The Pain Center of Fairfield, Fairfield, Connecticut 06824, USA.
J Pain Symptom Manage. 2012 Dec;44(6 Suppl):S15-22. doi: 10.1016/j.jpainsymman.2012.08.012.
Pharmacokinetic differences among opioids influence a patient's response to opioid treatment. An important element affecting a drug's pharmacokinetics, its metabolism, may be altered under various circumstances, thereby enhancing or mitigating a patient's response to opioids. The genetic background of the metabolic enzymes involved in opioid metabolism, comorbid medical conditions, older age, and the presence of other drugs that influence metabolism are such factors that can cause the response to opioid therapy to vary greatly from the expected response to a standard dose. As a result of the variability in individual responses to opioids, clinical management of pain with opioids must be empirical.
阿片类药物之间的药代动力学差异会影响患者对阿片类药物治疗的反应。影响药物药代动力学的一个重要因素是其代谢，在不同情况下可能会发生改变，从而增强或减轻患者对阿片类药物的反应。参与阿片类药物代谢的代谢酶的遗传背景、合并的医疗状况、年龄较大以及存在影响代谢的其他药物等因素，可能导致阿片类药物治疗的反应与标准剂量的预期反应有很大差异。由于个体对阿片类药物的反应存在差异，因此必须根据经验来进行阿片类药物治疗疼痛的临床管理。
