Zavaleta-Monestel Esteban, Anchía-Alfaro Adriana, Villalobos-Madriz Jorge, Munich Amil, García-Montero Jonathan, Quesada-Villaseñor Ricardo, Arguedas-Chacón Sebastián, Hernández-Ortiz Andrés, Rodríguez-Miranda Roberto
Pharmacy, Hospital Clínica Bíblica, San José, CRI.
Research, Hospital Clínica Bíblica, San José, CRI.
Cureus. 2024 Nov 23;16(11):e74307. doi: 10.7759/cureus.74307. eCollection 2024 Nov.
Pain is a prevalent issue among patients, requiring effective management to prevent the transition of acute pain into chronic pain and to mitigate significant clinical and socioeconomic impacts, such as increased morbidity, mortality, prolonged recovery, unplanned readmissions, and diminished quality of life. Despite advancements in pain management guidelines, achieving consistent pain relief remains challenging due to individual differences in pain thresholds, the nature of surgical procedures, patient age, and existing comorbidities. Tapentadol, an opioid that acts as both a μ-opioid receptor agonist and a noradrenaline reuptake inhibitor, presents a promising option for pain management. Approved by the FDA in 2008 for immediate release and in 2011 for extended release, tapentadol effectively addresses both nociceptive and neuropathic pain, offering a more favorable efficacy-safety profile compared to traditional opioids such as tramadol. Additionally, tapentadol is gaining recognition as a preferred option for managing significant pain in cancer patients due to its effectiveness and reduced side effects. This review evaluates tapentadol's clinical and pharmacological attributes, systematically analyzing literature on its efficacy, safety, pharmacokinetics, and comparative effectiveness, suggesting that tapentadol is a viable option for effective pain management with potential for broader clinical applications.
疼痛是患者中普遍存在的问题,需要进行有效管理,以防止急性疼痛转变为慢性疼痛,并减轻重大的临床和社会经济影响,如发病率和死亡率增加、恢复时间延长、计划外再入院以及生活质量下降。尽管疼痛管理指南有所进步,但由于疼痛阈值的个体差异、手术程序的性质、患者年龄和现有合并症,实现持续的疼痛缓解仍然具有挑战性。曲马多是一种兼具μ-阿片受体激动剂和去甲肾上腺素再摄取抑制剂作用的阿片类药物,为疼痛管理提供了一个有前景的选择。曲马多于2008年获美国食品药品监督管理局批准用于速释剂型,2011年批准用于缓释剂型,它能有效解决伤害性疼痛和神经性疼痛,与曲马多等传统阿片类药物相比,具有更有利的疗效-安全性概况。此外,由于其有效性和副作用减少,曲马多正逐渐被视为管理癌症患者重度疼痛的首选药物。本综述评估了曲马多的临床和药理学特性,系统分析了关于其疗效、安全性、药代动力学和比较有效性的文献,表明曲马多是有效疼痛管理的可行选择,具有更广泛临床应用的潜力。