목적: 경구 oxycodone/naloxone 복합제는 아편유사제에 의해 유발되는 변비를 완화시키거나 예방하는 목적으로 사용되고 있다. Naloxone에 의해 oxycodone의 진통 효과가 상쇄되거나 금단증상이 나타...
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https://www.riss.kr/link?id=A103289184
김정훈 (경상대학교) ; 송하나 (경상대학교) ; 이경원 (경상대학교) ; 강정훈 (경상대학교) ; Kim, Jung Hoon ; Song, Haana ; Lee, Gyeong-Won ; Kang, Jung Hun
2017
Korean
날록손 ; 옥시코돈/날론속 복합제 ; 마약 금단 증상 ; 아편유사제
KCI등재
학술저널
131-135(5쪽)
1
0
상세조회0
다운로드국문 초록 (Abstract)
목적: 경구 oxycodone/naloxone 복합제는 아편유사제에 의해 유발되는 변비를 완화시키거나 예방하는 목적으로 사용되고 있다. Naloxone에 의해 oxycodone의 진통 효과가 상쇄되거나 금단증상이 나타...
목적: 경구 oxycodone/naloxone 복합제는 아편유사제에 의해 유발되는 변비를 완화시키거나 예방하는 목적으로 사용되고 있다. Naloxone에 의해 oxycodone의 진통 효과가 상쇄되거나 금단증상이 나타난다는 보고는 거의 없었으나 저자는 실제 임상에서 몇몇 금단증상 예를 경험하였기에 이 환자들에 대한 조사 연구를 수행하였다. 방법: 2012년 1월 1일부터 2016년 12월 31일까지 경남 지역 암센터에 방문했던 진행성 암환자들로 oxycodone/naloxone extended-release tablets를 투약 받고 마약 금단증상이 나타났던 환자들의 의무기록을 후향적으로 조사하였다. 결과: 연구 기간 중 경구 oxycodone/naloxone을 처방 받은 1,641명의 암 환자 중, 총 10예(0.6%) 에서 마약 금단 증상을 겪었다. 금단증상 관련 통증 강도의 변화는 oxycodone/naloxone 투여 전 NRS 3에서 평균 NRS 6점으로 증가하였다. 금단증상 중 오한이 10예 중 7예에서 나타나 가장 많이 나타난 증상이었으며 그 외에 식은땀, 전신 쇠약감, 근육경련, 복부경련(각 5예), 불안(4예), 열, 어지럼증, 의식혼란, 하품(각 2예)의 순으로 빈번하게 관찰되었다. 결론: Oxycodone/naloxone extended-release 복합제에 의한 마약 금단증상은 흔하지는 않아도 적은 수의 환자에서라도 나타날 수 있다. 향후 이에 대한 다기관, 전향적 연구가 필요하다.
다국어 초록 (Multilingual Abstract)
Purpose: Oral naloxone is combined with oxycodone to alleviate or prevent opioid-induced constipation in cancer pain patients. However, there is still concern that oral naloxone may precipitate opioid withdrawal symptoms in patients on opioids. We ret...
Purpose: Oral naloxone is combined with oxycodone to alleviate or prevent opioid-induced constipation in cancer pain patients. However, there is still concern that oral naloxone may precipitate opioid withdrawal symptoms in patients on opioids. We retrospectively investigated clinical characteristics of cancer patients who experienced opioid withdrawal symptoms. Methods: We reviewed medical records of all patients who were prescribed with oral oxycodone/naloxone at a tertiary cancer center from January 1, 2012 through December 31, 2016. Eligible patients were screened based on demographics, opioid and naloxone dosages, clinical manifestation and pain intensity. Results: Among a total of 1,641 patients, 10 patients were selected. Seven patients were male, and the average age was 68.1 years. The median dose of naloxone that induced withdrawal symptoms was 20 mg. Most common withdrawal symptom was shivering (seven patients) followed by cold sweating (five), and muscle twitching (five). Other symptoms included restlessness, fever, dizziness, and yawning. Pain was exacerbated from the median intensity of numeric rating scale (NRS) 3 to NRS 6. Conclusion: Opioid withdrawal symptoms may occur when switching to oral oxycodone/naloxone for cancer patients who have been treated with other strong opioids. A prospective, multicenter study on this issue should be conducted in future.
