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口服羟考酮在人类痛觉过敏实验性疼痛模型中的药代动力学和药效学研究。

A pharmacokinetic and pharmacodynamic study of oral oxycodone in a human experimental pain model of hyperalgesia.

机构信息

Mech-Sense, Department of Gastroenterology, Aalborg Hospital, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Clin Pharmacokinet. 2010 Dec;49(12):817-27. doi: 10.2165/11536610-000000000-00000.


DOI:10.2165/11536610-000000000-00000
PMID:20873879
Abstract

BACKGROUND AND OBJECTIVE: Oxycodone is not as well characterized, with respect to its pharmacokinetic/pharmacodynamic properties, as other opioids. Moreover, the pharmacodynamic profile of oxycodone can be affected by changes in the pain system, e.g. hyperalgesia. Therefore, the aim of this study was to investigate the pharmacokinetic/pharmacodynamic profiles of oxycodone in a human experimental pain model of hyperalgesia. METHODS: Twenty-four healthy subjects received oral oxycodone (15 mg) or placebo. Pharmacodynamics were assessed utilizing a multimodal, multi-tissue paradigm where pain was assessed from skin (heat), muscle (pressure) and viscera (heat and electricity) before and 30, 60 and 90 minutes after induction of generalized hyperalgesia evoked by perfusion of acid and capsaicin in the oesophagus. Venous blood samples were obtained for quantification of oxycodone plasma concentrations before and 5, 10, 15, 30, 45, 60, 90 and 120 minutes after drug administration. RESULTS: Oxycodone blood concentrations could be described by a one-compartment model but, given the necessarily short timescale of the study, the concentrations were represented by linear interpolation for subsequent pharmacodynamic models. Time-dependent changes in the pain measures in the placebo arm of the study were represented by linear or quadratic functions. The time course of the pain measures in the oxycodone arm was taken to be the time course for the placebo arm plus a concentration-effect relationship that was either zero (no drug effect), linear or a maximum effect (E(max)) model. For three of the four pain measures, there was a time-dependent change after administration of placebo (e.g. due to the development of generalized hyperalgesia). CONCLUSION: There was a measurable effect of oxycodone, compared with placebo, on all pain measures, and a linear concentration-effect relationship without an effect delay was demonstrated. This could indicate an initial peripheral analgesic effect of oxycodone.

摘要

背景和目的:与其他阿片类药物相比,羟考酮在药代动力学/药效学特性方面的特征并不明显。此外,羟考酮的药效学特征可能会受到疼痛系统变化的影响,例如痛觉过敏。因此,本研究旨在探讨羟考酮在人类痛觉过敏实验性疼痛模型中的药代动力学/药效学特征。

方法:24 名健康受试者接受口服羟考酮(15mg)或安慰剂。在诱导酸和辣椒素灌注食管引起的全身痛觉过敏后,利用多模态、多组织范式评估药效学,在皮肤(热)、肌肉(压力)和内脏(热和电)之前和 30、60 和 90 分钟后评估疼痛。给药前和给药后 5、10、15、30、45、60、90 和 120 分钟采集静脉血样,以定量测定羟考酮的血浆浓度。

结果:羟考酮的血药浓度可以用单室模型来描述,但由于研究的时间尺度非常短,因此在随后的药效学模型中,通过线性内插来表示浓度。研究安慰剂组中疼痛测量值的时程变化用线性或二次函数来表示。在羟考酮组中,疼痛测量值的时程被认为是安慰剂组的时程加上浓度-效应关系,该关系要么是零(无药物效应),要么是线性或最大效应(E(max))模型。对于四个疼痛测量值中的三个,在给予安慰剂后会发生时间依赖性变化(例如,由于全身痛觉过敏的发展)。

结论:与安慰剂相比,羟考酮对所有疼痛测量值均有可测量的作用,并且表现出无作用延迟的线性浓度-效应关系。这可能表明羟考酮具有初始的外周镇痛作用。

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本文引用的文献

[1]
Evoked human oesophageal hyperalgesia: a potential tool for analgesic evaluation?

Basic Clin Pharmacol Toxicol. 2009-8

[2]
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Basic Clin Pharmacol Toxicol. 2009-4

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Eur J Clin Pharmacol. 2009-2

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Ann Pharmacother. 2008-10

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Pain Physician. 2008-3

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J Pharmacokinet Pharmacodyn. 2007-10

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Brain Res. 2007-7-30

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Pain. 2007-12-5

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