MEDIX, God. 20 Br. 113/114  •  Pregledni članak  •  Palijativna medicina HR ENG

Palijativna skrb i liječenje boliPalliative care and treatment of pain

Marko Jukić

Palijativna medicina skrbi o teško bolesnima koje se ne može izliječiti. Skrbi o bolesnicima s progredirajućim nemalignim bolestima (npr. KOPB, neurološke bolesti), bolesnicima s karcinomskom bolešću te o bolesnicima u terminalnoj fazi života. Bol je najčešći simptom koji treba ublažiti ili ukloniti da bi se poboljšala kvaliteta života bolesnika i njegove obitelji. Farmakoterapija je temelj liječenja boli. Osim farmakoterapije moraju se primjenjivati i nefarmakološke metode i postupci liječenja boli. Za liječenje boli primjenjuju se nesteroidni antireumatici, neopioidni analgetici, koksibi, opioidi i pomoćni analgetici (antikonvulzivi i antidepresivi). Pri primjeni analgetika potrebno je voditi računa o zdravstvenom stanju bolesnika, farmakokinetici i farmakodinamici lijekova te interakcijama i nuspojavama lijekova. Kombinacijom lijekova u nižim dozama, onih koji imaju različit mehanizam djelovanja moguće je uspješnije liječiti bol i smanjiti učestalost nuspojava. Nuspojave treba prevenirati (npr. začep stolice, povraćanje) i liječiti pa time i olakšati zdravstveno stanje bolesnika. 

Ključne riječi:
bol, liječenje, palijativna medicina

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 20 Br. 113/114

Palliative medicine takes care of terminally ill patients who cannot be cured. It cares for patients with progressive non-malignant diseases (e.g. COPD, neurological diseases), patients with cancer, and patients in the terminal stage of life. Pain is the most common symptom that needs to be reduced or eliminated in order to improve the quality of life of patients and their families. Pharmacotherapy is the basis for the treatment of pain. In addition to the pharmacotherapy, non-pharmacological methods and procedures for the treatment of pain must be applied. For the treatment of pain, non-steroidal antirheumatics, non-opioid analgesics, coxibs, opioids and additional analgesics (anticonvulsants and antidepressants) are applied. It is necessary to take into account the health status of patients, the pharmacokinetics and pharmacodynamics of drugs, drug interactions and side effects when administering analgesics. Using a combination of drugs in lower doses, those having a different mechanism of action, pain can successfully be treated and the incidence of side effects reduced. Side effects should be prevented (e.g. stool blockage, vomiting) and treated, thus facilitating the patients’ health condition. 

Key words:
pain; palliative medicine; treatment