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Opioidler, Ağrı, Opioidlerin Suistimali ve Yanlış Kullanımı

Yıl 2017, Cilt: 39 Sayı: 3, 125 - 129, 06.09.2017
https://doi.org/10.20515/otd.333567

Öz

Opioidler, gelincikgiller familyasından Papaver somniferum’dan (haşhaş
bitkisi) elde edilen, narkotik analjezikler olarak da bilinen ilaç gruplarıdır.
Güçlü ağrı kesici etkileri olması nedeniyle akut, kronik ve de kanser
ağrılarının tedavisinde kullanımları oldukça sıktır. Ancak bağımlılık yapıcı
etkileri nedeniyle tedaviye başlama sırasında ve tedavi sürecinde önemli
sorunlar ortaya çıkabilmektedir. Bu grup ilaçlar analjezik etkileri dışında
öksürük kesici ve antidiyareik olarak da kullanılmaktadır.  Opioidlerin özellikle de güçlü etkili
olanların, gittikçe artan oranda kötüye kullanımı ve yanlış kullanımı sonucunda
istenmeyen durumlarla karşılaşılabilmektedir. Ancak terminal dönem kanser
hastalarının ağrı tedavisinde yarar zarar oranlarına bakılarak kullanılmaları
gerektiği çok açıktır. Bu grup ilaçların kullanımında bağımlılık, hepatit, HIV
enfeksiyonları ve kullanılamadığı durumlarda ise oluşan yoksunluk sendromu çok
önemli bir sorun oluşturmaktadır. Son yıllarda özellikle gençlerde ve
mahkumlarda suiistimalinin ve yanlış kullanımının gittikçe arttığı dikkati çekmektedir.
Bu durumlarda kaçınılmaz olunan sonuçlardan ancak ve ancak eğitim ve
farkındalıklarla kurtulabiliriz.

Kaynakça

  • 1-Toprak Mahsulleri Ofisi "2009 Yılı Haşhaş Raporu", Ankara-2010
  • 2-Kayaalp SO: (2012). Opioid Analjezikler. Akılcıl tedavi yönünden Tıbbi Farmakoloji. 13. Baskı 2. Cilt. 826-45.
  • 3-Vadiveli N., Schermer E., Kodumudi G., Berger JM. (2016) The clinical applications of extended-release abuse deterrent opioids. CNS Drugs 30:637-646.
  • 4-Chapman CR., Lipschitz DL., Angst MS., Chou R., Denisco RC., Donaldson GW, et al.(2010). Opioid pharmacotheraphy for chronic non-cancer pain in the United states: a research guideline for developing an evidence base. J. Pain. 11(9):807-29.
  • 5-Jones CM., Mack KA.,Paulozzi IJ.(2010) JAMA, 309(7): 657-9.
  • 6-Marc AS. (2016) Treatment of opioid use disorders. The New England Journol of medicine. 357-67.
  • 7- Walhs SL., Babalonis S. (2016). The abuse potential of prescription opioids in humans closing in on the first century of research. Curr. Top Behav. Neurosci. (Epub ahead of print).
  • 8-Kruger R., Meissner W., Zimmer A (2014). Missuses of opioid analgesics. An internet analysis. 28(5) 473-82.
  • 9-Setty A. (2015). Opioid abuse cause for pause among physicians. News opinion Op-Eds. Maryland heroin and opioid emergency task force.
  • 10- Chou R.,Fanciullo GJ., Fine PG., Adler JA., Ballantyne JC et al. (2009). Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. The J of Pain. 10 (2) 113-30.
  • 11-Reuben J., Strayer MD., Sergey M., Motov MD., Lewis S et al. (2017). Something for pain:Responsible opioid use in emergency medicine. Am J Emerg Med. 35(2):337-341.
  • 12- Olsen JC, Ogarek JL, Goldenberg EJ, Sulo S. (2016). Impact of a chronic pain protocol on emergency department utilization. Acad Emerg Med. Apr;23(4):424–32.
  • 13- Nelson LS, Juurlink DN. (2015). Tramadole and hypoglycemia: one more thing to worry about. JAMA Intern Med. 175(2):194–5.
  • 14- Miller M, Barber CW, Leatherman S, Fonda J, Hermos JA, Cho K, et al. (2015). Prescription opioid duration of action and the risk of unintentional overdose among patients receiving opioid therapy. JAMA Intern Med.175(4):608–15.
  • 15- Ramasubbu C, Gupta A. (2011). Pharmacological treatment of opioid-induced hyperalgesia: a review of the evidence. J Pain Palliat Care Pharmacother. 25(3):219–30.
  • 16- Suzuki M, Tsueda K, Lansing PS et al. Small-dose ketamine enhances morphine-induced analgesia after outpatient surgery. AnesthAnalg 1999; 89: 98–103.
  • 17-Admiraal PV, Knape H, Zegveld C. (1972). Experience with bezitramide and droperidol in the treatment of severe chronic pain. Br J Anaesth. 44(11):1191–6.
  • 18- Sheridan DC., Laurie A., Hendrickson RG., Rongfei F., Kea B et al.(2016). Association of overall opioid prescriptions on adolescent opioid abuse. J Emerg Med. 51(5):485-490.

