癌痛治療的現(xiàn)狀和挑戰(zhàn) ppt課件

癌痛治療的現(xiàn)狀與挑戰(zhàn)Current situation and challenges of cancer pain management,Availability of opioids for pain management,Availability of opioids* for pain management (2010-2012 average),Availability of opioids for pain management,含有Oxycodone的鎮(zhèn)痛藥物共有28個(gè)品種！,Global Atlas of Palliative Care,Global Atlas of Palliative Care,Global Atlas of Palliative Care,Global Atlas of Palliative Care,Hospice and Palliative Care,Interdisciplinary Team of Hospice,Total Hospital Agencies by Year,Care Providers,Location of Hospice patients at Death,Proportion of Patients by Length of Service in 2013,Who conduct palliative care ?,Who conduct P.C in China?,Under-treatment of cancer pain,2018/4/16,N=3106，38 (six academic and 32 community) institutions,2018/4/16,只有1/3患者的疼痛得到改善，1/5疼痛加重!,Under-treatment of cancer pain,Under-treatment of cancer pain,2018/4/16,Challenges of cancer pain management,Challenges of cancer pain management,Questions and Answers(“奧”視群雄隊(duì)),決定阿片滴定起始劑量的因素是：A. 疼痛強(qiáng)度B. 安全性因素C. 疼痛性質(zhì)D. 患者的止痛目標(biāo),Questions and Answers (十全十“美”隊(duì)),阿片肝臟代謝的第一步為氧化,下述正確的是：經(jīng)3A4通路代謝的產(chǎn)物絕大多數(shù)沒有活性同服經(jīng)2D6通路代謝的藥物可導(dǎo)致阿片鎮(zhèn)痛效果增加 經(jīng)過3A4途徑代謝的藥物包括SSRI類、氟哌啶醇和氯丙嗪等,Different opioids, different metabolisms,Questions and Answers (勇爭“蒂”一隊(duì)),關(guān)于阿片類藥物之間的交叉耐受,錯(cuò)誤的是：A. 阿片類藥物之間都存在交叉耐受B. 交叉耐受是阿片轉(zhuǎn)換時(shí)劑量換算的基礎(chǔ)D. 阿片類藥物之間的交叉耐受是不完全的,Public health model