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The Impact of Family Support on Medication Adherence and Glycemic Control of Type 2 Diabetes Outpatients in a Nigerian Tertiary Hospital 尼日利亚某三级医院家庭支持对2型糖尿病门诊患者服药依从性及血糖控制的影响
Pub Date : 2019-05-15 DOI: 10.18314/JPT.V5I1.1653
C. Anene-Okeke, M. Adibe, C. Ukwe, C. Aguwa
Background: Diabetes management rarely target family support as a means of promoting diabetes self-care behaviour among adults. The potential influence of family member on individuals with Type 2 diabetes has not been fully explored. The study aims to examine the impact of family support on medication adherence and glycemic control of their Type 2 diabetes out-patients in a tertiary hospital.Methods: The study was a prospective cross-sectional survey conducted on Type 2 diabetes out-patients attending endocrinology clinic at the University of Nigeria Teaching Hospital (UNTH) between October 2013 and April 2014. The Diabetes Family Behavioral Checklist (DFBC-13) was used to assess family support while the MMAS-8 (Morisky medication Adherence Scale) was used to assess medication adherence. Fasting blood glucose readings were obtained from patients’ case files.Data were analysed using SPSS (Statistical package for social sciences) version 16 and level of statistical significance set at p<0.05. Result:  A total number of 250 patients were assessed. The mean score for family support was 42 of 65 (range 13 to 65). Family support score (diet, glucose, exercise, diabetic self-care) associated with educational status (socio-demographic characteristics) r = 0.171** p = 0.007. Family support was inversely correlated to adherence and glycemic control (-0.161**, P = 0.011, r = -0.098, p = 0.147) respectively. Medication adherence was low as only 1.6% of the respondents adhered to their medication.Conclusion: Family support had little influence on medication adherence and glycemic control.
背景:糖尿病管理很少将家庭支持作为促进成人糖尿病自我护理行为的一种手段。家庭成员对2型糖尿病患者的潜在影响尚未得到充分探讨。本研究旨在探讨家庭支持对某三级医院门诊2型糖尿病患者服药依从性和血糖控制的影响。方法:对2013年10月至2014年4月在尼日利亚大学教学医院内分泌科门诊就诊的2型糖尿病患者进行前瞻性横断面调查。采用糖尿病家庭行为检查表(DFBC-13)评估家庭支持,采用MMAS-8 (Morisky药物依从性量表)评估药物依从性。从患者的病例档案中获取空腹血糖读数。使用SPSS (Statistical package for social sciences)第16版对数据进行分析,统计学显著性水平设置为p<0.05。结果:共评估250例患者。家庭支持的平均得分为42分(范围从13到65)。家庭支持评分(饮食、血糖、运动、糖尿病自我护理)与教育状况(社会人口统计学特征)相关,r = 0.171** p = 0.007。家庭支持与依从性和血糖控制呈负相关(-0.161**,P = 0.011, r = -0.098, P = 0.147)。服药依从性较低,只有1.6%的受访者坚持服药。结论:家庭支持对患者服药依从性和血糖控制影响不大。
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引用次数: 0
Tacrolimus Pharmacokinetics in Living-Donor and Deceased-Donor Liver Transplant in Saudi Patients 他克莫司在沙特活体和死亡肝移植患者中的药代动力学
Pub Date : 2019-04-10 DOI: 10.18314/JPT.V5I1.1678
H. Abou-Auda, Eqbal Qaddour, Hussein Alsisi, A. Ajlan, M. Alsebayel
Introduction: Tacrolimus is a macrolide immunosuppressant. It has a narrow therapeutic index and serious side effects which necessitate monitoring of tacrolimus blood concentration. The trough concentration of the drug may also differ based on the type of liver transplant. This study was conducted to investigate differences in pharmacokinetics between transplant types and to determine tacrolimus population pharmacokinetic in liver transplant recipients in Saudi Arabia. Method: Patients on tacrolimus, as the main immunosuppressant, who underwent liver transplant throughout2012-2014 were retrospectively studied. Demographic characteristic, tacrolimus blood trough concentrations, liver, renal, biochemistry, and hematology lab results were all collected. The pharmacokinetic parameters were estimated assuming one compartment model. Results: Tacrolimus pharmacokinetic parameters were found to be as following; elimination rate constant () 0.094 ±  0.0123, apparent volume of distribution () 112.48±63.033 L/hr, elimination half-life () 7.46± 1.01 hr and apparent total body clearance () 10.27± 5.69 L/hr (mean ± SD). Statistically significant difference was found between living-donor and deceased-donor liver transplant with respect to apparent clearance and apparent volume of distribution. Living-donor liver transplant recipients have apparent volume of distribution of 97.39±47.00 L (mean ± SD) and an apparent clearance of 8.89±4.24L/hr (mean± SD). On the other hand, deceased-donor liver transplant has an apparent clearance of 12.97±7.09L/hr (mean ± SD) and an apparent volume of distribution of 142.17± 78.65 L (mean ± SD). Conclusions: Tacrolimus pharmacokinetics parameters were accurately determined in liver transplant recipients in Saudi Arabia. The results of the present study can be clinically used in the therapeutic drug monitoring of tacrolimus in the individualization of drug dosage and taking the appropriate clinical decisions to prevent allograft rejection.
