医药卫生癌痛规范化治疗课件.ppt

这是国内2006年1824例奥施康定?治疗中至重度癌痛大型临床试验，试验周期8周 结果显示：奥施康定? 有效缓解各种性质癌痛，特别是对于神经病理性疼痛患者的疼痛缓解率较高，末次疗效有 效率高达93.6%，高于总体人群的有效率（90.2%） * 奥施康定有效成分羟考酮主要作用于μ受体，中枢神经系统是其主要作用部位，其次是平滑肌。 奥施康定的镇痛作用强，其等效止痛作用强度与吗啡相比是吗啡的2倍。 奥施康定的药效作用个体差异较小，年龄及性别对奥施康定的药效作用影响不大。 奥施康定的血药浓度与药效作用之间有较好的相关性。因此，可通过检测血药浓度来预见药物的止痛作用。 本表内列出由其它常用阿片类药物向奥施康定转换的每日剂量转换系数，转换公式为：原阿片药物每日剂量(mg/d)×剂量转换系数＝奥施康定每日剂量(mg/d) * Results: Pain was poorly controlled at baseline, with only 18.1% of patients reporting adequate pain relief (NRS 3.5). All other patients reported uncontrolled pain, with an average NRS of 7.81. At baseline assessment, 47.89% of patients had been in pain for up to 3 months, 32.82% for 3–6 months, and 19.19% for more than 6 months. After baseline assessment, patients were switched to oxycodone CR monotherapy. The starting dose was individualized to each patient and titrated up over a 3- to 4-day period until effective pain management was achieved. Treatment was continued for an average of 37.24 days during the study. Pain control (fi nal mean NRS of 2.85) was attained with an average dose of oxycodone CR 221.84 mg/day. Standard adverse events (including constipations, nausea, and vomiting) were recorded in 39.64% of patients receiving high-dose oxycodone CR monotherapy. Side-effects tended to subside after the initial week of treatment and did not result in any participants leaving the study. * Oxycodone CR is an oral therapeutic option approved for the treatment of moderate to severe pain. It has a similar safety and effi cacy profi le to morphine, but offers several therapeutic advantages. The results of its use at high dosages for pain relief in cancer and non-cancer patients demonstrate that an adequate dose can bring previously uncontrolled moderate to severe pain under control rapidly, with minimal side-effects. However, further randomized, controlled studies involving oxycodone CR and a control arm are required to increase evidence for the effi cacy of oxycodone CR use in cancer and non-cancer pain. * 鉴