Chaudhary Kunal, Haddadin Shadi, Nistala Ravi, Papageorgio Chris
Clinical Medicine, University of Missouri-Columbia School of Medicine, Division of Nephrology and Hypertension, Harry S Truman VA Medical Center, 800 Hospital Dr., Columbia, MO 65201, USA.
Curr Clin Pharmacol. 2010 May;5(2):82-8. doi: 10.2174/157488410791110779.
The peritoneum is a cavity which has been successfully utilized by nephrologists to perform peritoneal dialysis (PD) in patients with renal failure. The physiologic characteristic of the peritoneal cavity not only helps remove toxic metabolites from the body, but also provides a useful portal of entry in the body for several pharmacological agents. Several medications such as antibiotics are given via the intraperitoneal (IP) route in PD patients to treat episodes of peritonitis. More recently the IP route has been used for chemotherapy in patients with intra-abdominal malignancies, i.e. gynecological and gastrointestinal cancers and has shown very promising results. In patients with peritoneal surface malignancies, perioperative IP chemotherapy has been used with good results. The rate and amount of drug transfer in the peritoneum are dependent on several factors. Factors such as peritoneal inflammation, surface area, peritoneal blood flow, time of contact, etc, influence the drug transfer. This review discusses the usefulness of IP drug therapy and the factors influencing it, as well as strategies to increase the efficacy, and conclude that IP route is an alternate route to the more conventional drug delivery routes, and can be successfully used when the target is within the peritoneal cavity or adjacent tissue.
腹膜是一个腔隙，肾脏病学家已成功利用它对肾衰竭患者进行腹膜透析（PD）。腹膜腔的生理特性不仅有助于从体内清除有毒代谢产物，还为多种药物进入人体提供了一个有用的途径。在PD患者中，几种药物（如抗生素）通过腹腔内（IP）途径给药以治疗腹膜炎发作。最近，IP途径已用于腹腔内恶性肿瘤（即妇科和胃肠道癌症）患者的化疗，并显示出非常有前景的结果。在腹膜表面恶性肿瘤患者中，围手术期IP化疗已取得良好效果。药物在腹膜中的转运速率和量取决于几个因素。诸如腹膜炎症、表面积、腹膜血流量、接触时间等因素会影响药物转运。本综述讨论了IP药物治疗的实用性及其影响因素，以及提高疗效的策略，并得出结论：IP途径是比传统给药途径更具替代性的途径，当靶点位于腹膜腔或邻近组织内时可成功使用。
