通过减少危害的镜头来检查布普伦诺芬转移:一种基于代理物的建模研究.
Joëlla W Adams1, Michael Duprey2, Sazid Khan2
1RTI International, Research Triangle, NC, USA. jadams@rti.org.
Harm reduction journal
|October 18, 2023
概括
增加布普伦诺芬转移可能会减少致命的阿片类药物过量服用. 我们的研究表明,即使转移率更高,阿片类药物使用障碍 (OUD) 患者使用布普伦诺芬-纳洛 (布普伦诺芬) 也没有增加过量死亡.
科学领域:
- 药理学和毒理学 药理学和毒理学
- 公共卫生和流行病学
- 卫生政策和管理卫生政策和管理
背景情况:
- 最近的政策变化减少了对阿片类药物使用障碍 (OUD) 的布普伦诺芬-纳洛处方的限制.
- 一个关键的问题是布普伦诺芬转移的可能性,但其对人口水平对过量剂量率的影响仍然不清楚.
- 如果转向布普伦诺芬用于替代海洛因或芬太尼,可能会对过量服用产生保护作用.
研究的目的:
- 估计布普伦诺芬转移对阿片类药物过量率的影响.
- 模拟阿片类药物滥用和相关结果在五年内使用基于代理的模型.
- 为了比较不同转移场景下的过量服用结果:现状,受控处方 (没有转移) 和增加转移.
主要方法:
- 一个基于代理的模型被开发和校准到北卡罗来纳州的数据.
- 模拟包括不同比例的布普伦诺芬转移和使用情况的场景在OUD的个人中.
- 敏感性分析探讨了过量服用风险的增加,更高的转移频率,以及未使用过阿片类药物的个人使用.
主要成果:
- 现状情景预测有10,658例致命的过量服用.
- 与现状相比,转移的增加导致死亡过量减少了357人 (3.35%).
- 没有转移的场景显示,致命的过量服用人数与现状相似;转移增加并没有增加过量死亡人数.
结论:
- 在OUD患者中增加了布普伦诺芬转移,显示了较低阿片类药物过量死亡的趋势.
- 建模表明,转移不一定会增加致命的过量服用,可能是保护性的.
- 调查结果支持倡导低至无障碍获得布普伦诺芬用于OUD治疗的政策.
相关概念视频
Drug Abuse and Addiction: Pharmacological Phenomena
489
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
489
Opioid Analgesics: Synthetic and Semisynthetic Opioids
311
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...
311
Opioid Receptors: Overview
939
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
939
Mechanistic Models: Overview of Compartment Models
90
Mechanistic models, a category encompassing both physiological and compartmental modeling, differ from empirical models' approaches to incorporating known factors about the systems being modeled. Empirical models describe data with minimal assumptions, while mechanistic models aim to provide a robust description of available data by specifying assumptions and integrating known factors about the system. Compartmental analysis is a key example of a mechanistic model in pharmacokinetics and...
90
Drug Distribution as One-Compartment Model and Elimination by Nonlinear Pharmacokinetics: Overview
75
Drug administration can occur through various routes, each of which may result in a different process of elimination. This process is often mixed with nonlinear and linear processes. It's important to understand that a single drug can be metabolized into different metabolites through parallel processes.
For instance, consider the metabolism of sodium salicylate. This compound is metabolized into two distinct substances: a glucuronide and a glycine conjugate. The rate of conjugation depends...
For instance, consider the metabolism of sodium salicylate. This compound is metabolized into two distinct substances: a glucuronide and a glycine conjugate. The rate of conjugation depends...
75
Pharmacokinetic Models: Overview
733
Pharmacokinetic models utilize mathematical analysis to achieve a detailed quantitative understanding of a drug's life cycle within the body. They are instrumental in simulating a drug's pharmacokinetic parameters, predicting drug concentrations over time, optimizing dosage regimens, linking concentrations with pharmacologic activity, and estimating potential toxicity.
There are three primary types of models: empirical, compartment, and physiological. Empirical models, with minimal...
There are three primary types of models: empirical, compartment, and physiological. Empirical models, with minimal...
733


