Kompendium der medikamentösen Schmerztherapie: Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten
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| Beteilige Person: | |
|---|---|
| Format: | Buch |
| Sprache: | Deutsch |
| Veröffentlicht: |
Wien
Springer
2012
|
| Ausgabe: | 5. Aufl. |
| Schlagwörter: | |
| Links: | http://deposit.dnb.de/cgi-bin/dokserv?id=4017173&prov=M&dok_var=1&dok_ext=htm http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025180105&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| Umfang: | XV, 145 S. graph. Darst. |
| ISBN: | 3709112818 9783709112816 |
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Datensatz im Suchindex
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| adam_text | Titel: Kompendium der medikamentösen Schmerztherapie
Autor: Beubler, Eckhard
Jahr: 2012
IX
Inhaltsverzeichnis
1 Der Schmerz......................................................................................................................................................1
1.1 Epidemiologie von Schmerzen....................................................................................................................2
1.2 Versuch einer Einteilung................................................................................................................................2
1.2.1 Nozizeptorschmerzen........................................................................................................................................3
1.2.2 Neuropathische Schmerzen..............................................................................................................................3
1.2.3 Nicht somatisch bedingte Schmerzen..........................................................................................................3
1.3 Komorbidität Depression ..............................................................................................................................4
1.4 Positive Bedeutung des Schmerzes..........................................................................................................4
1.5 Negative Folgen des Schmerzes..................................................................................................................4
1.6 Schmerzgedächtnis..........................................................................................................................................5
1.7 Wind-up-Phänomen..........................................................................................................................................5
1.8 Schmerz und mythische Auslegungen....................................................................................................5
1.9 Schmerzmessung..............................................................................................................................................6
1.10 Prinzipien der Schmerztherapie..................................................................................................................6
Literatur............................................................................................................................................................8
2 DerWHO-Stufenplan..................................................................................................................................9
2.1 Inhalte bei Beschlussfassung........................................................................................................................10
2.2 Entwicklung bis heute - 30 Jahre später................................................................................................11
2.3 Rechtsgrundsätze..............................................................................................................................................12
3 Arzneimittel in der Schmerztherapie..............................................................................................13
3.1 Arzneistoffe..........................................................................................................................................................15
3.2 Arzneiformen........................................................................................................................................................15
4 Schmerztherapie mit Nicht-Opioiden............................................................................................17
4.1 Arzneimittelgruppen........................................................................................................................................18
4.2 Nomenklatur und Einteilung........................................................................................................................18
4.3 Die Cydooxygenase..........................................................................................................................................19
4.4 Die COX-lsoenzyme..........................................................................................................................................20
4.4.1 COX-2-Hemmer....................................................................................................................................................20
4.4.2 Empfehlungen der »European Medicines Agency«..................................................................................21
4.5 Abhängigkeitspotential der Nicht-Opioid Analgetika......................................................................21
4.6 Arzneimittelwechselwirkungen mit Nicht-Opioid Analgetika......................................................22
4.6.1 Antikoagulantien..................................................................................................................................................22
4.6.2 Andere Interaktionen..........................................................................................................................................22
4.7 Nichtsaure, antipyretische Analgetika......................................................................................................22
4.7.1 Paracetamol............................................................................................................................................................22
4.7.2 Metamizol................................................................................................................................................................25
4.8 Nicht-Opioidanalgetika ohne antipyretische und antiphlogistische Wirkung......................25
4.8.1 Übersicht..................................................................................................................................................................25
X
4.8.2 Flupirtin....................................................................................................................................................................25
4.9 Saure antiphlogistische, antipyretische Analgetika (NSAR)..........................................................26
4.9.1 Topische Anwendung von NSAR....................................................................................................................31
4.9.2 Acetylsalicylsäure..................................................................................................................................................31
4.9.3 Arylessigsäurederivate........................................................................................................................................33
4.9.4 Arylpropionsäuren..............................................................................................................................................33
4.9.5 Heterozyklische Ketoenolsäuren....................................................................................................................34
4.10 Selektive COX-2-lnhibitoren..........................................................................................................................35
4.10.1 Celecoxib................................................................................................................................................................35
4.10.2 Parecoxib................................................................................................................................................................36
4.10.3 Etoricoxib................................................................................................................................................................37
4.10.4 Nebenwirkungen der selektiven COX-2-lnhibitoren................................................................................37
