一个新的静脉注射布普伦诺芬微输注策略:在重症监护和阿片类药物使用障碍中的应用
Journal of addiction medicine
|October 9, 2025
概括
一个新的静脉注射布普伦诺芬 (BUP) 微输注方案有效地使患者从完全阿片类药物激动剂转换,而不会导致戒断. 这种方法对管理阿片类药物使用障碍 (OUD) 和改善治疗坚持有希望.
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
- 临床治疗学 临床治疗学
背景情况:
- 布普伦诺芬 (BUP) 是一种部分片受体 (MOR) 激动剂,是治疗阿片类药物使用障碍 (OUD) 的标准治疗方法,也是有效的止痛药.
- 从完全MOR激动剂转换为BUP的患者可能面临挑战,因为潜在的BUP导致的阿片类药物戒断 (BPOW).
- 低剂量BUP启动方案旨在通过逐步增加BUP剂量来提高耐受性.
研究的目的:
- 评估一种新的静脉注射BUP微输注协议,以快速转换药物.
- 评估本协议在预防BPOW方面的耐受性和有效性.
- 为了确定OUD患者的退院后BUP治疗延续率.
主要方法:
- 一个回顾23名患者的病例系列,他们接受了8小时的1200微克IVBUP输液 (150微克/小时),随后是舌下BUP.
- 患者此前曾接受过用于止痛或非医疗用途的全MOR激动剂.
- 收集的数据包括人口统计,OUD状态,阿片类药物病史,BUP延续率和通过临床阿片类药物戒断量表 (COWS) 的BPOW评估.
主要成果:
- 在IV微灌输协议期间,没有患者符合BPOW的操作标准.
- 在23名患者中,有8人 (34.8%) 患有OUD,15人 (65.2%) 服用全方位的MOR抗痛药.
- 在8名OUD患者中,5名 (62.5%) 继续进行语言下BUP,并在出院后填写了他们的处方.
结论:
- 8小时的IV BUP微输注方案耐受性良好,有效防止临床上明显的BPOW.
- 这一协议有助于快速的药物转换的患者在完全的MOR激动剂.
- 出院后BUP治疗延续率与OUD患者的其他低剂量启动方案相提并论.
相关概念视频
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
232
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
232
Drug Delivery: Parenteral Route
1.5K
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
1.5K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
914
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...
914
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
176
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
176
Drug Delivery: Miscellaneous Routes
710
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...
710
Drug Accumulation During Multiple Dosing: Repetitive IV Injections
251
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
251


