Ahmedzai Sam H, Boland Jason
Academic Unit of Supportive Care, Section of Oncology, School of Medicine and Biomedical Sciences, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK.
Curr Opin Support Palliat Care. 2007 Aug;1(2):117-25. doi: 10.1097/SPC.0b013e3282f04e0c.
Opioid analgesics are being increasingly used for pain control in both cancer and noncancer patients. Despite thousands of years of their use, the biological basis of their action and adverse effects are only now being understood. It is important to understand these agents better so that the potentially large sections of the population who may eventually be eligible to receive therapeutic opioids are treated rationally and safely.
Recent advances in pain physiology, molecular biology of neurotransmission, in-vivo neuroimaging and the study of genomic influences on drug receptors and metabolism are beginning to clarify how opioids work, how they differ from each other and how they may cause harm.
Understanding the biological basis of how opioids work and produce adverse effects should help us to make better choices of which drugs to use for specific populations. Identifying individual genetic differences in opioid receptors and drug metabolism pathways may also pave the way to more targeted and safer medication in the future.
阿片类镇痛药在癌症患者和非癌症患者的疼痛控制中使用得越来越频繁。尽管它们已被使用了数千年，但人们直到现在才开始了解其作用及不良反应的生物学基础。更好地理解这些药物很重要，这样才能合理且安全地治疗那些最终可能有资格接受治疗性阿片类药物的大量人群。
疼痛生理学、神经传递分子生物学、体内神经成像以及基因组对药物受体和代谢影响的研究方面的最新进展，正开始阐明阿片类药物的作用方式、它们彼此之间的差异以及它们可能造成伤害的方式。
了解阿片类药物的作用方式及产生不良反应的生物学基础，应有助于我们为特定人群更好地选择用药。识别阿片受体和药物代谢途径中的个体遗传差异，也可能为未来更具针对性和安全性的药物治疗铺平道路。
