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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Oral morphine drops for prompt relief of breathlessness in patients with advanced cancer-a randomized, double blinded, crossover trial of morphine sulfate oral drops vs. morphine hydrochloride drops with ethanol (red morphine drops)
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Oral morphine drops for prompt relief of breathlessness in patients with advanced cancer-a randomized, double blinded, crossover trial of morphine sulfate oral drops vs. morphine hydrochloride drops with ethanol (red morphine drops)

机译：口服吗啡滴下患者提前缓解癌症的呼吸困难 - 一种随机，双盲，交叉反射的吗啡硫酸盐口腔滴与吗啡盐酸滴水（红色吗啡滴）

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Purpose Episodic breathlessness is frequent in palliative cancer patients. Opioids are the only pharmacological agents with sufficient evidence in treatment. In Denmark, the main recommendation is red morphine drops (RMD), an off-label solution of morphine, ethanol, and red color (cochenille) described since 1893 (Pharmacopoea Danica). In 2015, the Danish Medicines Agency increased focus on off-label medicines and recommended registered morphine drops without ethanol instead. However, our palliative patients told us that RMD was better. For that reason, we conducted a clinical trial to clarify any perceived difference between the two types of drops. Methods We conducted a randomized, double blinded, crossover trial. Patients were asked to perform standardized activity (2-min walk) aiming to provoke breathlessness. Primary endpoint (breathlessness NRS) and secondary endpoints (saturation, pulse, respiratory frequency) were measured before (t = 0) and after test medicine at t = 1, t = 3, t = 5, t = 10, and t = 20 min. After 2-4 days (washout period), the patients repeated the test, receiving the alternative drops in a blinded setup (crossover). Results In the first 3 min, the relative drop in breathlessness for morphine drops with ethanol (RMD) was significant more than for morphine drops without ethanol. We found no significant difference in secondary endpoints. Conclusions A conclusion could be that ethanol might facilitate morphine absorption in the mouth. Our results needs further research of opioid absorption in the mouth as well as trials, testing morphine vs. more lipophilic opioids. The RMD drops are cheap, easy to use, and noninvasive and keep the patient independent of health care professionals.
机译：目的在姑息性癌症患者中频繁出现困难。阿片类药物是唯一具有充分治疗证据的药物药物。在丹麦，主要推荐是红吗啡滴（RMD），自1893年（Pharmacopoea Danica）以来描述的对吗啡，乙醇和红颜色（Cochenille）的异标溶液。 2015年，丹麦药物局将重点放在灭绝药品上，推荐的登记的吗啡滴在没有乙醇的情况下。然而，我们的姑息患者告诉我们RMD更好。因此，我们进行了临床试验，以澄清两种类型的滴剂之间的任何感知差异。方法我们进行了随机，双盲，交叉试验。要求患者进行标准化活动（步行2分钟），旨在挑起令人困惑。在T = 1，T = 3，T = 5，T = 10处测量（T = 0）和次要终点（饱和，脉冲，呼吸频率）和次要终点（饱和，脉冲，呼吸频率）和在测试中进行测试，T = 3，T = 10，以及T = 20闵。经过2-4天（冲洗期）后，患者重复测试，在蒙蔽的设置（交叉）中接收替代滴。结果在前3分钟内，与乙醇（RMD）的吗啡滴下呼吸困难的相对下降比无乙醇的吗啡滴的显着大。我们发现辅助端点没有显着差异。结论结论可能是乙醇可能促进口腔中的吗啡吸收。我们的结果需要进一步研究口腔和试验中的阿片类药物，检测吗啡与更亲脂性阿片类药物。 RMD滴剂便宜，易于使用，无创业，并保持患者独立于医疗保健专业人员。

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