An evaluation of the validity of measureing salivary oxycodone concentrations for pharmacokinetic studies in patients

在许多国家，羟考酮正在取代吗啡，成为治疗中重度疼痛的首选阿片类药物。尽管如此，关于这种药物在体内是如何处理的，或者它控制疼痛的能力是如何受到其他药物、年龄或器官功能等因素的影响的，人们知之甚少。为了确定这一点，研究通常需要在设定的时间段内对单个患者进行多次血液测试。我们的团队能够测量唾液中的药物水平，并已证明这是测量血液中药物水平的有效替代方法。此外，我们中的一人开发了一个计算机模拟系统，只使用每个患者的几个样本就可以显示药物在体内是如何处理的。姑息治疗的患者一般都很虚弱，身体不适。我们不愿让他们接受侵入性测试，如重复抽血。如果我们能证明唾液采样和血液采样一样好，我们就会找到一种简单的非侵入性方法，极大地增加我们对羟考酮的了解，以及它在个别患者中的表现。这反过来可能使我们能够根据每个患者的独特特征定制药物剂量，并优化他们的疼痛控制。

In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a valid substitute for the measurement of drug levels in blood. Furthermore, one of us has developed a computer modelling system that shows how drugs are handled in the body using only a few samples from each patient. Palliative care patients are generally frail and unwell. We are reluctant to expose them to invasive tests such as repeated blood sampling. If we can prove that saliva sampling is as good as blood sampling, we will have identified a simple non-invasive means of greatly increasing our knowledge of oxycodone and how it behaves in individual patients. This in turn may allow us to tailor drug doses according to the unique characteristics of each patient and to optimise their pain control.