他克莫司是一种大环内酯类免疫抑制剂。治疗指标窄,副作用严重,需监测他克莫司血药浓度。药物的谷浓度也可能因肝移植类型而异。本研究旨在研究不同移植类型之间的药代动力学差异,并确定他克莫司在沙特阿拉伯肝移植受者中的群体药代动力学。方法:回顾性分析2012-2014年以他克莫司为主要免疫抑制剂的肝移植患者。收集人口统计学特征、他克莫司血槽浓度、肝脏、肾脏、生化和血液学实验室结果。采用单室模型估计药代动力学参数。结果:他克莫司药动学参数如下;消除速率常数()0.094±0.0123,表观分布容积()112.48±63.033 L/hr,消除半衰期()7.46±1.01 hr,表观全身清除率()10.27±5.69 L/hr (mean±SD)。活体肝移植与死亡肝移植在表观清除率和表观分布体积方面存在统计学差异。活体肝移植受者表观分布容积为97.39±47.00 L(平均±SD),表观清除率为8.89±4.24L/hr(平均±SD)。另一方面,死亡供者肝移植的表观清除率为12.97±7.09L/hr(平均±SD),表观分布容积为142.17±78.65 L(平均±SD)。结论:沙特阿拉伯肝移植受者他克莫司药代动力学参数测定准确。本研究结果可用于临床对他克莫司的治疗药物监测,个体化用药剂量,采取适当的临床决策,预防同种异体移植排斥反应。
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引用次数: 1
Pharmacological Options for Viral Induced Hemorrhagic Cystitis Management: A Review of the Literature 病毒性出血性膀胱炎治疗的药理学选择:文献综述
Pub Date : 2019-04-04 DOI: 10.18314/JPT.V5I1.1645
Amber B. Giles, Alyson G Wilder, M. Ritter, A. Wright, S. A. Afeli
Background: Viral induced hemorrhagic cystitis (VIHC) is very common among patients who become immunocompromised following organ transplantation. However, there is neither consensus on the standard of care nor clear guidelines to aid in clinical decision making when treatment VIHC. This review discusses currently available pharmacologic agents, presents investigational drug therapies, and outlines alternative treatment options that could be effective against VIHC.Recent findings: Letermovir is a novel antiviral agent approved for CMV prophylaxis in patients post-hematopoietic stem cell transplantation (HSCT). Although no studies have yet been conducted in patients with VIHC, this new antiviral agent shows promise in preventing emergence of CMV in patients after HSCT. Additionally, newer studies addressing the efficacy of brincidofovir, an experimental drug derived from cidofovir, against CMV infection may provide preliminary evidence for brincidofovir’s role in therapy and therefore warrant further investigation.Conclusion: Polyoma BK virus (BKV), cytomegalovirus (CMV), and adenovirus (ADV) are the primary culprits for HC occurrence in patients undergoing renal transplantation or allogeneic HSCT. CMV-associated HC could be prevented or treated by ganciclovir and valganciclovir because these agents’ effectiveness has been clearly established in other non-HC infections related to CMV. ADV-associated HC could be mitigated by brincidofovir and ribavirin, however the high toxicity associated with these agents may be a limiting factor for their use. BKV-associated HC is best managed by cidofovir and leflunomide, but not by fluoroquinolones. Finally, intravesicular instillation should be preferred in patients who experience toxicities associated with systemic use of antivirals.
