药代动力学
医学
咪唑安定
加药
氟哌啶醇
缓和医疗
病入膏肓
重症监护医学
药理学
人口
临床药理学
药效学
药品
内科学
护理部
多巴胺
镇静
环境卫生
作者
L Franken,Brenda C M de Winter,Harriëtte J. van Esch,Lia van Zuylen,Frans P. M. Baar,Dick Tibboel,Ron A. A. Mathôt,Teun van Gelder,Birgit C. P. Koch
标识
DOI:10.1080/17425255.2016.1179281
摘要
A variety of medications are used for symptom control in palliative care, such as morphine, midazolam and haloperidol. The pharmacokinetics of these drugs may be altered in these patients as a result of physiological changes that occur at the end stage of life.This review gives an overview of how the pharmacokinetics in terminally ill patients may differ from the average population and discusses the effect of terminal illness on each of the four pharmacokinetic processes absorption, distribution, metabolism, and elimination. Specific considerations are also given for three commonly prescribed drugs in palliative care: morphine, midazolam and haloperidol).The pharmacokinetics of drugs in terminally ill patients can be complex and limited evidence exists on guided drug use in this population. To improve the quality of life of these patients, more knowledge and more pharmacokinetic/pharmacodynamics studies in terminally ill patients are needed to develop individualised dosing guidelines. Until then knowledge of pharmacokinetics and the physiological changes that occur in the final days of life can provide a base for dosing adjustments that will improve the quality of life of terminally ill patients. As the interaction of drugs with the physiology of dying is complex, pharmacological treatment is probably best assessed in a multi-disciplinary setting and the advice of a pharmacist, or clinical pharmacologist, is highly recommended.
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