4.10.5 Wechselwirkungen mit anderen Arzneimitteln........................................................................................38
4.11 Intravenöse Gabe von Nicht-Opioiden....................................................................................................38
Literatur.............................................................................. 39
5 Schmerztherapie mit Opioiden..........................................................................................................41
5.1 Opioide - Eine pharmakologische Besonderheit................................................................................43
5.2 Zum Aufschrei der WHO..................................................................................................................................43
5.3 Ursachen für die therapeutische Zurückhaltung mit Opioiden............................................43
5.4 Kombinationen....................................................................................................................................................46
5.5 Schwangerschaft und Stillperiode............................................................................................................46
5.6 Abhängigkeitspotential..................................................................................................................................47
5.7 Schmerztherapie bei Opiatabhängigen..................................................................................................47
5.8 Prinzipien der Therapie mit Opioiden......................................................................................................48
5.8.1 Kritik am WHO-Stufenplan................................................................................................................................48
5.8.2 Akute Schmerzen..................................................................................................................................................49
5.8.3 Chronische Schmerzen......................................................................................................................................50
5.8.4 Substanzen............................................................................................................................................................50
5.8.5 Durchbruchschmerzen......................................................................................................................................51
5.9 Pharmakologische Eigenschaften der Opioide....................................................................................52
5.9.1 Die wichtigsten zentralen Wirkungen der Opioide..................................................................................52
5.9.2 Die wichtigsten peripheren Wirkungen der Opioide..............................................................................53
5.10 Applikationsarten für Opioide....................................................................................................................53
5.10.1 Perorale Verabreichung......................................................................................................................................53
5.10.2 Rektale Verabreichung........................................................................................................................................54
5.10.3 Transdermale Verabreichung............................................................................................................................55
5.10.4 Topische Verabreichung....................................................................................................................................55
5.10.5 Invasive Verabreichungsformen......................................................................................................................55
5.11 Dosis, Arzneiform und Dosisintervall........................................................................................................58
5.12 Management der Opioidnebenwirkungen............................................................................................59
5.12.1 Atemdepression....................................................................................................................................................59
5.12.2 Kreislaufdepression..............................................................................................................................................60
5.12.3 Übelkeit und Erbrechen......................................................................................................................................60
Inhaltsverzeichnis
XI
5.12.4 Sedierung................................................................................................................................................................60
5.12.5 Obstipation............................................................................................................................................................60
5.12.6 Juckreiz....................................................................................................................................................................61
5.12.7 Sehstörungen........................................................................................................................................................61
5.12.8 Hyperalgesie..........................................................................................................................................................61
5.12.9 Abhängigkeit bzw. Sucht..................................................................................................................................61
5.12.10 Das Serotoninsyndrom......................................................................................................................................62
5.12.11 Therapie des Serotoninsyndroms..................................................................................................................62
5.13 Opioidrotation....................................................................................................................................................62
5.14 Nomenklatur und Einteilung der Opioide..............................................................................................63
5.15 Mittelstarke Opioid-Analgetika..................................................................................................................63
5.15.1 Tramadol..................................................................................................................................................................63
5.15.2 Tramadol plus Paracetamol..............................................................................................................................65
5.15.3 Codein......................................................................................................................................................................66
5.15.4 Dihydrocodein......................................................................................................................................................67
5.15.5 Tapentadol..............................................................................................................................................................67
5.16 Starke Opioide....................................................................................................................................................68
5.16.1 Pethidin....................................................................................................................................................................68
5.16.2 Tilidin........................................................................................................................................................................70
5.16.3 Piritramid................................................................................................................................................................70
5.16.4 Morphin..................................................................................................................................................................71
5.16.5 Nicomorphin..........................................................................................................................................................73
5.16.6 Hydromorphon......................................................................................................................................................73
