Topical preparations for pain relief: efficacy and patient adherence.
Topical preparations for pain relief: efficacy and patient adherence.
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减轻疼痛的局部准备：功效和患者依从性。
DOI：
10.2147/jpr.s9492
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发表时间：
2010-12-20
影响因子：
2.7
通讯作者：
Teles VE
中科院分区：
文献类型：
--
作者：
Jorge LL;Feres CC;Teles VE
人们越来越关注开发新的给药途径，为患者提供定制治疗，而不降低镇痛疗效，与疼痛机制知识的进展成比例。急性疼痛是一种警报，而慢性疼痛则是一种综合征，需要精心选择生物利用度高的镇痛药物长期使用。这些标准是局部药物旨在克服的挑战，允许活性组分的渐进递送，保持稳定的血浆水平，具有良好的安全性。这篇综述介绍了最近的研究结果，关于最广泛使用的疼痛治疗药物，如非甾体抗炎药，麻醉剂和辣椒素，和物理制剂的作用，作为传递增强剂（超声和离子电渗）的局部制剂。虽然局部药物的数量是有限的，用于外周条件下，越来越多的证据支持这些制剂在阻断伤害性疼痛和神经性疼痛的疗效。患者坚持药物治疗也是一个挑战，特别是在慢性疼痛的情况下。众所周知，减少治疗复杂性和药丸负担是提高患者依从性的良好策略，如本文所述。然而，专题介绍的作用，与传统途径相比，尚未得到充分探讨，因此仍然不清楚。
There has been an increasing focus on development of new routes of drug administration to provide tailored treatments for patients, without decreasing efficacy of analgesia, in proportion to the progression of the knowledge of pain mechanisms. While acute pain acts as an alarm, chronic pain is a syndrome requiring meticulous selection of analgesic drugs of high bioavailability for long-term use. Such criteria are challenges that topical medications aim to overcome, allowing progressive delivery of active component, maintaining stable plasma levels, with a good safety profile. This review presents recent findings regarding topical formulations of the most widely used drugs for pain treatment, such as nonsteroidal anti-inflammatory agents, anesthetics, and capsaicin, and the role of physical agents as delivery enhancers (phonophoresis and iontophoresis). Although the number of topical agents is limited for use in peripheral conditions, increasing evidence supports the efficacy of these preparations in blocking nociceptive and neuropathic pain. Patient adherence to medical treatment is also a challenge, especially in chronic painful conditions. It is known that reduction of treatment complexity and pill burden are good strategies to increase patient compliance, as discussed here. However, the role of topical presentations, when compared to traditional routes, has not yet been fully explored and thus remains unclear.