疼痛科常用药物.pptVIP

1.抗惊厥类药物 普瑞巴林： 1、广泛性焦虑障碍 (Generalized Anxiety Disorder GAD) 2、糖尿病性外周神经病 (Diabetic Peripheral Neuropathy DPN) 3、疱疹后神经痛 (Post-herpetic Neuralgia PHN) 4、纤维肌痛综合征 (Fibromyaigia Syndrome FMS) 5、癫痫的辅助治疗 不良反应：头晕嗜睡、乏力；血管性水肿；超敏反应 外周水肿；体重增加；肌酸激酶升高 血小板计数减少；药物滥用和依赖；增加自杀行为和想法 2.抗代谢药物 ①抗痛风药 碳酸氢钠片 别嘌醇 秋水仙碱 苯溴马隆 2.抗代谢药物 ②抗骨质疏松药物 碳酸钙 醋酸钙 维生素D 阿法骨化醇 骨化三醇 阿伦磷酸钠 鲑降钙素 依降钙素  TCA机制 抑制NA、5-HT再摄取——抗抑郁及镇痛 抗胆碱能作用——口干、便秘、尿潴留 肾上腺受体及H1（组胺）受体阻断——镇静 使用TCA注意 代表：丙米嗪，阿米替林，多塞平（多虑平） 前列腺肥大及青光眼禁用，糖尿病慎用 另有氟西汀（百忧解），赛洛特，米氮平（抑NA强，但抑5-HT及胆碱能弱——无恶心、头痛等）  谢谢！ ICD 国际疾病分类 世界卫生组织制定 * * Cyclooxygenase (COX) is the enzyme that converts arachidonic acid into various forms of prostaglandins. It exists in two distinct forms: COX-1 and COX-2.1 Nonspecific NSAIDs inhibit both forms of the enzyme, causing a beneficial decrease in pain and inflammation but an adverse alteration in normal body homeostasis1 COX-2 specific inhibitors were developed to inhibit only the COX-2 enzyme, resulting in a reduction in pain and inflammation without the degree of adverse effects that result from COX-1 inhibition1 Reference: 1. Needleman P, Isakson PC. The discovery and function of COX-2. J Rheumatol. 1997;24(Suppl 49):6-8. * The major problem with use of nonspecific NSAIDs is the occurrence of adverse events, which can limit their utilization in perioperative analgesia. Gastrointestinal: Gastropathy associated with the use of both Rx and OTC nonselective NSAIDs is the most frequent adverse drug event in the U.S. It was conservatively estimated that it is associated with approximately 16,500 deaths and 107,000 hospitalizations annually in patients with arthritis1 Hematologic: Hematologic reactions associated with nonspecific NSAIDs include inhibition of platelet aggregation and function, which can lead to an increased risk of bleeding and bruising2 Cardiorenal: Nonspecific NSAIDs can increase blood pressure and interfere with the blood pressure-lowering effects of certain antih