{"id":2218,"date":"2024-08-02T01:48:00","date_gmt":"2024-08-01T16:48:00","guid":{"rendered":"https:\/\/happytest.shop\/?p=2218"},"modified":"2024-12-01T01:56:45","modified_gmt":"2024-11-30T16:56:45","slug":"the-role-of-fentanyl-in-pain-management-according-to-academia","status":"publish","type":"post","link":"https:\/\/happytest.shop\/fr\/information\/the-role-of-fentanyl-in-pain-management-according-to-academia\/","title":{"rendered":"Le r\u00f4le du fentanyl dans la gestion de la douleur selon les universitaires"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Qu&#039;est-ce que le Fentanyl?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Le fentanyl est un analg\u00e9sique opio\u00efde synth\u00e9tique puissant, 50 \u00e0 100 fois plus puissant que la morphine. Il a \u00e9t\u00e9 synth\u00e9tis\u00e9 pour la premi\u00e8re fois par Paul Janssen en 1959 et introduit cliniquement dans les ann\u00e9es 1960 comme anesth\u00e9sique intraveineux. Le fentanyl appartient \u00e0 la classe des opio\u00efdes synth\u00e9tiques de la ph\u00e9nylpip\u00e9ridine et sa structure chimique est la N-(1-ph\u00e9n\u00e9thyl-4-pip\u00e9ridyl) propionanilide.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">M\u00e9canisme d&#039;action pour soulager la douleur<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Comme d&#039;autres agonistes opio\u00efdes, le fentanyl produit une analg\u00e9sie en se liant aux r\u00e9cepteurs mu-opio\u00efdes du cerveau, de la moelle \u00e9pini\u00e8re et d&#039;autres zones impliqu\u00e9es dans la perception et la r\u00e9gulation de la douleur. Cette liaison inhibe la lib\u00e9ration de neurotransmetteurs comme la substance P, modulant ainsi efficacement les voies de la douleur. La forte solubilit\u00e9 lipidique du fentanyl lui permet de traverser rapidement la barri\u00e8re h\u00e9mato-enc\u00e9phalique.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Utilisations th\u00e9rapeutiques et mode d&#039;administration<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">La puissance du fentanyl le rend particuli\u00e8rement utile pour la prise en charge des douleurs aigu\u00ebs ou chroniques s\u00e9v\u00e8res, notamment les douleurs postop\u00e9ratoires, les douleurs canc\u00e9reuses et les douleurs neuropathiques. Il peut \u00eatre administr\u00e9 :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Par voie intraveineuse<\/strong><\/li>\n\n\n\n<li><strong>Par voie transdermique<\/strong>\u00a0(via des correctifs)<\/li>\n\n\n\n<li><strong>Par voie transmuqueuse<\/strong>\u00a0(sous forme de pastilles ou de sucettes)<\/li>\n\n\n\n<li><strong>Via de nouvelles m\u00e9thodes de livraison<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Effets ind\u00e9sirables et risques<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Bien qu&#039;il soit efficace comme analg\u00e9sique, le fentanyl comporte des risques importants, notamment :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>D\u00e9pression respiratoire<\/strong><\/li>\n\n\n\n<li><strong>Constipation<\/strong><\/li>\n\n\n\n<li><strong>S\u00e9dation<\/strong><\/li>\n\n\n\n<li><strong>Vertiges<\/strong><\/li>\n\n\n\n<li><strong>Naus\u00e9es\/vomissements<\/strong><\/li>\n\n\n\n<li><strong>Potentiel de d\u00e9pendance et d\u2019addiction<\/strong>\u00a0avec une utilisation \u00e0 long terme<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Sa puissance \u00e9lev\u00e9e augmente consid\u00e9rablement les risques de surdosage, m\u00eame des quantit\u00e9s de l&#039;ordre du microgramme \u00e9tant potentiellement mortelles.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">R\u00f4le dans l\u2019\u00e9pid\u00e9mie d\u2019opio\u00efdes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Le r\u00f4le du fentanyl dans l\u2019\u00e9pid\u00e9mie d\u2019opio\u00efdes est en grande partie li\u00e9 \u00e0 sa fabrication, sa distribution et son utilisation illicites. Le fentanyl fabriqu\u00e9 ill\u00e9galement est souvent m\u00e9lang\u00e9 \u00e0 de l\u2019h\u00e9ro\u00efne ou \u00e0 des pilules contrefaites, ce qui aggrave les risques de surdose. Entre 2010 et 2017, les fentanyls fabriqu\u00e9s ill\u00e9galement ont \u00e9t\u00e9 impliqu\u00e9s dans plus de 67 000 d\u00e9c\u00e8s par surdose aux \u00c9tats-Unis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">La lutte contre la crise des opio\u00efdes