Hydrocodone, Oxycodone, and Morphine Metabolism and Drug-Drug Interactions.
Hydrocodone, Oxycodone, and Morphine Metabolism and Drug-Drug Interactions.
复制标题
DOI：
10.1124/jpet.123.001651
复制
发表时间：
2023-11
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
了解涉及阿片类药物的药物相互作用对患者治疗至关重要，因为它们是许多护理环境中常用的治疗方法，包括慢性和疾病相关疼痛。阿片类药物不仅具有狭窄的治疗指标和广泛的应用，而且具有潜在的严重毒性。阿片类药物是治疗中度至重度疼痛患者的经典止痛药。更重要的是，阿片类药物通常与多种其他药物联合使用，特别是在通常需要大量药物治疗的患者群体中。本文综述了目前常见的阿片类药物-药物相互作用（ddi）的知识，特别是氢可酮、羟考酮和吗啡的ddi。本综述涵盖的DDI包括由酶抑制或诱导引起的药代动力学DDI，主要是由于细胞色素p450酶（CYPs）的抑制。然而，吗啡等阿片类药物是由尿苷-5 ' -二磷酸葡萄糖醛酸转移酶（UGTs）代谢的，主要是UGT2B7，葡萄糖醛酸化是阿片类药物相互作用的另一个重要途径。本综述还涵盖了DDI的一些药效学研究以及CYP和UGT代谢的基础知识，包括详细的阿片代谢和代谢酶基因变异在DDI中的潜在参与。基于目前的文献，需要进一步的研究来充分调查和描述阿片类药物在疼痛和相关疾病环境中的DDI潜力，以改善患者的临床结果。回顾涉及阿片类药物的药物-药物相互作用的文献是很重要的，因为它们可能是有毒的和潜在的致命的，通过药效学相互作用以及通过抑制或诱导药物代谢而发生的药代动力学相互作用。
Awareness of drug interactions involving opioids is critical for patient treatment as they are common therapeutics used in numerous care settings, including both chronic and disease-related pain. Not only do opioids have narrow therapeutic indexes and are extensively used, but they have the potential to cause severe toxicity. Opioids are the classical pain treatment for patients who suffer from moderate to severe pain. More importantly, opioids are often prescribed in combination with multiple other drugs, especially in patient populations who typically are prescribed a large drug regimen. This review focuses on the current knowledge of common opioid drug–drug interactions (DDIs), focusing specifically on hydrocodone, oxycodone, and morphine DDIs. The DDIs covered in this review include pharmacokinetic DDI arising from enzyme inhibition or induction, primarily due to inhibition of cytochrome p450 enzymes (CYPs). However, opioids such as morphine are metabolized by uridine-5’-diphosphoglucuronosyltransferases (UGTs), principally UGT2B7, and glucuronidation is another important pathway for opioid-drug interactions. This review also covers several pharmacodynamic DDI studies as well as the basics of CYP and UGT metabolism, including detailed opioid metabolism and the potential involvement of metabolizing enzyme gene variation in DDI. Based upon the current literature, further studies are needed to fully investigate and describe the DDI potential with opioids in pain and related disease settings to improve clinical outcomes for patients. A review of the literature focusing on drug–drug interactions involving opioids is important because they can be toxic and potentially lethal, occurring through pharmacodynamic interactions as well as pharmacokinetic interactions occurring through inhibition or induction of drug metabolism.
影响因子：
3.7
作者：
Stamer UM;Zhang L;Book M;Lehmann LE;Stuber F;Musshoff F
通讯作者：
Musshoff F
影响因子：
3.4
作者：
Babalonis S;Comer SD;Jones JD;Nuzzo P;Lofwall MR;Manubay J;Hatton KW;Whittington RA;Walsh SL
通讯作者：
Walsh SL