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癌症晚期止痛药有哪些?

发布时间:2016-08-17   问大夫  责任编辑:红豆

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癌症在现今的社会是一种常见的绝症,越来越多的人被癌症折磨,与疾病进行着抗争。癌症患者发展到晚期,自身需要承受着很大的痛苦。那么,癌症晚期患者应该怎么缓解疼痛呢?有没有好的止痛药物呢?下面小编就为大家详细介绍一下常见的止痛药物。

癌症晚期止痛药有哪些

第一类是非阿片类药,适用于轻至中度疼痛。这些药一般都是非处方药,可自己在药店买到,疗效肯定,对重度疼痛也有辅助治疗作用。主要包括阿司匹林、扑热息痛、消炎痛、布洛芬、萘普生等药物。这类药一般用起来比较安全,副作用较轻,偶尔可出现胃肠道反应,若与牛奶或抗酸剂同服,或饭后服用可减少其反应。患溃疡病时不用或慎用。另外,偶尔还可见肝肾毒性,影响凝血机制,有上述疾病者慎用。在这些药物中,扑热息痛副作用小,但注意用量不能过大,每天总量不超过6克,再增加剂量不但止痛效果不再增加,而且会出现副作用。若出现副作用可换用其它种非阿片类药物,如副作用持续,就换为阿片类药物,老年人尤其要注意药物的副作用。

第二类是阿片类药物,分弱、强两种。弱阿片类用于轻度至中度疼痛主要包括可待因、曲马朵、强痛定等。强阿片类用于缓解中度至重度疼痛,吗啡为强阿片类的代表药物,另外还有美沙酮、芬太尼等药。

第三类为辅助药物。可用于任何程度疼痛的辅助治疗。该类药虽不是止痛药,但它可和止痛药起到协同增效作用,主要包括抗惊厥药,如卡马西平、苯妥英钠;广泛的临床经验提示,这些药物具有治疗特发性神经痛的作用,如烧灼样疼痛和刺痛;抗抑郁药,如阿米替林,不仅可改善心理状态,而且还具有显著的止痛作用,特别是对烧灼样神经痛;抗焦虑药,如安定,可镇静、催眠;皮质类固醇,如强的松,对神经压迫和脊髓压迫引起的疼痛很有效。这些药物的应用要在医生指导下根据个人不同的病情而定。止痛药多种多样,合理的应用会达到理想的止痛效果,使肿瘤患者消除疼痛。

癌症晚期止痛药的副作用

阿片类药物的常见副作用主要包括:①便秘。几乎所有病人均出现,因此,在开始使用阿片类止痛剂时,就应着手制定一个有规律的通便方案,包括使用轻泻剂和大便松软剂。如番泻叶、麻仁润肠丸等。轻泻剂的用量要因人而异,经数日试用,调到最适量,同时患者本身注意调整饮食结构,多吃一些富含纤维素的食物。

②恶心、呕吐。一般为一过性,有50%以上发生在头34天,可逐渐适应耐受,若吗啡用量由小剂量开始则会减少此反应,必要时服用止吐药对症处理,如胃复安等。

③镇静、嗜睡、意识模糊:一般经35天便可产生耐受性,并恢复意识正常。对此副作用最好的处理办法是减少每次剂量,增加给药次数,同时患者可多饮茶和咖啡类饮料,听听音乐,提高大脑兴奋性,另外要注意嗜睡与吗啡中毒的区别:吗啡中毒表现为昏睡,叫不醒,呼吸减慢,瞳孔缩小呈针尖样,体温下降;而服用吗啡后的嗜睡无上述表现。

④呼吸抑制:虽然很少发生,但却是最令人担心的副作用,因此对有明显呼吸功能障碍的病人要慎用或禁用,而且初次用药者必须在有经验医生指导下进行。在用药过程中,注意观察呼吸的变化,如出现呼吸次数明显减少,不均匀,叹气样呼吸等呼吸抑制的表现,应给予纳洛酮拮抗可马上缓解。若未在医院或者周围无此药,可采取创伤性刺激,如针刺痛穴等,使对阿片需要增加;另外要注意不能单纯吸氧,因为缺氧是对呼吸中枢的一个刺激因素,若这惟一的刺激也消失,则会加重呼吸抑制。

服用癌症晚期止痛药注意事项

1、按阶梯用药:疼痛按程度分级法分成4级,即0级为无痛;Ⅰ级为轻度疼痛,可忍受,能正常生活,睡眠不受干扰;Ⅱ级为中度疼痛,睡眠受到干扰;Ⅲ级为重度疼痛,不能忍受,睡眠受到严重干扰。Ⅰ级轻度疼痛选择非阿片类药物,Ⅱ级疼痛选用弱阿片类药物,Ⅲ级疼痛选用强阿片类药物。

2、坚持口服用药:口服给药是最方便的给药途径,既经济又安全。口服给药应占各种药物给药途径的80%以上。只有在口服给药无效或不适合口服给药的患者,才考虑用肠道外给药的办法。

3、按时给药:止痛药物要在血中维持一定的血浓度才能起到止痛的效果。例如,硫酸吗啡控释片(美菲康)口服后由胃肠道吸收,服后23小时血药浓度达到峰值,持续止痛效果可达12小时。因此,只要早晚各一次就可达到止痛要求。

4、个体化:每个病人对疼痛的耐受程度不同,对止痛药敏感性也不同,个体间存在较大差异。患者应根据实际情况试用,只要达到缓解疼痛的目的,即应视为最佳剂量。达到最佳疗效就应坚持下去。

以上都是常见的一些止痛药物和用药方法,希望对朋友们会有一定的帮助。针对不同程度的疼痛感用不同的药物进行治疗,因为每一种止痛药都会有一定的副作用。癌症患者如果到了晚期一般都需要给患者注射一些,白蛋白主要是可以很好的改善生存质量,延长生存时间。癌症患者承受很大的痛苦,所以一般是要用合适的药物来缓解疼痛。

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