Adjustment of Analgesic in a Patient with Pain and Renal Dysfunction

Abstract

Opioid drugs are widely used in the treatment of cancer pain. Renal dysfunction slows down the clearance of opioids, which can easily lead to drug accumulation and overdose, posing a challenge to safe medication. This article takes a patient with cancerous abdominal pain and chronic low back pain combined with severe renal function damage as an example. This patient experienced central inhibitory, such as somnolence, hypoxemia, and needle like pupil contraction during the use of oxycodone sustained-release tablets for pain treatment. Clinical pharmacist conducted a comprehensive pain assessment of patient and adjusted oxycodone sustained-release tablets to tramadol capsules. The physician followed the pharmacist's advice and the patient's pain was satisfactorily controlled without obvious adverse effects. This article discusses the pharmacological and pharmacokinetic characteristics of commonly used opioid drugs in clinical practice, as well as their application in patients with renal function impairment. This article also provides an in-depth analysis of the application of oxycodone and tramadol in patients with cancer pain, chronic low back pain, and renal function damage, based on case studies. This case suggests that for patients with severe renal dysfunction and opioid intolerance, it is not only necessary to choose drugs that are less reliance on renal clearance and short acting formulations, but also to gradually titrate from a small dose to an appropriate dose; For pain patients with complex clinical conditions, physicians should focus on collaborating with pharmacists to develop personalized and refined medication plans for patients, in order to achieve satisfactory pain control and ensure patient medication safety.