摘要
阿片类药物是控制癌痛的必备药物。对于癌症合并有肝肾功能不全的患者,阿片类药物的选择应慎重。吗啡的缓释剂型应注意调整剂量和给药的间隔时间,即释剂型可临时应用。应禁用可待因。轻中度的肝肾功能不全患者,羟考酮的应用是安全的;但重度肾功能不全者禁用羟考酮。芬太尼透皮贴剂是重度肝肾功能不全患者和透析患者的首选。丁丙诺啡在某些情况下可代替芬太尼应用于透析患者。
Opioid is essential drug for cancer pain.It should be very careful to choose opioid drugs for patients with hepatic or renal dysfunction.Dose and dosing interval of the sustained-released formulation of morphine should be adjusted,while the immediate-released formulation could be prescribed temporarily.Codeine should be forbidden.Oxycodone is safe for patients with mild or moderate hepatic or renal dysfunction,but should not be used in ones with severe renal dysfunction.Transdermal fentanyl is the first choice for patients with severe hepatic or renal dysfunction,and for dialytic patients.However,in some cases buprenorphine could replace it for dialytic patients.
出处
《中国肿瘤》
CAS
2011年第4期278-282,共5页
China Cancer
关键词
阿片类药物
肝肾功能不全
癌痛
opioid drugs
hepatic or renal dysfunction
cancer pain