참고문헌 (Reference)
1 김명자, "변비에 아편양제제 길항제의 유용성" 한국호스피스완화의료학회 4 (4): 113-121, 2001
2 Latasch L, "Treament of morphine-induced constipation with oral naloxone" 46 : 191-194, 1997
3 Leppert W, "Role of oxycodone and oxycodone/naloxone in cancer pain management" 62 : 578-591, 2010
4 Wilcock A, "Prolonged-release naloxone can cause systemic opioid withdrawal" 13 : 1001-, 2009
5 van den Beuken-van Everdingen MH, "Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years" 18 : 1437-1449, 2007
6 Wong A, "Oxycodone/naloxone preparation can cause acute withdrawal symptoms when misused parenterally or taken orally" 53 : 815-818, 2015
7 Bell T, "Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey" 5 : 137-144, 2009
8 Rehni AK, "Opioid withdrawal syndrome:emerging concepts and novel therapeutic targets" 12 : 112-125, 2013
9 Kang JH, "Opioid withdrawal syndrome after treatment with low-dose extended-release oxycodone and naloxone in a gastric cancer patient with portal vein thrombosis" 46 : e15-e17, 2013
10 Liu M, "Low-dose oral naloxone reverses opioid-induced constipation and analgesia" 23 : 48-53, 2002
1 김명자, "변비에 아편양제제 길항제의 유용성" 한국호스피스완화의료학회 4 (4): 113-121, 2001
2 Latasch L, "Treament of morphine-induced constipation with oral naloxone" 46 : 191-194, 1997
3 Leppert W, "Role of oxycodone and oxycodone/naloxone in cancer pain management" 62 : 578-591, 2010
4 Wilcock A, "Prolonged-release naloxone can cause systemic opioid withdrawal" 13 : 1001-, 2009
5 van den Beuken-van Everdingen MH, "Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years" 18 : 1437-1449, 2007
6 Wong A, "Oxycodone/naloxone preparation can cause acute withdrawal symptoms when misused parenterally or taken orally" 53 : 815-818, 2015
7 Bell T, "Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey" 5 : 137-144, 2009
8 Rehni AK, "Opioid withdrawal syndrome:emerging concepts and novel therapeutic targets" 12 : 112-125, 2013
9 Kang JH, "Opioid withdrawal syndrome after treatment with low-dose extended-release oxycodone and naloxone in a gastric cancer patient with portal vein thrombosis" 46 : e15-e17, 2013
10 Liu M, "Low-dose oral naloxone reverses opioid-induced constipation and analgesia" 23 : 48-53, 2002
11 Smith K, "Low absolute bioavailability of oral naloxone in healthy subjects" 50 : 360-367, 2012
12 Pond SM, "First-pass elimination. Basic concepts and clinical consequences" 9 : 1-25, 1984
13 Lowenstein O, "Combined prolonged-release oxycodone and naloxone improves bowel function in patients receiving opioids for moderate-to-severe non-malignant chronic pain: a randomised controlled trial" 10 : 531-543, 2009
14 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2014" 대한암학회 49 (49): 292-305, 2017
15 Ahmedzai SH, "A randomized, double-blind, active-controlled, double-dummy, parallel-group study to determine the safety and efficacy of oxycodone/naloxone prolonged-release tablets in patients with moderate/severe, chronic cancer pain" 26 : 50-60, 2012
임종돌봄에 대한 교육의 필요성: 2개 대학병원의 인턴을 대상으로 예비 분석
학술지 이력
연월일 | 이력구분 | 이력상세 | 등재구분 |
---|---|---|---|
2027 | 평가예정 | 재인증평가 신청대상 (재인증) | |
2021-03-01 | 학술지명변경 | 한글명 : 한국호스피스완화의료학회지 -> Journal of Hospice and Palliative Care외국어명 : The Korean Journal of Hospice and Palliative Care -> Journal of Hospice and Palliative Care | |
2021-01-01 | 평가 | 등재학술지 유지 (재인증) | |
2018-01-01 | 평가 | 등재학술지 유지 (등재유지) | |
2015-01-01 | 평가 | 등재학술지 유지 (등재유지) | |
2011-01-01 | 평가 | 등재학술지 선정 (등재후보2차) | |
2010-01-01 | 평가 | 등재후보 1차 PASS (등재후보1차) | |
2008-01-01 | 평가 | 등재후보학술지 선정 (신규평가) |
학술지 인용정보
기준연도 | WOS-KCI 통합IF(2년) | KCIF(2년) | KCIF(3년) |
---|---|---|---|
2016 | 0.88 | 0.88 | 1.13 |
KCIF(4년) | KCIF(5년) | 중심성지수(3년) | 즉시성지수 |
0.99 | 0.98 | 1.534 | 0.13 |