背景:病毒性出血性膀胱炎(VIHC)在器官移植后免疫功能低下的患者中非常常见。然而,在治疗VIHC时,既没有就护理标准达成共识,也没有明确的指导方针来帮助临床决策。本综述讨论了目前可用的药物,提出了研究药物治疗,并概述了可能有效对抗VIHC的替代治疗方案。最近发现:Letermovir是一种新的抗病毒药物,被批准用于造血干细胞移植(HSCT)后患者的巨细胞病毒预防。虽然目前还没有在VIHC患者中进行研究,但这种新的抗病毒药物有望预防HSCT后患者出现巨细胞病毒。此外,关于brincidofovir(一种西多福韦衍生的实验性药物)抗巨细胞病毒感染功效的最新研究可能为brincidofovir在治疗中的作用提供初步证据,因此值得进一步研究。结论:多瘤BK病毒(BKV)、巨细胞病毒(CMV)和腺病毒(ADV)是肾移植或同种异体造血干细胞移植患者发生HC的主要原因。更昔洛韦和缬更昔洛韦可以预防或治疗巨细胞病毒相关的丙型肝炎,因为这些药物在其他与巨细胞病毒相关的非丙型肝炎感染中的有效性已得到明确证实。brincidofovir和利巴韦林可以减轻adva相关的HC,但是与这些药物相关的高毒性可能是其使用的限制因素。bkv相关HC的最佳治疗方法是西多福韦和来氟米特,而不是氟喹诺酮类药物。最后,对于经历与全身使用抗病毒药物相关的毒性的患者,应首选囊泡内滴注。
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引用次数: 0
Application of Molecularly Structured Ben Oil in Gentamicin Entrapped Lipospheres 分子结构本油在庆大霉素包埋脂球中的应用
Pub Date : 2019-03-19 DOI: 10.18314/JPT.V5I1.1594
S. Chime, I. V. Onyishi, I. O. Eze
Objective: To formulate extended release gentamicin-entrapped lipospheres using natural lipids from Irvingia wombolu (IWF) and Moringa oleifera seed (MO) popularly known as Ben oil. Methods: Different lipid combinations including IWF and Phospholipon 90H (P90H) and IWF and MO were employed in the formulation of lipospheres. The formulations were analysed for particle size, encapsulation efficiency (EE), pH stability and antimicrobial studies amongst other tests. Also the in vitro release properties were studied in Phosphate buffer pH 7.2. Results: High EE of up to 90 % were obtained for the various LM combinations. The pH was stable over 30 days and the formulations showed about 93 % release of gentamicin at 12 h. Lipospheres formulated with MO matrices showed synergism in the microbial inhibition than other formulations. Conclusion: Natural lipids from Irvingia wombolu and Moringa oleifera seed could be used in formulating oral extended release gentamicin lipospheres.
目的:利用山茱萸(IWF)和辣木籽(MO)的天然脂质(俗称本油)制备庆大霉素包封的缓释脂球。方法:采用IWF与磷脂90H (P90H)、IWF与MO等不同脂质组合制备脂球。分析了配方的粒径,包封效率(EE), pH稳定性和抗菌研究等测试。并在pH为7.2的磷酸盐缓冲液中研究了其体外释放特性。结果:不同LM组合的EE最高可达90%。pH值在30天内保持稳定,12 h庆大霉素释放量约为93%。与其他制剂相比,MO基质配制的脂球具有协同抑菌作用。结论:山茱萸和辣木籽的天然脂质可用于制备口服缓释庆大霉素脂球。
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引用次数: 3
Use of Ketamine to Treat Depressive Symptoms in Schizoaffective Disorder 氯胺酮治疗分裂情感性障碍患者抑郁症状
Pub Date : 2019-03-15 DOI: 10.18314/JPT.V5I1.1602
Isaac G. Freedman, D. Rabin, Prabhneet Pannu, Tariq Bandoo, B. Nandra, I. Wiesman, F. Podbielski
The use of subanesthetic ketamine infusions in treatment resistant depression and bipolar depression is becoming more common. Subanesthetic doses of ketamine cause the patient to dissociate, which was initially considered a side effect of this treatment; it is believed to play a role in a patient’s clinical improvement. Researchers attribute this result to an increase in brain-derived neurotrophic factor, a growth factor that stimulates the formation of new synaptic connections. Due to its psychogenic affect, ketamine treatment is less suitable for patients who experience mood disorders with psychotic features. Although symptomatic hallucinations seemingly conflict with the dissociative effects of ketamine, treatment of a patient with depressive type schizoaffective disorder revealed significant improvements in his depressive symptoms, demonstrating ketamine’s potential to be safely administered to patients with a variety of complex disorders.
