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更新的羟考酮临床药代动力学和药效学。

Updated Clinical Pharmacokinetics and Pharmacodynamics of Oxycodone.

机构信息

School of Medicine, University of Eastern Finland, Kuopio, Finland.

Anaesthesiology and Intensive Care, Kuopio University Hospital, PO Box 100, 70029 KYS, Kuopio, Finland.

出版信息

Clin Pharmacokinet. 2019 Jun;58(6):705-725. doi: 10.1007/s40262-018-00731-3.


DOI:10.1007/s40262-018-00731-3
PMID:30652261
Abstract

Global oxycodone consumption has increased sharply during the last two decades, and, in 2008, oxycodone consumption surpassed that of morphine. As oxycodone was synthesized in 1916 and taken to clinical use a year later, it has not undergone the same approval process required by today's standards. Most of the basic oxycodone pharmacokinetic (PK) data are from the 1990s and from academic research; however, a lot of additional data have been published over the last 10 years. In this review, we describe the latest oxycodone data on special populations, including neonates, children, pregnant and lactating women, and the elderly. A lot of important drug interaction data have been published that must also be taken into account when oxycodone is used concomitantly with cytochrome P450 (CYP) 3A inducers and inhibitors and/or CYP2D6 inhibitors. In addition, we gathered data on abuse-deterrent oxycodone formulations, and the PK of alternate administration routes, i.e. transmucosal and epidural, are also described.

摘要

在过去的二十年中,全球羟考酮的消耗量急剧增加,并且在 2008 年,羟考酮的消耗量超过了吗啡。由于羟考酮于 1916 年合成并于次年投入临床使用,因此它没有经历当今标准所要求的相同的审批程序。大多数基本的羟考酮药代动力学(PK)数据来自于 20 世纪 90 年代和学术研究;然而,在过去的 10 年中已经发表了许多其他数据。在这篇综述中,我们描述了最新的羟考酮在特殊人群中的数据,包括新生儿、儿童、孕妇和哺乳期妇女以及老年人。已经发表了许多重要的药物相互作用数据,在羟考酮与细胞色素 P450(CYP)3A 诱导剂和抑制剂以及/或 CYP2D6 抑制剂同时使用时,这些数据也必须加以考虑。此外,我们还收集了关于具有防滥用性能的羟考酮制剂的数据,以及经粘膜和硬膜外等替代给药途径的 PK 数据也进行了描述。

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本文引用的文献

[1]
Pharmacokinetics of oxycodone/naloxone and its metabolites in patients with end-stage renal disease during and between haemodialysis sessions.

Nephrol Dial Transplant. 2019-4-1

[2]
Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines.

Ann Oncol. 2018-10-1

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Abuse of immediate-release opioids and current approaches to reduce misuse, abuse and diversion.

Postgrad Med. 2022-5

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Does co-administration of paroxetine change oxycodone analgesia: An interaction study in chronic pain patients.

Scand J Pain. 2010-1-1

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Br J Clin Pharmacol. 2018-6-21

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Acta Obstet Gynecol Scand. 2018-6-5

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Neuroimage. 2018-5-12

[9]
Ketamine and norketamine attenuate oxycodone tolerance markedly less than that of morphine: from behaviour to drug availability.

Br J Anaesth. 2017-12-2

[10]
Oxycodone-induced tolerance to respiratory depression: reversal by ethanol, pregabalin and protein kinase C inhibition.

Br J Pharmacol. 2018-5-7

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