老朋友与新面孔:钠通道阻滞剂兼职止痛药管理的未来?

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托马斯,阿特金森TJ

老朋友与新面孔:钠通道阻滞剂兼职止痛药管理的未来?

J痛苦。2018年1月,19 (1):1 - 9。doi: 10.1016 / j.jpain.2017.08.001。Epub 2017年8月24日。

PubMed ID
28842369 (在PubMed
]
文摘

供应商被要求减少重点和overutilization长期阿片类药物治疗,但许多人没有适当的指导适当的利用非阿片类药物。此外,治疗选择非常有限,许多供应商缺乏信心区分现实可用的选择。在患者一线治疗失败时,有一个明显的缺乏知识关于如何进行选择后续治疗。选择替代代理,了解药理学,药物动力学,针对各种疼痛的有效性是必要的。本文主要关注使用酰胺类的钠离子通道阻滞剂(卡马西平、奥卡西平、eslicarbazepine)兼职止痛药管理包括研究更新在药理学、药物动力学,现有的证据疼痛和有前途的领域的研究。这是一个证据更新临床使用钠通道阻滞剂,澄清误解关于它们的使用,改善疼痛和凸显了新兴研究目标,证明额外的研究。我们进行一个完整的回顾文献使用搜索条件,”奥卡西平,”“卡马西平,”和“eslicarbazepine”与“药物动力学”,“负面影响”,“药理学”,“电压门控钠通道亚型,”“神经性疼痛,”“炎症性疼痛”,“新陈代谢”,“环氧代谢物形成,”“药物相互作用”,“CYP450互动”,“疼痛表型,”和“慢性疼痛管理”。Databases searched included PubMed and Google Scholar. Package inserts were used for drug structure illustration, adverse reactions, and bioavailability. Pharmacology and pharmacokinetic data were taken from randomized controlled trials evaluating this area as well as in vitro published results. For validity, only peer-reviewed literature was included. Evidence for sodium channel blockers in chronic pain management was limited. This review focuses on highlighting the data available for the use of sodium channel blockers for certain pain syndromes as well as underutilized potential. Emerging literature on sodium channel subtypes and their connection to neuropathic, inflammatory, and mechanical pain transmission is elucidated. The authors also scrutinize literature surrounding the pharmacokinetics of oxcarbazepine and eslicarbazepine to provide clearer guidance to the significance of any drug interactions and refute assumptions made on the basis of structural similarity to carbamazepine and its known undesirable drug interactions. Side effect profiles are outlined and compared, emphasizing the differences between agents. Sodium channel blocker doses used in certain pain syndromes are outlined with a call for further research to better understand their place in chronic pain management. Identification of sodium channel subtypes with links to specific pain conditions and the ability to target them hints at the potential for truly individualized therapy. Sodium channel inhibitors are underutilized on the basis of available evidence, and emerging research has identified this area as promising for additional clinical trials to better guide clinical practice. PERSPECTIVE: This article provides a review of the pharmacology, evidence for pain management, and pharmacokinetics of oxcarbazepine, carbamazepine, and eslicarbazepine. There is a disparity in evidence using sodium channel blockers for pain and this article highlights the potential that is currently underutilized. The authors believe this will catalyze interest for further studies.

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药物
药物靶点
药物 目标 类 生物 药理作用 行动
奥卡西平 钠离子通道蛋白质(蛋白质组) 蛋白质组 人类
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