在一项人体实验室研究中，描述氢吗啡酮相对于海洛因的主观、观察者评估和生理效应。
Characterizing the subjective, observer-rated, and physiological effects of hydromorphone relative to heroin in a human laboratory study.
机构信息
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Health Canada, Ottawa, ON, Canada.
出版信息
Psychopharmacology (Berl). 2018 Apr;235(4):971-981. doi: 10.1007/s00213-017-4814-3. Epub 2017 Dec 21.
BACKGROUND
This study compared the effects of the several doses of the opioid agonists heroin and hydromorphone across two routes of administration in humans. The goal was to guide development of human laboratory studies of opioid effects and inform subsequent injection pharmacotherapy trials of hydromorphone-assisted treatment.
METHODS
A within-subject (N = 16), double-blind, double-dummy, placebo-controlled, evaluation of acute doses of heroin and hydromorphone was completed at four dose levels (placebo, low, medium, high) across two routes of administration (intravenous, subcutaneous) in non-physically dependent, opioid-experienced individuals. Subject and observer ratings, as well as physiological outcomes, were assessed.
RESULTS
Within each route of administration, heroin and hydromorphone produced effects that were qualitatively similar on most variables across the doses examined. All effects were dose-dependent. The drugs produced different effects on VAS ratings of "Feels Like Heroin," a Heroin Identification Test, observer agonist ratings, and oxygen saturation levels. Drug-dependent differences emerged at the highest doses in all cases. Few significant main effects of Route were identified and their pattern was not uniform. Relative potency calculations across all subject, observer, and physiological outcomes that met analysis criteria revealed similar profiles and resulted in mean heroin:hydromorphone potencies of 3.35:1 and 2.88:1 for the intravenous and subcutaneous routes, respectively, and intravenous:subcutaneous potencies of 0.47:1 and 0.49:1 for heroin and hydromorphone, respectively.
CONCLUSIONS
Hydromorphone produced similar subjective and physiological effects as heroin, but was more potent than heroin. The current findings support the use of hydromorphone as a model for heroin in human laboratory and clinical treatment studies, and help identify appropriate hydromorphone dose conversion ratios to produce effects qualitatively similar to heroin.
背景
本研究比较了几种剂量的阿片类激动剂海洛因和氢吗啡酮在两种给药途径下对人体的影响。目的是指导阿片类药物效应的人体实验室研究，并为随后的氢吗啡酮辅助治疗注射药物治疗试验提供信息。
方法
在非躯体依赖、阿片类药物经验丰富的个体中，通过两种给药途径（静脉内、皮下），在四个剂量水平（安慰剂、低、中、高）下进行了单次剂量的阿片类药物（海洛因和氢吗啡酮）的单盲、双盲、双模拟、安慰剂对照、评估。评估了主观和客观评估以及生理结果。
结果
在每种给药途径下，海洛因和氢吗啡酮在大多数研究剂量下产生的作用在大多数变量上均相似。所有作用均呈剂量依赖性。药物在 VAS 评分“感觉像海洛因”、海洛因识别测试、观察者激动剂评分和氧饱和度水平上产生了不同的作用。在所有情况下，在最高剂量下都出现了药物依赖性差异。确定了很少有主要的途径效应，并且其模式不统一。满足分析标准的所有受试者、观察者和生理结果的相对效力计算显示出相似的特征，并导致静脉内和皮下途径的海洛因：氢吗啡酮效力分别为 3.35:1 和 2.88:1，以及静脉内：皮下效力分别为 0.47:1 和 0.49:1。
结论
氢吗啡酮产生了与海洛因相似的主观和生理作用，但比海洛因更有效。目前的发现支持将氢吗啡酮用作人体实验室和临床治疗研究中海洛因的模型，并有助于确定适当的氢吗啡酮剂量转换比，以产生与海洛因相似的作用。
Zotero 插件