| Abstract | Osobe starije životne dobi smatramo sve osobe starije od 65 godina. Starenje se definira kao progresivna, o
vremenu ovisna akumulacija promjena na molekularnoj, staničnoj i tkivnoj razini, koja rezultira gubitkom
funkcionalnih jedinica. Zbog toga je ustrajana bol učestalija u toj populaciji i raste primjena opioidnih
analgetika koji su najsnažniji poznati analgetici. Rast propisivanja opioidnih analgetika je briga u mnogim
razvijenim zemljama. Međutim, propisivanje opioidnih analgetika trebalo bi se smatrati prikladnim kao
odgovor na kliničke potrebe osoba starije životne populacije, koje zahtijevaju efektivan olakšanje za
kroničnu tešku bol.
Opioidni analgetici djeluju kao agonisti, parcijalni agonisti i antagonisti μ, κ i δ- opiodinih receptora. Kod
propisivanja opioidnih analgetika važno je dobro procijeniti izvor i intenzitet boli, kako bi se bol što
uspješnije liječila. U radu smo opisali farmakološku aktivnost morfin, kodein, oksikodon, hidromorfon,
fentanil, tramadol, metadon, buprenorfin, tapentadol i problematika njihove primjene kod osoba starije
životne dobi.
Cilj rada bio je ukazati na posljedice neprikladne primjene opioidnih analgetika, do koji nuspojava najčešće
dolazi, kako upravljati nuspojavama ako do njih dođe, kako pristupiti pravilnoj primjeni opioidnih
analgetika kod osoba starije životne dobi i koja je uloga ljekarnika u liječenju boli. U izradi su korišteni
znanstveni radovi iz časopisa dostupnih u bazama podataka Medline, PubMed i Mendeley, te udžbenici i
sva dostupna relevantna literatura. U ovom slučaju vidi se važnost ljekarničke skrbi, kao sve raširenijeg
kocepta, kojom se osigurava prikladna, učinkovita i sigurna uporaba lijekova, te pridonosi povećanju
adherencije pacijenta i poboljšanju kvalitete života. |
| Abstract (english) | Persons who are older than 65 years are considered to be elderly. Aging is defined as a progressive, timedependent
accumulation of changes in molecular, cellular and tissue levels, resulting in loss of functional
units. This is why persistent pain often persist in this population and the use of opioid analgesics is
growing. Opioid analgesics are the most powerful known analgesics. The growth in prescribing opioid
analgesics is a concern in many developed countries. However, the prescribing of opioid analgesics should
be considered appropriate in response to the clinical needs of the elderly population, which require effective
relief for chronic severe pain.
Opioid analgesics act as agonists, partial agonists and antagonists of μ, κ and δ-opiodine receptors. When
prescribing opioid analgesics it is important to evaluate well the source and intensity of the pain in order to
treat pain as effectively as possible. When prescribing opioid analgesics it is important to evaluate well the
source and intensity of the pain in order to treat pain as effectively as possible. In the diploma thesis we
have described the pharmacological activity of morphine, codeine, oxycodone, hydromorphone, fentanyl,
tramadol, methadone, buprenorphine, tapentadol and problems of their use in older persons.
The aim of the study was to point to the consequences of inappropriate use of opioid analgesics, the most
common side effect, how to manage side effects if they appear, how to access the correct application of
opioid analgesics in older persons and the role of a pharmacist in the treatment of pain. Scientific papers
from the journals available in Medline, PubMed, and Mendeley databases, as well as textbooks and all
available relevant literature, have been used. In this case, the importance of pharmacy care, as an
increasingly widespread approach, is demonstrated to ensure the appropriate, effective and safe use of
drugs, and contributes to increasing patient adherence and improving the quality of life. |