亚麻醉氯胺酮输注治疗难治性抑郁症和双相抑郁症正变得越来越普遍。亚麻醉剂量的氯胺酮导致患者游离,这最初被认为是这种治疗的副作用;它被认为在病人的临床改善中起作用。研究人员将这一结果归因于脑源性神经营养因子的增加,这是一种刺激新突触连接形成的生长因子。由于其心因性影响,氯胺酮治疗不太适合患有精神病性特征的情绪障碍的患者。尽管症状性幻觉似乎与氯胺酮的解离作用相冲突,但对一名抑郁型分裂情感障碍患者的治疗显示,他的抑郁症状得到了显著改善,这表明氯胺酮有可能安全用于各种复杂疾病的患者。
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引用次数: 0
Effect of Juglan Regiaon Patients Having Metabolic Syndrome: A Controlled Feeding Trial 核桃地区代谢综合征患者的控制喂养试验
Pub Date : 2019-03-07 DOI: 10.18314/JPT.V5I1.1581
S. Sikander, M. Imran, Ali Hassan, Fasiha Ahsan, Sana Noreen, M. H. Mughal
Metabolic syndrome is a cluster of disorders diagnosed simultaneously in an individual. The percentage of individuals affected from this syndrome is escalating around the globe as well as in Pakistan mainly due to more consumption of energy dense foods and sedentary lifestyle. Dietary modification with nutrient dense foods is a globally adapted strategy to reduce the complexity of this issue. This present project has been designed to see the impact of nutrient dense walnuts consumption on selective biomarkers in human subjects. The screening of human subjects was done by taking the anthropometric measurements, lipid profile, blood glucose level and blood pressure whereas the dietary pattern of patients was collected by validated food frequency questionnaire. The proximate analysis of walnuts was also done. Twenty patients were selected and divided into two groups randomly. Experimental group consumed walnuts daily for 8 weeks and placebo group consumed the diet without walnut. Selective physical parameters included BMI was performed at the regular basis whereas, the blood samples were collected at 1st , 4th  and  8th week of the study period followed by the evaluation of serum triglyceride and high density lipoprotein cholesterol level. Walnuts were found to be high in fat content i.e 64.6% and also contained all other important nutrients as moisture (3.9%), ash (1.5%), protein (15.3%), fiber (1.5%) and nitrogen free extract (10.7%). Walnuts reduced triglycerides significantly and HDL was also raised significantly. No significant change was observed in BMI. Statistical analysis was employed to draw the conclusive outcomes of the research studies.
代谢综合征是个体同时诊断出的一系列疾病。在全球以及巴基斯坦,受这种综合征影响的个人比例正在不断上升,这主要是由于更多地消耗能量密集型食物和久坐不动的生活方式。用营养丰富的食物来改变饮食是一种全球性的策略,以减少这一问题的复杂性。本项目旨在观察营养丰富的核桃消费对人类受试者的选择性生物标志物的影响。受试者的筛选通过人体测量、血脂、血糖水平和血压进行,而患者的饮食模式则通过有效的食物频率问卷收集。对核桃进行了近似分析。选取20例患者,随机分为两组。试验组连续8周每天食用核桃,安慰剂组不食用核桃。定期进行包括BMI在内的选择性身体参数检测,并于研究周期的第1、4、8周采集血样,评估血清甘油三酯和高密度脂蛋白胆固醇水平。核桃的脂肪含量高达64.6%,还含有所有其他重要的营养成分,如水分(3.9%)、灰分(1.5%)、蛋白质(15.3%)、纤维(1.5%)和无氮提取物(10.7%)。核桃可显著降低甘油三酯,并显著提高HDL。BMI未见明显变化。采用统计分析得出研究的结论性结果。
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引用次数: 0
Current Strategies of Quetiapine Fumarate Delivery in Management of Bipolar Disorder and Schizophrenia 富马酸喹硫平治疗双相情感障碍和精神分裂症的当前策略
Pub Date : 2019-03-07 DOI: 10.18314/JPT.V5I1.1554
D. Patil, Seema V. Pattewar, Sarvesh Paliwal, G. Singh, Swapnil Sharma
Bipolar disorder is psychological illness with periodic episodes of mania and depression. Schizophrenia is a complex mental disorder identified by delusions, hallucinations, disorganized behavior, impaired cognitive ability, disorganized speech and sudden change in personality. In both the diseases quetiapine fumarate (QF) drug is worth important in today’s scenario. This review gives complete QF drug profile along with mechanism of action. Quetiapine alone is successful for acute bipolar depression and the prevention of mania/hypomania switching. Literature survey section of this review gives information about quetiapine in different dosage form. By this review one can explore the scale up of quetiapine fumarate not only with immediate release and sustained release dosage form but also with novel drug delivery system like solid lipid nanoparticle and nanostructured lipid carrier.
