Licup Nerissa, Baumrucker Steven J
Department of Internal Medicine, East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA.
Am J Hosp Palliat Care. 2011 Feb;28(1):59-61. doi: 10.1177/1049909110373507. Epub 2010 Aug 27.
Opioids have become the gold standard for treatment of severe pain in advanced disease, but adverse effects can affect the quality of life. Opioid-induced bowel dysfunction can lead to refractory constipation. Methylnaltrexone bromide is a peripherally acting mu antagonist and is indicated for the treatment of opioid-induced constipation in patients with advanced illness, when response to standard laxative therapy has been inefficacious. This pharmacology update will review the etiology, pathophysiology, and treatment of opioid-induced constipation, focused on methylnaltrexone as a novel treatment for refractory cases.
阿片类药物已成为晚期疾病中重度疼痛治疗的金标准，但不良反应会影响生活质量。阿片类药物引起的肠道功能障碍可导致难治性便秘。甲基纳曲酮溴化物是一种外周作用的μ受体拮抗剂，适用于晚期疾病患者阿片类药物引起的便秘治疗，当标准泻药治疗无效时使用。本药理学更新将回顾阿片类药物引起便秘的病因、病理生理学和治疗方法，重点关注甲基纳曲酮作为难治性病例的新型治疗方法。
