治疗神经病痛和纤维肌痛的抗药物
Andrew Moore1, Philip Wiffen1, Eija Kalso2
1Pain Research and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England.
JAMA
|July 10, 2014
概括
像 gabapentin 和 pregabalin 这样的抗药可以缓解糖尿病神经病变和术后神经疼痛等神经病变性疼痛症状的适度疼痛. 对治疗这些疾病或纤维肌痛的其他抗药的证据有限.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
- 疼痛管理 疼痛管理
背景情况:
- 神经病痛和纤维肌痛是慢性疾病,有显著的未满足的治疗需求.
- 抗药物 (AED) 越来越多地用于治疗疼痛.
- 在特定疼痛条件下AED疗效的证据需要系统评估.
研究的目的:
- 评估抗药物与神经病痛或纤维肌痛患者疼痛强度降低之间的关联.
- 综合当前关于AED在特定疼痛症状中的有效性的证据.
主要方法:
- 随机对照试验的系统审查和元分析.
- 与安慰剂相比,AEDs (加巴丁,普雷加巴林,其他) 的比较.
- 作为主要结果,评估有意义的疼痛减轻.
主要成果:
- 与安慰剂相比, gabapentin和pregabalin在糖尿病神经病变和后神经疼痛的有意义的疼痛减轻中显示出适度增加.
- 与安慰剂相比,Pregabalin在纤维肌痛的有意义的疼痛减轻方面显示出小幅增加.
- 没有足够的证据证明其他AED在这些疼痛条件中的有效性.
结论:
- gabapentin和pregabalin在特定的神经病痛疾病和纤维肌痛方面具有适度的益处.
- 目前的证据不支持使用其他AED用于这些适应症.
- 需要进一步的研究来澄清AED在疼痛管理中的作用.
相关概念视频
Antiepileptic Drugs: Glutamate Antagonists
1.3K
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
1.3K
Antiepileptic Drugs: Sodium Channel Blockers
2.3K
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
2.3K
Analgesia and Pain Management
3.3K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
3.3K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
1.5K
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.5K
Antiepileptic Drugs: Calcium Channel Blockers
1.7K
Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
1.7K
Antiepileptic Drugs: Potassium Channel Activators
1.0K
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
1.0K


