Prommer Eric E
UCLA School of Medicine, Division of Hematology/Oncology, USA.
J Opioid Manag. 2005 Jul-Aug;1(3):131-8. doi: 10.5055/jom.2005.0032.
Tramadol (Ultram, Ortho-McNeil Pharmaceutical, Inc., Raritan, NJ) is considered a Step 2 analgesic under the World Health Organization's guidelines for the treatment of patients with cancer pain. It is a centrally acting analgesic that has affinity for opioid receptors and influences the action of norepinephrine and serotonin at the synapse. This dual mechanism of analgesia makes it unique among Step 2 agents. It is metabolized by CYP2D6, which increases the potentialfor drug interactions. Unlike other opioids, it does not cause respiratory depression. Tramadol has been studied in cancer pain and neuropathic pain. It compares well with low-dose morphine as an analgesic. The purpose of this review is to critically examine the pharmacodynamics, pharmacology, drug interactions, and adverse effects of the drug, and, based on the data presented, discuss the drug's role in cancer care.
曲马多（奥施康定，奥多-麦克尼尔制药公司，拉里坦，新泽西州）在世界卫生组织癌症疼痛患者治疗指南中被视为二级镇痛药。它是一种中枢性镇痛药，对阿片受体有亲和力，并在突触处影响去甲肾上腺素和5-羟色胺的作用。这种双重镇痛机制使其在二级药物中独具特色。它通过细胞色素P450 2D6代谢，这增加了药物相互作用的可能性。与其他阿片类药物不同，它不会引起呼吸抑制。曲马多已在癌症疼痛和神经性疼痛方面进行了研究。作为镇痛药，它与低剂量吗啡效果相当。本综述的目的是严格审查该药物的药效学、药理学、药物相互作用和不良反应，并根据所提供的数据讨论该药物在癌症治疗中的作用。