Opioids, Pain, its Abuse and Missuse

Yıl 2017, Cilt: 39 Sayı: 3, 125 - 129, 06.09.2017
https://doi.org/10.20515/otd.333567

Öz

Opioids, also known as narcotic analgesics,
are the drug groups which are derived from Papaver somniferum, one of the
member of Papaveraceae family. They are commonly used in the treatment of
acute, chronic pains and also cancer pains because of their strong pain killer
effects. However, since opioids have addictive qualities, some problems can
occur on the beginning or during the treatment. Besides their analgesics effects,
opioids can also use as antitussive and antidiarrheal medicines. Unwanted
events can occur based on increasing abuse and misuse of opioids, particularly
strong ones. However, it is very obvious that they should be used in terminal
cancer patients experiencing pain by looking at benefit-harm ratio. Dependence,
hepatitis, HIV infections in the use of this group of drugs and withdrawal
syndromes in cases where it is not used are very important problems. In recent
years, it is noteworthy that abuse and missuse of opioids have increased,
especially in juveniles and prisoners. We can only get through these inevitable
results with education and awareness.

Kaynakça

  • 1-Toprak Mahsulleri Ofisi "2009 Yılı Haşhaş Raporu", Ankara-2010
  • 2-Kayaalp SO: (2012). Opioid Analjezikler. Akılcıl tedavi yönünden Tıbbi Farmakoloji. 13. Baskı 2. Cilt. 826-45.
  • 3-Vadiveli N., Schermer E., Kodumudi G., Berger JM. (2016) The clinical applications of extended-release abuse deterrent opioids. CNS Drugs 30:637-646.
  • 4-Chapman CR., Lipschitz DL., Angst MS., Chou R., Denisco RC., Donaldson GW, et al.(2010). Opioid pharmacotheraphy for chronic non-cancer pain in the United states: a research guideline for developing an evidence base. J. Pain. 11(9):807-29.
  • 5-Jones CM., Mack KA.,Paulozzi IJ.(2010) JAMA, 309(7): 657-9.
  • 6-Marc AS. (2016) Treatment of opioid use disorders. The New England Journol of medicine. 357-67.
  • 7- Walhs SL., Babalonis S. (2016). The abuse potential of prescription opioids in humans closing in on the first century of research. Curr. Top Behav. Neurosci. (Epub ahead of print).
  • 8-Kruger R., Meissner W., Zimmer A (2014). Missuses of opioid analgesics. An internet analysis. 28(5) 473-82.
  • 9-Setty A. (2015). Opioid abuse cause for pause among physicians. News opinion Op-Eds. Maryland heroin and opioid emergency task force.
  • 10- Chou R.,Fanciullo GJ., Fine PG., Adler JA., Ballantyne JC et al. (2009). Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. The J of Pain. 10 (2) 113-30.
  • 11-Reuben J., Strayer MD., Sergey M., Motov MD., Lewis S et al. (2017). Something for pain:Responsible opioid use in emergency medicine. Am J Emerg Med. 35(2):337-341.
  • 12- Olsen JC, Ogarek JL, Goldenberg EJ, Sulo S. (2016). Impact of a chronic pain protocol on emergency department utilization. Acad Emerg Med. Apr;23(4):424–32.
  • 13- Nelson LS, Juurlink DN. (2015). Tramadole and hypoglycemia: one more thing to worry about. JAMA Intern Med. 175(2):194–5.
  • 14- Miller M, Barber CW, Leatherman S, Fonda J, Hermos JA, Cho K, et al. (2015). Prescription opioid duration of action and the risk of unintentional overdose among patients receiving opioid therapy. JAMA Intern Med.175(4):608–15.
  • 15- Ramasubbu C, Gupta A. (2011). Pharmacological treatment of opioid-induced hyperalgesia: a review of the evidence. J Pain Palliat Care Pharmacother. 25(3):219–30.
  • 16- Suzuki M, Tsueda K, Lansing PS et al. Small-dose ketamine enhances morphine-induced analgesia after outpatient surgery. AnesthAnalg 1999; 89: 98–103.
  • 17-Admiraal PV, Knape H, Zegveld C. (1972). Experience with bezitramide and droperidol in the treatment of severe chronic pain. Br J Anaesth. 44(11):1191–6.
  • 18- Sheridan DC., Laurie A., Hendrickson RG., Rongfei F., Kea B et al.(2016). Association of overall opioid prescriptions on adolescent opioid abuse. J Emerg Med. 51(5):485-490.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm DERLEMELER / REVIEWS
Yazarlar

Fatma Sultan Kılıç

Yayımlanma Tarihi 6 Eylül 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 39 Sayı: 3

Kaynak Göster

Vancouver Kılıç FS. Opioidler, Ağrı, Opioidlerin Suistimali ve Yanlış Kullanımı. Osmangazi Tıp Dergisi. 2017;39(3):125-9.


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