n\u00e9cessite une approche \u00e0 plusieurs volets :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Am\u00e9lior\u00e9\u00a0<strong>gestion des opio\u00efdes<\/strong><\/li>\n\n\n\n<li>\u00c9tendu\u00a0<strong>acc\u00e8s au traitement de la toxicomanie<\/strong><\/li>\n\n\n\n<li>Am\u00e9lior\u00e9\u00a0<strong>services de r\u00e9duction des risques<\/strong><\/li>\n\n\n\n<li><strong>Application de la loi<\/strong>\u00a0pour lutter contre les approvisionnements illicites<\/li>\n\n\n\n<li><strong>\u00c9ducation publique<\/strong>\u00a0sur l&#039;extr\u00eame puissance du fentanyl<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">R\u00e9f\u00e9rences acad\u00e9miques<\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Mulier JP.\u00a0<em>Opio\u00efdes p\u00e9riop\u00e9ratoires : revue narrative pharmacocin\u00e9tique et pharmacodynamique<\/em>. Cor\u00e9en J Anesthesiol. 2019;72(5):413-428.<\/li>\n\n\n\n<li>Benyamin R, Trescot AM, Datta S et al.\u00a0<em>Complications et effets secondaires des opio\u00efdes<\/em>. M\u00e9decin sp\u00e9cialiste de la douleur. 2008;11(2 Suppl):S105-S120.<\/li>\n\n\n\n<li>Pathan H, Williams J.\u00a0<em>Pharmacologie de base des opio\u00efdes : une mise \u00e0 jour<\/em>. Br J Pain. 2012;6(1):11-16.<\/li>\n\n\n\n<li>Soleimanpour H, Hassanzadeh K, Vaezi H et al.\u00a0<em>Efficacit\u00e9 de l&#039;analg\u00e9sie intraveineuse contr\u00f4l\u00e9e par le patient avec du fentanyl dans la gestion de la douleur apr\u00e8s une c\u00e9sarienne<\/em>. Anesth Pain Med. 2014;4(3):e17654.<\/li>\n\n\n\n<li>Zhu Y, Bao Y, Gao Y, et al.\u00a0<em>Formulations de fentanyl \u00e0 usage th\u00e9rapeutique : une revue<\/em>. Formule r\u00e9cente de d\u00e9livrance de m\u00e9dicaments Pat. 2019;13(3):180-192.<\/li>\n\n\n\n<li>Prommer E, Thompson L.\u00a0<em>Pastilles permettant l\u2019administration de m\u00e9dicaments \u00e0 travers la muqueuse buccale \u2013 une nouvelle forme de m\u00e9dicament pour l\u2019administration syst\u00e9mique de m\u00e9dicaments<\/em>. Curr Pharm Des. 2011;17(35):3754-3765.<\/li>\n\n\n\n<li>Jannetto PJ, Helander A, Garg U et al.\u00a0<em>L&#039;\u00e9pid\u00e9mie de fentanyl et l&#039;\u00e9volution des analogues du fentanyl aux \u00c9tats-Unis et dans l&#039;Union europ\u00e9enne<\/em>. Clin Chem. 2019;65(2):242-253.<\/li>\n\n\n\n<li>Dasgupta N, Beletsky L, Ciccarone D.\u00a0<em>Crise des opio\u00efdes : pas de solution simple \u00e0 ses d\u00e9terminants sociaux et \u00e9conomiques<\/em>. Am J Public Health. 2018;108(2):182-186.<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>What is Fentanyl? Fentanyl is a potent synthetic opioid analgesic that is 50-100 times more potent than morphine. It was first synthesized by Paul Janssen in 1959 and introduced clinically in the 1960s as an intravenous anesthetic. Fentanyl belongs to the phenylpiperidine class of synthetic opioids, and its chemical structure is N-(1-phenethyl-4-piperidyl) propionanilide. Mechanism of [&hellip;]<\/p>","protected":false},"author":1,"featured_media":2221,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_robots_primary_cat":"none","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_seopress_analysis_target_kw":"","footnotes":""},"categories":[115],"tags":[139,73,75,138,125],"drug":[44],"location":[90],"class_list":["post-2218","post","type-post","status-publish","format-standard","has-post-thumbnail","category-information","tag-epidemic","tag-opioids","tag-overdose","tag-pain-relief","tag-synthetic-drugs-2","drug-fentanyl","location-worldwide"],"acf":[],"_links":{"self":[{"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/posts\/2218","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/comments?post=2218"}],"version-history":[{"count":0,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/posts\/2218\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/media\/2221"}],"wp:attachment":[{"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/media?parent=2218"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/categories?post=2218"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/tags?post=2218"},{"taxonomy":"drug","embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/drug?post=2218"},{"taxonomy":"location","embeddable":true,"href":"https:\/\/happytest.shop\/fr\/wp-json\/wp\/v2\/location?post=2218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}