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羟考酮:新型“旧”药。

Oxycodone: new 'old' drug.

作者信息

Olkkola Klaus T, Hagelberg Nora M

机构信息

Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Turku, Finland.

出版信息

Curr Opin Anaesthesiol. 2009 Aug;22(4):459-62. doi: 10.1097/ACO.0b013e32832bc818.

Abstract

PURPOSE OF REVIEW

Since the introduction of oral immediate release and controlled-release oxycodone preparations to the market in the 1990s, the clinical use and scientific interest in oxycodone has increased greatly.

RECENT FINDINGS

Recent studies have shown that the pharmacokinetics of oxycodone are dependent on age of the patient and therefore individual titration of the dose is necessary, especially in the elderly. Oxycodone has good oral bioavailability and it produces more predictable plasma concentrations than morphine, which has a poor and more variable bioavailability. Oxycodone has clinically significant drug interactions with drugs affecting cytochrome P450 3A enzymes. Clinical studies have demonstrated that oxycodone is a useful opioid analgesic in acute postoperative pain, cancer pain, visceral pain and chronic nonmalignant pain.

SUMMARY

The availability of oxycodone preparations has increased its clinical use exponentially during the last decade. Further clinical studies are still needed to fully understand its clinical pharmacology. Oxycodone is still a new 'old' drug whose pharmacology and clinical potential is not yet fully understood.

摘要

综述目的

自20世纪90年代口服速释和控释羟考酮制剂上市以来,羟考酮的临床应用和科研关注度大幅增加。

最新发现

近期研究表明,羟考酮的药代动力学取决于患者年龄,因此需要个体化滴定剂量,尤其是在老年患者中。羟考酮具有良好的口服生物利用度,与生物利用度差且变异性更大的吗啡相比,其产生的血浆浓度更可预测。羟考酮与影响细胞色素P450 3A酶的药物存在具有临床意义的药物相互作用。临床研究表明,羟考酮在急性术后疼痛、癌痛、内脏痛和慢性非恶性疼痛中是一种有效的阿片类镇痛药。

总结

在过去十年中,羟考酮制剂的可获得性使其临床应用呈指数级增长。仍需进一步的临床研究以全面了解其临床药理学。羟考酮仍是一种新型“老”药,其药理学和临床潜力尚未完全明了。

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