Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus
Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus
复制标题
DOI：
10.1016/s0140-6736(09)60139-2
复制
发表时间：
2009-04-04
期刊：
影响因子：
168.9
通讯作者：
Blum, Hubert E.
中科院分区：
文献类型：
--
作者：
Becker, Gerhild;Blum, Hubert E.
外周作用的β-阿片受体拮抗剂甲基纳洛酮和阿维莫泮是一类新的药物，旨在逆转阿片类药物引起的胃肠道系统的副作用，而不影响疼痛缓解。本文概述了这些药物的药理学，疗效和不良反应。这两种化合物似乎通常耐受性良好，可有效治疗阿片类药物相关的肠功能障碍和术后肠梗阻。甲基纳洛酮最近获得了美国食品和药物管理局（FDA）和欧洲药品管理局的批准，用于治疗晚期疾病患者的阿片类药物相关肠功能障碍。Alvimopan最近被FDA批准用于治疗术后肠梗阻，但该药物的使用仅限于住院患者，因为它与心肌梗死率增加有关。进一步的研究应评估这些药物在临床实践中的有效性和安全性。
Peripherally acting p-opioid receptor antagonists methylnaltrexone and alvimopan are a new class of drugs designed to reverse opioid-induced side-effects on the gastrointestinal system without compromising pain relief This article gives an overview of the pharmacology, the efficacy, and adverse effects of these drugs. Both compounds seem to be generally well tolerated and effective for the treatment of opioid-related bowel dysfunction and postoperative ileus. Methylnaltrexone recently received approval by the US Food and Drug Administration (FDA) and the European Medicines Agency for treatment of opioid-related bowel dysfunction in patients with advanced illness. Alvimopan was recently approved by the FDA for treatment of postoperative ileus, but the use of the drug is restricted to inpatients because it has been associated with an increased rate of myocardial infarction. Further research should assess the effectiveness and safety of these drugs in clinical practice.