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METHADONE AND LUNG TRANSPLANTS

Aurélie Maricq ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Denis Jacques ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Nicolas Zdanowicz ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Eric Marchand ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Patrick Evrard ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Pierre Bulpa ; Université Catholique de Louvain, 5530 Yvoir, Belgium
Christine Reynaert ; Université Catholique de Louvain, 5530 Yvoir, Belgium

Sažetak

Objectives: The aim of this article is to better understand the role of the liason psychiatrist regarding the pulmonary pretransplantation
assessment for a patient treated by methadone.
Method: At the beginning, we collected data concerning the different habits of patients requiring pulmonary transplantation.
Through a literature review, we studied the possible guidelines related to this subject, the effects of methadone, the side-effects
explaining the psychiatrist’s concerns. Finally, this problem is involved in the bio-psycho-social model to underline the influence of
methadone on post-operative prognosis.
Results: In our database, only 4.3% of patients were treated by methadone. However, this addiction is one of the most important
stresors for psychiatrists and involves a great deal of multidisciplinary staff time. There are absolutely no guidelines on this topic.
Due to the action of methadone, the pulmonary, cardiac, urologic, drug and immune side effects are more understandable. Thanks to
clinical labels, we are able to handle this dual problem. Different parameters are considered such as patient’s history, drug
addiction, deterioration of physical condition, possible surgery and its consequences, choice of treatment to better estimate the postoperative
prognosis.
Conclusion: Until now, there is nor indication or contra-indication regarding the duration of treatment by methadone for patients
requiring pulmonary transplantation. The main advantage is the patient’s stabilization by minimizing possible relapses. This advantage
is to compare the following major inconvenients: increased confusional risk, delicate management of the post-operative pain, negative
impact on the immunity. The support, a double psychoeducation and the patient’s decision making are to be encouraged.

Ključne riječi

methadone - lung transplants - liaison psychiatry - side-effects – confusion – anesthesia - post-operative pain - immune response - biopsychosocial model

Hrčak ID:

264691

URI

https://hrcak.srce.hr/264691

Datum izdavanja:

1.9.2011.

Posjeta: 288 *