长期阿片类药物治疗对疼痛患者性功能障碍的影响
Morgan Streett1, Michael Chandler2, Lisa Luciani3
1Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, Arkansas, USA.
Journal of pain & palliative care pharmacotherapy
|December 11, 2025
概括
布普伦诺芬可以降低慢性疼痛患者的阿片类药物诱导的阴性过敏症 (OIH). 这项研究发现,与服用全agonist阿片类药物的患者相比,服用布普伦诺芬的患者经历过OIH的患者较少.
科学领域:
- 内分泌学 在内分泌学.
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 治疗慢性疼痛的阿片类药物治疗可能导致阿片类药物诱导的阴性过敏症 (OIH).
- OIH与降低丸激素水平和像勃起功能障碍这样的症状有关.
- 基于使用的阿片类药物的类型,OIH的发生率可能会有所不同.
研究的目的:
- 估计长期使用阿片类药物治疗的慢性疼痛患者中OIH的发生率.
- 为了比较布普伦诺芬和全agonist阿片类药物之间的OIH发生率.
- 评估不同阿片类药物治疗的内分泌相关副作用.
主要方法:
- 在一个单一中心进行回顾性图表审查.
- 纳入标准:成年男性退伍军人接受长期阿片类药物治疗 (≥90天供应) 以之前的无阿片类药物间隔 (90天).
- 主要终点:血中低的复合 (<300 ng/dL),开始使用替代剂或勃起功能障碍 (ED) 药物,或新的ED/低性腺症诊断.
主要成果:
- 与完全激动性阿片类药物组 (n=55) 相比,布普伦诺芬组 (n=45) 中较少的患者达到初级复合终点 (13.3%对29.1%,p=0.058).
- 布普伦诺芬组在治疗后显著减少了ED或阴性过敏症的新诊断 (0%对12.7%,p=0.013).
- 两组之间没有观察到基线特征的显著差异.
结论:
- 与完全激素阿片类药物相比,布普伦诺芬治疗与阿片类药物诱导的阴性腺的发病率较低有关.
- 这些发现表明,当内分泌副作用令人担忧时,布普伦诺芬可能是首选的选择.
- 进一步的研究可能会探索长期的结果和机制.
相关概念视频
Analgesia and Pain Management
1.4K
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...
1.4K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
878
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...
878
Opioid Analgesics: Morphine and Other Natural Cogeners
808
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...
808
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
597
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
597
Opioid Receptors: Overview
3.9K
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,...
3.9K
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
236
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
236