5.16.7 Oxycodon................................................................................................................................................................74
5.16.8 Oxycodon plus Naloxon....................................................................................................................................74
5.16.9 Methadon................................................................................................................................................................74
5.17 Sehr starke Opioid-Analgetika....................................................................................................................75
5.17.1 Fentanyl....................................................................................................................................................................75
5.17.2 Sufentanil, Alfentanil, Remifentanil................................................................................................................78
5.18 Opioid-Agonist-Antagonisten......................................................................................................................79
5.18.1 Buprenorphin........................................................................................................................................................79
5.18.2 Buprenorphin-Pflaster........................................................................................................................................80
5.18.3 Nalbuphin................................................................................................................................................................81
5.19 Opioid-Antagonisten......................................................................................................................................82
5.19.1 Naloxon....................................................................................................................................................................82
5.19.2 Naltrexone..............................................................................................................................................................82
5.19.3 Methylnaltrexone ................................................................................................................................................82
Literatur.............................................................................. 83
6 Schmerztherapie mit Nicht-Analgetika......................................................................................85
6.1 Antidepressiva..................................................................................................................................................86
6.2 Antikonvulsiva..................................................................................................................................................88
6.3 Neuroleptika......................................................................................................................................................88
6.4 Tranquiliantien und Muskelrelaxantien................................................................................................89
XII
Inhaltsverzeichnis
6.5 Glucocorticoids................................................................................................................................................89
6.6 Antiarrhythmika................................................................................................................................................90
6.7 Lokalanästhetika..............................................................................................................................................90
6.7.1 Lidocain-Pflaster..................................................................................................................................................91
6.7.2 Tolperison..............................................................................................................................................................91
6.8 Clonidin................................................................................................................................................................91
6.9 Triptane................................................................................................................................................................91
6.10 Calcitonin............................................................................................................................................................92
6.11 Bisphosphonate................................................................................................................................................93
6.12 Ketamin................................................................................................................................................................93
6.13 Cannabinoide....................................................................................................................................................94
6.14 Capsaicin..............................................................................................................................................................94
6.15 Benzydamin........................................................................................................................................................94
6.16 Ziconotid..............................................................................................................................................................95
6.17 Antirheumatika................................................................................................................................................95
6.17.1 DMARDs................................................................................................................................................................95
6.17.2 Biologicals............................................................................................................................................................96
Literatur........................................................................................................................................................98
7 Auswahl des richtigen Analgetikums............................................................................................99
8 Schmerztherapie in Schwangerschaft und Stillzeit............................................................101
8.1 Besonderheiten................................................................................................................................................102
8.2 Substanzen..........................................................................................................................................................102
8.2.1 Paracetamol..........................................................................................................................................................102
8.2.2 Acetylsalicylsäure................................................................................................................................................102
8.2.3 Metamizol..............................................................................................................................................................103
8.2.4 Kombinationen....................................................................................................................................................103
8.2.5 Nicht steroidale Antirheumatika (NSAR)....................................................................................................104
8.2.6 Opioide..................................................................................................................................................................105
8.2.7 Spezielle Migränemittel....................................................................................................................................106
8.3 Zusammenfassung..........................................................................................................................................107
Literatur........................................................................................................................................................107
9 Schmerztherapie bei Kindern............................................................................................................109
