Lam Lisa H, Pirrello Rosene D, Ma Joseph D
University of California, San Diego, Skaggs School of Pharmacy & Pharmaceutical Sciences, La Jolla, CA, USA.
University of California, Irvine Health, Orange, CA, USA.
J Clin Pharmacol. 2016 Jul;56(7):785-93. doi: 10.1002/jcph.676. Epub 2015 Dec 30.
Opioids are prescribed for cancer pain. Over the past decade, the annual increase in opioid prescriptions has been accompanied by an increase in opioid-associated deaths. Health care professionals must be proficient in proper dosing, titrating, and monitoring of opioid medications. With the numerous opioid medications and formulations available, an understanding of pharmacokinetic (PK) and pharmacodynamic (PD) concepts is necessary to appropriately individualize opioid-based cancer pain regimens. The purpose of this review is to highlight PK/PD concepts that are clinically relevant to the use of opioids. By way of a cancer pain patient case scenario, PK/PD concepts that are relevant in the initiation, titration, and rotation of an opioid regimen are discussed.
阿片类药物被用于治疗癌症疼痛。在过去十年中,阿片类药物处方量的逐年增加伴随着阿片类药物相关死亡人数的上升。医疗保健专业人员必须精通阿片类药物的正确剂量、滴定和监测。鉴于有众多阿片类药物和制剂可供使用,了解药代动力学(PK)和药效动力学(PD)概念对于合理个体化基于阿片类药物的癌症疼痛治疗方案是必要的。本综述的目的是强调与阿片类药物使用临床相关的PK/PD概念。通过一个癌症疼痛患者的病例场景,讨论了在阿片类药物治疗方案的起始、滴定和转换中相关的PK/PD概念。