Multimodalni pristup liječenju boli

master's thesis

• Title (english): A multimodal approach to pain management
• Author: Valerija Mihovljanec
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Marijana Zovko Končić (član povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2022-04-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Bol, posebice ona kroničnog trajanja, predstavlja veliki javnozdravstveni problem jer je često
neadekvatno liječena zbog svog kompleksnog mehanizma nastanka i ograničenih farmakoloških
mogućnosti. Suvremena terapija i smjernice za liječenje boli zamjenjuju monomodalne pristupe
liječenja multimodalnim. Multimodalna analgezija podrazumijeva primjenu više lijekova različitog
mehanizma djelovanja koji djeluju na različita mjesta duž nociceptivnog puta. Sinergističko ili
aditivno terapijsko djelovanje pažljivo odabranih lijekova u kombinacijama omogućuju primjenu
lijekova u nižim dozama od pojedinačnih, te bolju podnošljivost i sigurnost, a smanjuje se i potreba
za visokim dozama opioidnih analgetika. Lijekovi koji se koriste u kombinaciji su analgetici i
lijekovi kojima analgezija nije primarna funkcija, a na tržištu postoje i kombinacije fiksnih doza
analgetika. Sve navedene kombinacije imaju veliki potencijal u liječenju boli te je potrebno daljnje
istraživanje multimodalnog pristupa i njegovo korištenje u praksi, kako bi se bol napokon mogla
svrstati u kategoriju uspješno liječenih i/ili uspješno kontroliranih zdravstvenih problema. Neke od
navedenih kombinacija dostupne su i u bezreceptnom režimu izdavanja te se koriste u samoliječenju
akutne boli različitog uzroka, pri čemu važnu ulogu ima ljekarnik. Pravilnom edukacijom pacijenata
i odabirom odgovarajućeg analgetika ljekarnik može doprinijeti učinkovitom ublažavanju boli,
smanjenju pojave štetnih učinaka lijekova i prevenciji razvoja komplikacija neodgovarajuće liječene
boli.

Abstract (english)

Pain, especially that of chronic duration, is a major public health problem because it is often
inadequately treated due to its complex mechanism of occurrence and limited pharmacological
possibilities. Modern therapy and guidelines for pain management are replacing the monomodal
approach to multimodal treatment. Multimodal analgesia involves the administration of multiple
drugs with different mechanisms of action acting at different sites along the nociceptive pathway.
The synergistic or additive therapeutic effect of carefully selected drugs in combination allows the
use of drugs in lower doses than individual, and better tolerability and safety, and reduces the need
for high doses of opioid analgesics. Drugs used in combination are analgesics and drugs for which
analgesia is not the primary function, and there are combinations of fixed doses of analgesics on the
market. All these combinations have great potential in the treatment of pain and further research is
needed on the multimodal approach and its use in practice, in order to better classify it in the category
of successfully treated and / or successfully controlled health problems. Some of these combinations
are also available over-the-counter and are used in the self-treatment of acute pain of various causes,
with the pharmacist playing an important role. Proper education of patients and selection of the
appropriate analgesic pharmacist can contribute to reducing the effectiveness of pain relief, the
occurrence of adverse effects of drugs and prevent the development of complications of
inappropriately treated pain.

• Keywords: multimodalna analgezija; bol; akutna bol; postoperativna bol; nesteroidni protuupalni lijekovi; opioidi; paracetamol; analgetici
• Keywords (english): multimodal analgesia; pain; acute pain; postoperative pain; NSAIDs; opioids; paracetamol; analgesics
• Language: croatian
• URN:NBN: urn:nbn:hr:163:494109
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-05-26 13:23:54