Prospects for the use of opioid analgesics in the stages of medical evacuation
- Authors: Miroshnichenko Y.V.1, Shchegolev А.V.1, Shcherba М.P.1, Merkulov А.V.1, Gritsai А.N.1, Povedenok V.А.1
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Affiliations:
- The S.M.Kirov Military Medical Academy
- Issue: Vol 344, No 7 (2023)
- Pages: 70-82
- Section: Военная фармация и медицинская техника
- URL: https://journals.eco-vector.com/0026-9050/article/view/630712
- DOI: https://doi.org/10.52424/00269050_2023_344_7_70
- ID: 630712
Cite item
Abstract
To determine the prospects for the use of injectable forms of opioid analgesics registered in Russia at the stages of medical evacuation, their comparative analysis was carried out according to such key criteria as pharmacological properties, “strategic” and price accessibility, and compliance with the conditions of use. The results of the analysis showed that at present trimeperidine remains the drug of choice for use at the stages of medical evacuation. At the same time, in the near future, it is necessary to carry out work to resume and establish the production of buprenorphine, morphine, and fentanyl in syringe tubes with improved characteristics. In addition, it is necessary to establish interaction between the Ministry of Defense, as well as other power ministries and departments, with federal executive authorities that determine policy in the field of health protection and the functioning of the pharmaceutical industry in terms of determining priority areas for the strategic development of the production of medicines with specified characteristics for the needs of the country’s defense and ensuring its drug independence in the face of possible external economic and political threats and military conflicts of varying intensity.
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About the authors
Yu. V. Miroshnichenko
The S.M.Kirov Military Medical Academy
Author for correspondence.
Email: miryv61@gmail.com
заслуженный работник здравоохранения РФ, профессор, полковник медицинской службы запаса
Russian Federation, Saint PetersburgА. V. Shchegolev
The S.M.Kirov Military Medical Academy
Email: miryv61@gmail.com
заслуженный врач РФ, профессор, полковник медицинской службы
Russian Federation, Saint PetersburgМ. P. Shcherba
The S.M.Kirov Military Medical Academy
Email: miryv61@gmail.com
кандидат фармацевтических наук
Russian Federation, Saint PetersburgА. V. Merkulov
The S.M.Kirov Military Medical Academy
Email: miryv61@gmail.com
кандидат фармацевтических наук, полковник медицинской службы
Russian Federation, Saint PetersburgА. N. Gritsai
The S.M.Kirov Military Medical Academy
Email: miryv61@gmail.com
кандидат медицинских наук, полковник медицинской службы
Russian Federation, Saint PetersburgV. А. Povedenok
The S.M.Kirov Military Medical Academy
Email: miryv61@gmail.com
майор медицинской службы
Russian Federation, Saint PetersburgReferences
- Абузарова Г.Р., Данилова Т.В. Промедол в терапии онкологической боли: не пора ли забыть старый препарат? // Врач. – 2011. – № 12. – С. 75–77.
- Арбух Д.М., Абузарова Г.Р., Алексеева Г.С. Опиоидные анальгетики в терапии болевых синдромов (часть 1) // Вестн. анестезиол. и реаниматол. – 2017. – Т. 14, № 3. – C. 58–67.
- Арбух Д.М., Абузарова Г.Р., Алексеева Г.С. Опиоидные анальгетики в терапии болевых синдромов (часть 2) // Вестн. анестезиол. и реаниматол. – 2017. – Т. 14, № 4. – C. 61–71.
- Панов В.А. Современные методы обезболивания на передовых этапах оказания медицинской помощи в Вооруженных Силах Российской Федерации: Дис. ... канд. мед. наук. – СПб, 2015. – 114 с.
- Bujedo B.M., Santos S.G., Azpiazu A.U. A review of epidural and intrathecal opioids used in the management of postoperative pain // J. Opioid Manag. – 2012. – Vol. 8, N 3. – P. 177–192.
- Bullingham R.E., McQuay H.J., Moore A., Bennett M.R. Buprenorphine kinetics // Clin. Pharmacol. Ther. – 1980. – Vol. 28, N 5. – P. 667–672. doi: 10.1038/clpt.1980.219
- Calvey T.N., Williams N.E. Analgesic Drugs. Principles and Practice of Pharmacology for Anaesthetists / 4th Ed. Blackwell Science. – Oxford, 2001. – P. 196–228.
- Davis M.P., Walsh D. Methadone for relief of cancer pain: a review of pharmacokinetics, pharmacodynamics, drug interactions and protocols of administration // Support Care Cancer. – 2001. – Vol. 9. – P. 73–83.
