Duarte Danilo Freire
Rev Bras Anestesiol. 2005 Feb;55(1):135-46.
In addition to their major influence on human behavior, opium and opioids have been used for a long time as sedative and analgesic drugs. As from the 19th century, with the isolation of opium alkaloids and easy parenteral administration of these substances, there has been increased interest in the judicious medical use of opioids and in the analysis of social consequences of their abuse, which has justified a historical review of opium and opioids.
Further understanding of opium, natural product extracted from Papaver somniferum, and of opioids, natural opium-extracted semi-synthetic and synthetic substances, as well as major references to these substances since ancient times are evaluated. Breakthroughs after Setürner's studies, which have resulted in morphine isolation, are emphasized. Reference is made to other authors' investigations in the search for synthetic substances with advantages over natural products. The importance the discovery of opioid receptors and their endogenous binders is highlighted.
In the dawning of the third millennium, regardless of studies with analgesic drugs of different pharmacological groups, opioids are still the most potent analgesics, although their efficacy has been questioned for some types of pain. Current Clinical Pharmacology knowledge allows for the selection of the opioid based on patient's disease and conditions, in the search for the best cost-benefit ratio.
除了对人类行为有重大影响外,鸦片和阿片类药物长期以来一直被用作镇静和镇痛药。从19世纪起,随着鸦片生物碱的分离以及这些物质易于进行肠胃外给药,人们对阿片类药物的合理医学应用及其滥用的社会后果分析越来越感兴趣,这使得对鸦片和阿片类药物进行历史回顾成为必要。
对从罂粟中提取的天然产物鸦片、从天然鸦片中提取的半合成和合成物质阿片类药物以及自古以来对这些物质的主要参考文献进行了评估。强调了塞图尔纳研究后导致吗啡分离的突破。提及了其他作者为寻找比天然产物更具优势的合成物质所做的研究。突出了阿片受体及其内源性结合物发现的重要性。
在第三个千年伊始,尽管针对不同药理组的镇痛药进行了研究,但阿片类药物仍然是最有效的镇痛药,尽管其对某些类型疼痛的疗效受到了质疑。当前的临床药理学知识有助于根据患者的疾病和状况选择阿片类药物,以寻求最佳的成本效益比。