常用阿片类药物.pptVIP

曲 马 多(2) 药理作用 中枢性镇痛药 1. 弱阿片μ受体完全激动剂,结构与可待因有相似之处 2.“胺能”作用, 抑制中枢神经系统内参与镇痛的单胺类神经递制质——去甲肾上腺素（NE）和5-羟色胺（5-HT）的再摄取。从而提高中枢NE和5-HT浓度达到镇痛效果。 旋光异构性：临床使用混旋体 * 曲 马 多(3) （1）镇痛强度中等，为二阶梯药物 （2）可用于急、慢性中度疼痛 （3）用法：普通制剂：50-100mg, 4-6h一次 缓释制剂：100mg-200mg,q12h 每日总量一般不超过400mg （4）不良反应：头晕、嗜睡、恶心、呕吐等 呼吸抑制及心血管影响较少 （5）依赖性很低，滥用潜力很低 （6）非管制药品 * * * * * * 与吗啡等麻醉镇痛药相同，盐酸二氢埃托啡通过激动中枢的阿片受体，减少疼痛信号的传导而达到镇痛效果，而与吗啡等药物所不同的是…… * Oxycodone is a strong opioid analgesic with affinity for mu and kappa opioid receptors. Its side effects are typical of opioid analgesics and include constipation, nausea and drowsiness. Oxycodone has been in clinical use for 80 years. Compulsory slide * 奥施康定采用了全球保护的专利技术－AcroContin控释技术，即控释与即释相结合，38%的药物即释、62％的药物缓释，使羟考酮不仅能够持续延长疼痛控制时间，还能够在服药后1小时内迅速起效 * OxyContin tablets are a prolonged release formulation from which oxycodone is released in two phases. The first phase allows a rapid onset of action and the second allows sustained pain relief. Compulsory slide - * k * * * In terms of changes for your patients, the result is that a number of important features of the patch have been changed with the following technology advantages: The patch structure has no longer a visible reservoir filled with gel, but a thin layer of viscoelastic flexible matrix, thereby creating a patch with maximum flexibility for wearing on the body. The overall patch size has been reduced; the matrix patch is thus considerably smaller and discreet. The adhesive has been changed from a silicon-adhesive to the polyacrylate polymer adhesive, with much better adhesion properties to the skin. As already mentioned in the previous slide, fentanyl is incorporated differently, ..... There is no longer presence of ethanol as a permeation enhancer; potential irritant effects of the ethanol in patients with sensitive skin are thus eliminated. The slit in the protective liner allows easier applic