Jackson Leanne K, Poon Ivy O, Garcia Mary A, Imam Syed, Braun Ursula K
Rehabilitation & Extended Care Line, Section of Palliative Medicine, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.
Division of Geriatric and Palliative Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Pharmacy (Basel). 2024 May 13;12(3):78. doi: 10.3390/pharmacy12030078.
Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans), or a buccal film (Belbuca). Buprenorphine's unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, available formulations, drug-drug interactions, initiation and conversion strategies, and identifies ideal populations for use, especially within the palliative care patient population.
丁丙诺啡是一种半合成的长效μ-阿片受体（MOR）激动剂，可作为舌下片、透皮贴剂（Butrans）或口腔膜剂（Belbuca）用于慢性疼痛。丁丙诺啡独特的高受体结合亲和力以及在MOR处的缓慢解离，使其在有效镇痛的同时，与完全激动剂阿片类药物相比不良反应更少，尤其是对呼吸抑制和便秘的担忧较少。由于其在阿片类物质使用障碍（OUD）中的使用存在误解和污名化，它在慢性疼痛和姑息治疗中的使用不足。本病例报告讨论了丁丙诺啡独特的药理学，包括其优点、缺点、可用剂型、药物相互作用、起始和转换策略，并确定了理想的使用人群，尤其是在姑息治疗患者群体中。
