延长释放7天注射布普伦诺芬用于患有最小至轻度阿片类药物戒断的患者
Gail D'Onofrio1,2,3, Andrew A Herring4,5,6, Jeanmarie Perrone7
1Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA network open
|July 8, 2024
概括
一种新的7天注射性布普伦诺芬配方对于阿片类药物使用障碍 (OUD) 患者具有最小至轻度戒断的患者来说是安全的,并且耐受性良好. 这种延长释放的选择可以提高OUD治疗的可访问性和坚持性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
- 临床试验 临床试验
背景情况:
- 布普伦诺芬是一种有效的治疗阿片类药物使用障碍 (OUD),但其使用不足仍然是一个挑战.
- 延长释放配方在改善治疗坚持性和可访问性方面具有潜在的优势.
研究的目的:
- 评估可行性,包括可接受性,耐受性和安全性,为期7天的可注射延长释放布普伦诺芬在经历微小到轻度阿片类药物戒断的患者中.
- 评估患者报告的结果,如注射疼痛,满意度和渴望.
主要方法:
- 一项非随机试验,涉及100名中度至重度OUD和低临床阿片类戒断量表 (COWS) 评分 (0-7) 的成年患者,在美国四个急诊室进行.
- 患者每周接受一次24毫克的延长释放布伦诺芬剂量,每天通过电话和7天后亲自进行评估.
主要成果:
- 可注射配方被发现是可以接受和耐受的,显著的戒断增加率 (10%) 或急性戒断率低 (2%在1小时内,7%在4小时内).
- 注射部位的疼痛是最小的. 患者满意度很高,许多患者报告没有食欲或使用阿片类药物. 73%的人在7天开始接受OUD治疗.
结论:
- 七天内可注射延长释放布伦诺芬是一种可行的,安全的选择,对于患有最小至轻度阿片类药物戒断 (COWS 4-7).
- 这种新的配方有可能显著扩大OUD患者获得布普伦诺芬治疗的机会.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
271
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...
271
Opioid Receptors: Overview
704
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,...
704
Drug Delivery: Miscellaneous Routes
336
Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection, and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
336
Drugs for Treatment of Constipation-Predominant IBS
154
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
154
Drugs for Treatment of Diarrhea-Predominant IBS
156
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
156
Opioid Analgesics: Morphine and Other Natural Cogeners
225
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
225


