晓敏. 盐酸羟考酮控释片治疗癌痛的研究进展[J].广西医科大学学报,2009,26(5):813-815. [9] Meeker MA,Finnell D, Othman AK. Family caregivers and cancer pain management: a review[J]. J Fam Nurs, 2011,17(1):29-60.
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