Constance Jonathan E, Campbell Sarah C, Somani Amit A, Yellepeddi Venkata, Owens Katie H, Sherwin Catherine M T
a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , Utah , USA.
b Nelson Laboratories LLC , Salt Lake City , Utah , USA.
Expert Opin Drug Metab Toxicol. 2017 Jul;13(7):715-724. doi: 10.1080/17425255.2017.1329415. Epub 2017 Jun 5.
Advancing appropriate and adequate analgesic pharmacotherapy in pediatric patients with cancer is an area of clinical need. Few studies have been performed to evaluate the selection of an analgesic and appropriate dosing corresponding to analgesic effect among pediatric cancer patients. This review describes information related to pharmacokinetic, pharmacodynamic, and pharmacogenomic (when applicable) considerations for analgesics that are commonly used to manage pain experienced by pediatric patients with cancer. Areas covered: Analgesics commonly used to treat pediatric patients with malignancy patterned after the World Health Organization's 'analgesic ladder' for cancer pain management. Expert opinion: Addressing pain management safely and effectively in pediatric patients with cancer will require advances in both drug development, to increase the armament of analgesics available for children, and our pharmacologic understanding of those analgesics in current use. However, performing the necessary types of studies to develop new analgesics, or gain knowledge of existing therapy, within a population that is relatively small, diverse, and who experience pain originating from a variety of sources, is a tremendous challenge.
在患有癌症的儿科患者中推进适当且充分的镇痛药物治疗是一个临床需求领域。很少有研究评估儿科癌症患者中镇痛药的选择以及与镇痛效果相对应的合适剂量。这篇综述描述了与常用于管理患有癌症的儿科患者所经历疼痛的镇痛药的药代动力学、药效学和药物基因组学（如适用）考量相关的信息。涵盖领域：按照世界卫生组织用于癌症疼痛管理的“镇痛阶梯”模式，常用于治疗患有恶性肿瘤的儿科患者的镇痛药。专家意见：要在患有癌症的儿科患者中安全有效地解决疼痛管理问题，既需要在药物研发方面取得进展，以增加可供儿童使用的镇痛药种类，也需要我们对当前使用的那些镇痛药有药理学上的了解。然而，在一个相对较小、多样化且疼痛源于多种原因的人群中开展开发新镇痛药或了解现有疗法所需的各类研究，是一项巨大的挑战。