双相情感障碍是一种伴有周期性躁狂和抑郁发作的心理疾病。精神分裂症是一种复杂的精神障碍,表现为妄想、幻觉、行为紊乱、认知能力受损、言语紊乱和性格突然改变。在这两种疾病中,富马酸喹硫平(QF)药物在今天的情况下都很重要。本文综述了完整的QF药物概况及其作用机制。奎硫平单独用于急性双相抑郁症和预防躁狂/轻躁狂转换是成功的。本综述的文献调查部分给出了不同剂型喹硫平的信息。本文综述了富马酸喹硫平的快速释放和缓释剂型,以及固体脂质纳米颗粒和纳米结构脂质载体等新型给药系统。
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引用次数: 0
Formulation Development and Evaluation of Rosuvastatin Sustained Release Tablets 瑞舒伐他汀缓释片的处方开发与评价
Pub Date : 2019-02-06 DOI: 10.18314/JPT.V5I1.1459
R. Gunda, Prasada Rao Manchineni
Purpose: The main objective of present research investigation is to formulate the sustained release formulation of Rosuvastatin. Rosuvastatin, an antihyperlipidemic agent, belongs BCS class-II agent.Methods: The SR tablets of Rosuvastatin were prepared employing different concentrations of HPMCK4M and SCMC in different combinations by Direct Compression using 32 factorial design. The concentration of Polymers , HPMCK4M and SCMC required to achieve the desired drug release was selected as independent variables, X1 and X2 respectively whereas, time required for 10% of drug dissolution (t10%), 50% (t50%), 75% (t75%) and  90% (t90%)  were selected as dependent variables.Results and Discussion: Totally nine formulations were designed and are evaluated for hardness, friability, thickness, % drug content, In-vitro drug release. From the Results it was concluded that all the formulation were found to be with in the Pharmacopoeial limits and  the In-vitro dissolution profiles of all formulations were fitted in to different Kinetic models, the statistical parameters like intercept, slope & regression coefficient  were calculated. Polynomial equations were developed for dependent variables. Validity of developed polynomial equations were verified by designing 2 check point formulations (C1, C2). According to SUPAC guidelines the formulation (F4) containing 30 mg of HPMCK4M and 40 mg of SCMC, is the most similar formulation (similarity factor f2= 89.561, dissimilarity factor f1= 1.543 & No significant difference, t= 0.0056) to marketed product (CRESTOR).Conclusion: The selected formulation (F4) follows Zero order, Higuchi’s kinetics, and the mechanism of drug release was found to be Non-Fickian Diffusion (n= 0.963).
目的:研制瑞舒伐他汀缓释制剂。瑞舒伐他汀是一种抗高脂血症药物,属于BCS ii类药物。方法:采用32因子设计,采用不同浓度的HPMCK4M和SCMC进行直接压缩,制备瑞舒伐他汀SR片。分别以聚合物、HPMCK4M和SCMC的浓度为自变量X1和X2,以药物溶出度10% (t10%)、50% (t50%)、75% (t75%)和90% (t90%)所需时间为因变量。结果与讨论:共设计了9种制剂,并对其硬度、脆度、厚度、药物含量、体外释放度进行了评价。结果表明,各制剂均符合药典标准,并将各制剂的体外溶出度曲线拟合到不同的动力学模型中,计算了其截距、斜率和回归系数等统计参数。建立了因变量的多项式方程。通过设计2个检查点公式(C1, C2)验证了所建立的多项式方程的有效性。根据SUPAC指南,含有30 mg HPMCK4M和40 mg SCMC的配方(F4)与上市产品(CRESTOR)最相似(相似因子f2= 89.561,不同因子f1= 1.543,无显著差异,t= 0.0056)。结论:所选配方(F4)符合零阶、Higuchi动力学,药物释放机制为非菲克扩散(n= 0.963)。
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引用次数: 2
A Case Report on Warfarin Induced Skin Necrosis: Drug-drug Interaction or Inappropriate Therapy 华法林致皮肤坏死1例:药物相互作用或治疗不当
Pub Date : 2018-11-27 DOI: 10.18314/jpt.v4i1.1445
Dutta S, S. Pk, Misra Ak, Kumar R, Rai S, Chaudhary R
Introduction: Warfarin is one of the most frequently prescribed oral anticoagulant. Necrosis and/or gangrene ofskin and other tissues is an uncommon but serious risk associated with warfarin. The incidence of warfarin inducedtissue necrosis is about 0.01 % to 0.1%.Case description: A 62-year-old male presented to emergency with a complaint of skin discoloration and edema onleft lower limb diagnosed as warfarin induced skin necrosis. He had an episode of hemiparesis 20 days back for whichhe was started on oral warfarin along with other medications. On diagnosis warfarin was stopped and fresh frozenplasma (FFP) was given along with vitamin K. Due to progressing tissue necrosis, above knee limb amputation wasdone. We assume that an interaction between rosuvastatin and warfarin or possibly lack of adequate bridge therapywith heparin resulted in this complication.Conclusion: Warfarin induced skin necrosis is a known early complication of the therapy. Though late onsetappearance of this event is rare but not unknown. Bridging therapy with heparin and avoiding use of interactingdrugs concomitantly could prevent many such reactions.
