药物治疗教学课件：D-Pain Management.pptVIP

Thank you! Additional Options Opioids maybe helpful in those who are refractory to other modalities long-acting agents preferred may titrate with short acting (IR) then switch to long-acting 曲马多(Tramadol): may mimic MOA of both an opioid and an antidepressant 选择性5HT再摄取抑制剂(SSRIs): disappointing results adequate treatment trials require a long-term commitment Combination therapy often needed Opiate addition 阿品类成瘾 Withdrawal (停药) 症状：可持续3-14天 早期：哈欠，流涎/鼻涕/泪/汗, 恶寒颤栗，胃肠道反应 晚期：兴奋,不安,失眠,↑血压/脉搏,肌肉疼痛, 扩瞳 严重程度: 药品，剂量，服用时间，健康，个性 短效药物(meperidine杜冷丁)：更强 3hr发作, 8-12hr峰值, 持续4-5天 长效药物(methadone美沙酮): 较弱，