围手术期疼痛管理PPT演示课件.ppt

This slide summarizes some information about use in special patient populations. Dose adjustments are not required in patients with renal impairment. Buprenorphine is predominately metabolized by the liver. So, the buprenorphine transdermal patch should be used with caution in patients with impaired liver function. All patients with hepatic impairment should be carefully monitored during treatment. No dose adjustment is needed for mild to moderate hepatic impairment, but an alternative therapy should be used for patients with severe hepatic impairment. Dose adjustments are not required based on age, ethnicity or gender. The buprenorphine transdermal patch is not recommended for use in patients under 18 years of age as no clinical data are available in this age group. There are no data available on the use of the buprenorphine transdermal patch during pregnancy and lactation. Therefore, this medication is contraindicated during pregnancy and should be avoided during lactation. Febrile patients and those with increased skin temperature due to other causes should be monitored carefully during treatmentwith the buprenorphine transdermal patch, because exposure to external heat sources and fever may increase the absorption of buprenorphine. References Filitz J, Griessinger N, Sittl R, et al. Effects of intermittent haemodialysis on buprenorphine and norbuprenorphine plasma concentrations in chronic pain patients treated with transdermal buprenorphine. Eur J Pain 2006;10:743–748. Norspan? Transdermal Patch Product Monograph. Mundipharma Pte Ltd. December 2009. Eltahtawy A, Cipriano A, McGoey D, et al. 7-day bioavailability of buprenorphine from a novel transdermal system in demographic subgroups. J Clin Pharmacol 2001;41:1027. Abstract 56. Reidenberg BE, Eltahtawy A, Munera C, et al. Pharmacokinetics and safety of buprenorphine transdermal system (BTDS) for 7 day application comparing healthy elderly and young adult subjects. In: Program Book, 19th Annual Scientific M