华法林是最常用的口服抗凝剂之一。皮肤和其他组织坏死和/或坏疽是华法林不常见但严重的危险。华法林诱导的组织坏死发生率约为0.01% ~ 0.1%。病例描述:一名62岁男性,主诉左下肢皮肤变色和水肿,诊断为华法林引起的皮肤坏死。20天前,他有过一次偏瘫发作,为此他开始服用口服华法林和其他药物。诊断后停用华法林,给予新鲜冷冻血浆(FFP)和维生素k。由于组织坏死进展,进行膝以上截肢。我们假设瑞舒伐他汀和华法林之间的相互作用或可能缺乏适当的肝素桥治疗导致了这种并发症。结论:华法林引起的皮肤坏死是一种已知的治疗早期并发症。虽然发病较晚,但并不罕见。肝素桥接治疗和避免同时使用相互作用的药物可以防止许多此类反应。
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引用次数: 1
Role and Advantageousness of Ketamine in Obese and Non-Obese Patients: Peri-Interventional Considerations 氯胺酮在肥胖和非肥胖患者中的作用和优势:围介入期考虑
Pub Date : 2018-11-06 DOI: 10.18314/jpt.v4i1.1404
Weinbroum Aa, Amit U
Obese and morbidly obese patients are a growing group of individuals that generates medical, social and economicproblems worldwide. They undergo various interventions that require anesthesia and/or analgesia. Despite theirhealthy look, these individuals are graded at high ASA physical status, mainly because of their impaired respiratoryand cardiovascular conditions, and the metabolic changes their body undergoes. Opioids are the default drugsfor perioperative analgesia. Nevertheless, their use has reached a frightening epidemic-like condition worldwide.Multimodal analgesia regimens have been recommended as a perioperative standard of care, particularly useful in theobese. These regimens employ combinations of opioids and non-opioid compounds that reciprocate each analgesicpotencies, thus providing superior pain relief at rest, movement, or on effort, while reducing opioid consumption andtheir concerned adverse effects. The most important perioperative IV adjuvant currently employed is ketamine thatsees resurgence among physicians from diverse medical specialties. After summarizing obese patients’ perioperativedrawbacks, this review will illustrate ketamine’s neuropharmacology, and will describe its therapeutic usefulness asan analgesic adjuvant. Since data regarding the use of the drug in obese patients is scarce, brief exemplifications ofits benefits in non-obese cohorts will be portrayed as well.
肥胖和病态肥胖患者是一个日益增长的群体,在全球范围内产生了医疗、社会和经济问题。他们接受各种需要麻醉和/或镇痛的干预。尽管他们看起来很健康,但这些人的身体状况被评为高ASA,主要是因为他们的呼吸和心血管疾病受损,以及他们身体经历的代谢变化。阿片类药物是围手术期镇痛的默认药物。然而,它们的使用在世界范围内已达到可怕的流行病程度。多模式镇痛方案已被推荐作为围手术期护理标准,特别适用于肥胖患者。这些方案采用阿片类药物和非阿片类药物的组合,相互作用,从而在休息、运动或努力时提供更好的疼痛缓解,同时减少阿片类药物的消耗及其相关的副作用。目前使用的最重要的围手术期静脉辅助药物是氯胺酮,它在不同医学专业的医生中重新流行起来。在总结肥胖患者围手术期的缺点后,本文将阐述氯胺酮的神经药理学,并将描述其作为镇痛辅助剂的治疗作用。由于关于肥胖患者使用该药的数据很少,因此也将简要说明其在非肥胖人群中的益处。
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引用次数: 1
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