- Duthie D.J., McLaren A.D., Nimmo W.S. Pharmacokinetics of fentanyl during constant rate i.v. infusion for the relief of pain after surgery // Br. J. Anaesth. – 1986. – Vol. 58, N 9. – P. 950–956. doi: 10.1093/bja/58.9.950
- Erstad B.L., Meeks M.L., Chow H.H. et al. Site-specific pharmacokinetics and pharmacodynamics of intramuscular meperidine in elderly postoperative patients // Ann. Pharmacother. – 1997. – Vol. 31, N 1. – P. 23–28. doi: 10.1177/106002809703100102
- Farshchi A., Ghiasi G. Comparison the analgesic effects of single dose administration of tramadol or piroxicam on postoperative pain after cesarean delivery // Acta Med. Iran. – 2010. – Vol. 48, N 3. – P. 148–153.
- Ghosh A., Berger A. Opioids, adjuvants, and interventional options for pain management of symptomatic metastases // Ann. Palliat. Med. – 2014. – Vol. 3, N 3. – P. 172–179.
- Hutton P., Cooper G.M., James F.M. et al. Opioid Analgesics. Fundamental Principles and Practice of Anaesthesia. – Martin Dunits Ltd, 2002. – P. 621–626.
- Johnson R.E., Fudala P.J., Payne R. Buprenorphine: considerations for pain management // J. Pain. Symptom. Manage. – 2005. – Vol. 29, N 3. – P. 297–326. doi: 10.1016/j.jpain symman.2004.07.005
- Kanowitz A. Dunn T.M., Kanowitz E.M. et al. Safety and effectiveness of fentanyl administration for prehospital pain management // Prehosp. Emerg. Care. – 2006. – Vol. 10, N 1. – P. 1–7.
- Khan M.I., Walsh D., Brito-Dellan N. Opioid and adjuvant analgesics: compared and contrasted // Am. J. Hosp. Palliat. Care. – 2011. – Vol. 28, N 5. – P. 378–378.
- Mather L.E., Lindop M.J., Tucker G.T., Pflug A.E. Pethidine revisited: plasma concentrations and effects after intramuscular injection // Br. J. Anaesth. – 1975. – Vol. 47, N 12. – P. 1269–1275. doi: 10.1093/bja/47.12.1269
- Melzack R. Pain – an overview // Acta Anaesthesiol. Scand. – 1999. – Vol. 43, N 9. – P. 880–884.
- National Center for Biotechnology Information. PubChem Compound Summary for CID 3345, Fentanyl. https://pubchem. ncbi.nlm. nih.gov/compound/Fentanyl. Accessed Mar. 10, 2023
- Panagiotou I., Mystakidou K. Intranasal fentanyl: from pharmacokinetics and bioavailability to current treatment applications // Expert Rev. Anticancer Ther. – 2010. – Vol. 10, N 7. – P. 1009–1021. doi: 10.1586/era.10.77
- Pande A.C., Pyke R.E., Greiner M. et al. Analgesic efficacy of enadoline versus placebo or morphine in postsurgical pain // Clin. Neuropharmacol. – 1996. – Vol. 19, N 5. – P. 451–456.
- Peng Ph.W.H., Sandler A.N. A Review of the Use of Fentanyl Analgesia in the Management of Acute Pain in Adults // Anesthesiology. – 1999. – Vol. 90. – P. 576–599.
- Schlick K.H., Hemmen T.M., Lyden P.D. Seizures and Meperidine: Overstated and Underutilized // Ther. Hypothermia Temp. Manag. – 2015. – Vol. 5, N 4. – P. 223–227. doi: 10.1089/ther.2015.0013
- Strain E.C., Walsh S.L., Bigelow G.E. Blockade of hydromorphone effects by buprenorphine/naloxone and buprenorphine // Psychopharmacology (Berl). – 2002. – Vol. 159, N 2. – P. 161–166.
- Tarmey N.T., Park C.L., Aldington D. et al. Acute pain management on overseas operations: UK Military Guidelines // MCIF. – 2014. – N 4. – P. 40–43.
- TCCC Guidelines for Medical Personnel. 1 August 2019. [Internet] [Place unknown]. deployedmedicine.com/market/31/content/40.[cited 2019 Nov 23]. Available from: https://books.allogy.com/web/tenant/8/books/b729b76a-1a34-4bf7-b76b-66bb2072b2a7/
- Wedmore I.S., Butler F.K.Jr. Battlefield Analgesia in Tactical Combat Casualty Care // Wilderness Environ Med. – 2017. – Vol. 28, N 2S. – P. S109–S116.
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