Dispnede Güvenli Opioid Kullanımı ve Bakımı

Öz

ÖZET Dispne yaşam kalitesini ve temel insan ihtiyaçlarını olumsuz yönde etkileyen yaygın subjektif bir semptomdur. Dispnenin nedenleri arasında akciğer hastalıkları başta olmak üzere kardiyovasküler hastalıklar, kanser, nöromüsküler, metabolik, nörolojik, psikolojik, sosyal ya da çevresel birçok faktör vardır. Farmakolojik ve nonfarmakolojik yöntemleri olan dispnenin tedavisinde sıklıkla kullanılan opioidler ventilasyonu, anksiyeteyi ve santral dispne algısını azaltarak etki gösterir. Ülkemizde Sağlık Uygulamaları Tebliği kapsamında yer alan opioidler kurum tarafından karşılanmaktadır. Ancak opioidlerin gelişmekte olan ve gelişmemiş ülkelerdeki erişim sorunu, doktorların reçete ederken, hemşirelerin uygularken yaşamış olduğu tedirginlik ve opiofobi medikal opioid kullanımını azaltmaktadır. Oysa opioidlerin ciddi yan etkilere neden olmadan kanıt temelli opioid dozları, uygulama yolları, ideal monitörizasyon ve holistik bakım ile dispne tedavisinde güvenle kullanılabileceğini kanıtlayan birçok çalışma mevcuttur. Opioid kullanımının önündeki bilgi eksiliğinden ve güvensizlikten kaynaklanan engeller sağlık personelinin eğitimi ile giderilmelidir. Buradan yola çıkarak son yıllarda yapılan çalışma sonuçlarının ele alındığı bu derlemenin amacı, opioidlerin dispne tedavisindeki yerini, kullanımının önündeki engelleri, güvenli kullanımını ve bakımını incelemektir

Anahtar Kelimeler

• opioid
• dispne
• dispne tedavisi
• opioid kullanımı
• hemşirelik bakımı

Safe Opioid Use and Care in Dyspnea

Abstract

ABSTRACT Dyspnea is a common subjective symptom that negatively affects the quality of life and basic human needs. Among the causes of dyspnea are cardiovascular diseases, cancer, neuromuscular, metabolic, neurological, psychological, social, or environmental factors, especially lung diseases. Opioids, which are frequently used in the treatment of dyspnea with pharmacological and non-pharmacological methods, act by reducing ventilation, anxiety, and the perception of central dyspnea. In our country, opioids within the scope of the Communiqué on Health Practices are covered by the institution. However, the problem of access to opioids in developing and undeveloped countries, the anxiety experienced by doctors while prescribing and nurses while applying them, and opiophobia reduce the use of medical opioids. However, there are many studies that prove that opioids can be safely used in the treatment of dyspnea with evidence-based opioid doses, administration routes, ideal monitoring, and holistic care without causing serious side effects. Obstacles arising from lack of knowledge and insecurity in the use of opioids should be eliminated with the education of healthcare professionals. From this point of view, the aim of this review, in which the results of recent studies are discussed, is to examine the place of opioids in the treatment of dyspnea, the barriers to their use, their safe use, and care.

Keywords

• opioid
• dyspnea
• dyspnea treatment
• opioid use
• nursing care

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