9.1 Allgemeine Gesichtspunkte........................................................................................................................110
9.2 Substanzgruppen............................................................................................................................................110
9.3 Arzneiformen im Kindesalter......................................................................................................................111
9.4 Prinzipien der Schmerztherapie bei Kindern......................................................................................111
9.5 Schmerztherapie mit Nicht-Opioiden bei Kindern..........................................................................112
9.5.1 Nicht saure antipyretische Analgetika........................................................................................................112
9.5.2 Saure, antiphlogistische, antipyretische Analgetika (NSAR)................................................................113
9.6 Opioide für Kinder............................................................................................................................................113
9.6.1 Mittelstarke Opioide..........................................................................................................................................113
XIII
Inhaltsverzeichnis
9.6.2 Stark wirksame Opioide, für Kinder....................................................... 114
9.6.3 Besonderheiten der Opioidverabreichung in der Kinderschmerztherapie.................. 114
9.6.4 Nebenwirkungen der Opioide im Kindesalter...................... .............................................115
9.7 Schmerztherapie mit Nicht-Analgetika bei Kindern........................................................................116
9.8 Patienten-kontrollierte Analgesie (PCA) bei Kindern......................................................................116
Literatur........................................................................................................................................................117
I o Schmerztherapie beim älteren Menschen................................................................................119
10.1 Multimorbidität und Multilokalität..........................................................................................................120
10.2 Veränderte Pharmakinetik im Alter........................................................................................................120
10.3 Praktische Hinweise zum Analgetika-Einsatz bei alten Menschen............................................121
10.3.1 Galenik....................................................................................................................................................................121
10.3.2 Dosierung..............................................................................................................................................................121
10.3.3 NSAR........................................................................................................................................................................121
10.3.4 Opioide..................................................................................................................................................................122
10.4 Neuropathische Schmerzen........................................................................................................................123
Literatur........................................................................................................................................................123
II Verschreibung und Rezeptur starker Analgetika................................................................125
11.1 Rezeptur starker Analgetika in Österreich............................................................................................126
11.2 Rezeptur starker Analgetika in der Schweiz........................................................................................127
11.3 Rezeptur starker Analgetika in Deutschland......................................................................................127
11.3.1 Betäubungsmittel-Rezepte............................................................................................................................128
11.3.2 Angaben auf dem BtM-Rezept......................................................................................................................128
11.3.3 Verschreibungs-Höchstmengen....................................................................................................................128
11.3.4 Ausnahmeregelungen......................................................................................................................................129
11.3.5 Notfall-Verschreibung......................................................................................................................................129
11.3.6 Abgabe der Betäubungsmittel durch den Apotheker..........................................................................130
11.3.7 Verordnung im stationären Bereich............................................................................................................130
11.3.8 Grenzüberschreitender Reiseverkehr..........................................................................................................130
Glossar................................................................................................................................................................133
Literatur..............................................................................................................................................................139
Wichtige Adressen......................................................................................................................................141
Stichwortverzeichnis................................................................................................................................143
|
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| discipline | Medizin |
| edition | 5. Aufl. |
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| illustrated | Illustrated |
| indexdate | 2024-12-20T16:12:35Z |
| institution | BVB |
| isbn | 3709112818 9783709112816 |
| language | German |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-025180105 |
| oclc_num | 802724704 |
| open_access_boolean | |
| owner | DE-355 DE-BY-UBR DE-19 DE-BY-UBM |
| owner_facet | DE-355 DE-BY-UBR DE-19 DE-BY-UBM |
| physical | XV, 145 S. graph. Darst. |
| publishDate | 2012 |
| publishDateSearch | 2012 |
| publishDateSort | 2012 |
| publisher | Springer |
| record_format | marc |
| spellingShingle | Beubler, Eckhard 1945- Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten Pain - drug therapy Analgesics, Non-Narcotic - therapeutic use Narcotics - therapeutic use Pharmakotherapie (DE-588)4076066-2 gnd Analgetikum (DE-588)4001848-9 gnd Schmerztherapie (DE-588)4179800-4 gnd |
| subject_GND | (DE-588)4076066-2 (DE-588)4001848-9 (DE-588)4179800-4 |
| title | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten |
| title_auth | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten |
| title_exact_search | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten |
| title_full | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten Eckhard Beubler |
| title_fullStr | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten Eckhard Beubler |
| title_full_unstemmed | Kompendium der medikamentösen Schmerztherapie Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten Eckhard Beubler |
| title_short | Kompendium der medikamentösen Schmerztherapie |
| title_sort | kompendium der medikamentosen schmerztherapie wirkungen nebenwirkungen und kombinationsmoglichkeiten |
| title_sub | Wirkungen, Nebenwirkungen und Kombinationsmöglichkeiten |
| topic | Pain - drug therapy Analgesics, Non-Narcotic - therapeutic use Narcotics - therapeutic use Pharmakotherapie (DE-588)4076066-2 gnd Analgetikum (DE-588)4001848-9 gnd Schmerztherapie (DE-588)4179800-4 gnd |
| topic_facet | Pain - drug therapy Analgesics, Non-Narcotic - therapeutic use Narcotics - therapeutic use Pharmakotherapie Analgetikum Schmerztherapie |
| url | http://deposit.dnb.de/cgi-bin/dokserv?id=4017173&prov=M&dok_var=1&dok_ext=htm http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025180105&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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