阿片类药物( Opioids) 天然来源的 吗啡、可待因 人工合成的 哌替啶、美沙酮、芬太尼、海洛因等
阿片类药物 (Opioids) • 天然来源的 – 吗啡、可待因 • 人工合成的 – 哌替啶、美沙酮、芬太尼、海洛因等
The WH.o3-step pain " Ladder Step 1 non opioid± adjuvant Step weak opioid step I meds Step 3 strong opioid step I meds
The W.H.O 3-step Pain “Ladder ” • Step 1: – non opioid + adjuvant • Step 2: – “weak ” opioid + step 1 meds • Step 3: – “strong ” opioid + step 1 meds
Management of Severe Pain with Opioids Titrate Titrate TITRATE!!!
Management of Severe Pain with Opioids: Titrate! Titrate!! TITRATE!!!
Side Effects: Respiratory Depression Tolerance usually develops quickly Sedation before respiratory depression Risk factors Opioid naive IV administration Rapid dose escalation Removal of painful stimulus Relative risk: chronic lung disease( CO2 retention), renal dysfunction
Side Effects: Respiratory Depression • Tolerance usually develops quickly • Sedation before respiratory depression • Risk factors – Opioid na ïve – IV administration – Rapid dose escalation – Removal of painful stimulus – Relative risk: chronic lung disease (CO 2 retention), renal dysfunction
药物依赖性 与 药物滥用
药物依赖性 与 药物滥用