암환자의 기저 통증 조절에 있어 Oxycodone 및 Naloxone 복합제의 사용 적정성 평가
The Drug Use Evaluation of a Fixed-dose Combination with Oxycodone and Naloxone for the Baseline Pain Control in Cancer Patients
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Purpose : There is compelling evidence that the fixed-dose combination with oxycodone and naloxone (Targin PR tab) is useful for the management of baseline pain control for cancer patients. The purpose of the study was to evaluate the appropriate use of Targin PR tab in the cancer-related pain management. Methods : The retrospective study was conducted in cancer patients who were prescribed the Targin PR tab(5/2.5 mg, 10/5 mg, 20/10 mg, 40/20 mg) from January 2016 to August 2016, and who were then reviewed using the self-developed Drug Use Evaluation (DUE) criteria. Results : 86 patients were finally enrolled in the study. The justification of use for the study was with 70 cases (81.4%). The adequacy of the initial dose and usage was noted at 54 cases (62.8%) and 79 cases (91.9%), respectively. The Targin PR tab was prescribed to 32 patients (37.2%) who were contraindicated in the use of this drug. Notably, the drug-related adverse effects were reported in 24 cases (27.9%). It is noted that most of the side effects experienced by participants in this study were from gastrointestinal events, such as constipation. In 72 of the cases (83.7%), the Targin PR tab was prescribed with other drugs, potentially changing its PK/PD profile. The compliance rates of the initial pain evaluation during the patient hospitalization stage were 85 cases (98.8%). However, the appropriate control of breakthrough pain and reevaluation of pain showed in 64 cases (74.4%). In 52 cases (60.5%), the dose or type of drug is effectively modified according to the appropriate pain control guidelines in the cancer patients. Conclusion : The justification of the use indicated in accordance with the medication was considered as highly suitable in this case. However, according to regular pain evaluation, the modification of the dose and the associated formulation were slightly inadequate. These results suggest the need to upgrade the management of the cancer-related-pain to help cancer patients improve their quality of life with the use of this drug therapy.
Abstract
Purpose : There is compelling evidence that the fixed-dose combination with oxycodone and naloxone (Targin PR tab) is useful for the management of baseline pain control for cancer patients. The purpose of the study was to evaluate the appropriate use of Targin PR tab in the cancer-related pain management. Methods : The retrospective study was conducted in cancer patients who were prescribed the Targin PR tab(5/2.5 mg, 10/5 mg, 20/10 mg, 40/20 mg) from January 2016 to August 2016, and who were then reviewed using the self-developed Drug Use Evaluation (DUE) criteria. Results : 86 patients were finally enrolled in the study. The justification of use for the study was with 70 cases (81.4%). The adequacy of the initial dose and usage was noted at 54 cases (62.8%) and 79 cases (91.9%), respectively. The Targin PR tab was prescribed to 32 patients (37.2%) who were contraindicated in the use of this drug. Notably, the drug-related adverse effects were reported in 24 cases (27.9%). It is noted that most of the side effects experienced by participants in this study were from gastrointestinal events, such as constipation. In 72 of the cases (83.7%), the Targin PR tab was prescribed with other drugs, potentially changing its PK/PD profile. The compliance rates of the initial pain evaluation during the patient hospitalization stage were 85 cases (98.8%). However, the appropriate control of breakthrough pain and reevaluation of pain showed in 64 cases (74.4%). In 52 cases (60.5%), the dose or type of drug is effectively modified according to the appropriate pain control guidelines in the cancer patients. Conclusion : The justification of the use indicated in accordance with the medication was considered as highly suitable in this case. However, according to regular pain evaluation, the modification of the dose and the associated formulation were slightly inadequate. These results suggest the need to upgrade the management of the cancer-related-pain to help cancer patients improve their quality of life with the use of this drug therapy.
참고문헌 (28)
- [URL]
- 박소민, "암성 통증 관리 지침에 따른 완화병동의 마약성 진통제 사용 적절성 평가", 병원약사회지, 29(3), pp.281~287 (2012), 한국병원약사회[DOI]
- 김현태, "NCCN 암성 통증 가이드라인에 따른 폐암 환자의 암성 통증 조절", Tuberculosis and Respiratory Diseases, 67(3), pp.221~225 (2009), 대한결핵및호흡기학회
- 박수석, "약물요법", 암성 통증 관리-아편유사제, 2010, pp.53(3), 250~257[DOI]
- Ministry of Health and Welfare, "Cancer pain management guideline", pp.2~43 (2017), National Cancer Center
- "WHO's pain relief ladder" (2017)[URL]
- 박휴정, "노년내과 심포지엄_노인의 흔한 문제 : 만성통증의 관리", 대한내과학회추계학술발표논문집, 85(2), pp.206~207 (2013)
- 김혁, "암성통증의 약물치료", 대한내과학회지, 81(2), pp.185~189 (2011), 대한내과학회
- 조윤숙, "단일 상급종합병원에서 마약성 진통제의 최근 13년간 사용 경향 조사", 약 학 회 지, 58(4), pp.268~276 (2014), 대한약학회
- Park JS, "A survey of nurses'knowledge of pain", J Korean Acad Funda Nurs, 10(1), pp.87~95 (2003)
- [URL]
- [URL]
- [URL]
- [URL]
- [URL]
- [URL]
- [URL]
- Sungkyunkwan University Samsung Changwon Hospital, "02-04-031, Regulation of pain management", ~ (2016)
- [URL]
- 우지연, "악성종양 환자에서의 사구체 여과율 평가법 비교", 병원약사회지, 30(5), pp.439~449 (2013), 한국병원약사회[DOI]
- 식품의약품안전청, "간질환 환자에 대한 의약품 적정사용 정보집", 식품의약품안전청, 15~46 (2012)
- Liukas A, "Plasma concentrations of oral oxycodone are greatly increased in the elderly", Clinical Pharmacology & Therapeutics, 84(4), pp.462~467 (2008)[DOI]
- 박중철, "만성통증의 최신 약물치료", 대한의사협회지, 53(9), pp.815~823 (2010), 대한의사협회
- Caraceni A, "Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC", The Lancet Oncology, 13(2), pp.e58~e68 (2012)[DOI]
- 박지영, "병용금기와 의약품 사용평가", 대한의사협회지, 55(5), pp.484~490 (2012), 대한의사협회[DOI]
- Park JS, "A survey of nurses'knowledge of pain", J Korean Acad Funda Nurs, 10(1), pp.87~95 (2003)
- [URL]
- Portenoy RK, "Treatment of cancer pain", The Lancet, 377, pp.2236~2247 (2011)[DOI]
