阿片类癌痛治疗药物制剂的研究进展

中国药物警戒 ›› 2014, Vol. 11 ›› Issue (1): 19-22.

阿片类癌痛治疗药物制剂的研究进展

俞丽华,刘孟娟,王增

浙江省肿瘤医院药剂科,浙江杭州 310022

收稿日期:2016-02-03 修回日期:2016-02-03 出版日期:2014-01-08 发布日期:2016-02-03
作者简介:俞丽华,女,药师,医院药学

Research Progress of Opioid Preparations in Cancer Pain Treatment

YU Li-hua, LIU Meng-juan, WANG Zeng

Department of Pharmacy, Zhejiang Cancer Hospital, Zhejiang Hangzhou 310022, China

Received:2016-02-03 Revised:2016-02-03 Online:2014-01-08 Published:2016-02-03

摘要/Abstract

摘要： 目的梳理阿片类癌痛治疗药物常规剂型和新剂型,为相关剂型的临床合理选择和应用提供依据。方法主要对治疗癌痛的阿片类常规剂型（固体制剂,半固体制剂,液体制剂等）和新剂型（口含剂,喷雾剂,泡腾片等）的文献报道进行归纳分析。结果目前国内外强阿片类癌痛治疗药物存在多种剂型,无创给药的制剂仍然是使用最为广泛和依从性较好的剂型。结论根据不同给药途径的特点,选择切实有效的阿片类给药剂型,做到最大限度地减轻患者痛苦,提高癌症患者生活质量。

关键词: 阿片类药物, 癌痛, 剂型

Abstract: ObjectiveAccording to the reports in literature review, conventional and new forms of opioid medications were arranged, so as to provide information for related forms'rational selection and application in clinic. MethodsThe opioid conventional dosage forms for the treatment of cancer pain(solid preparations, semi-solid preparations, liquid preparations etc.) and new dosage forms(oral agents, sprays, effervescent tablets) reported in the literature were analyzed. ResultsAt present, strong opioid medications have many forms at home and abroad, non-invasive drug delivery preparation is still the most widely used with better compliance formulations. ConclusionTo select the effective opioid dosage forms according to the features of different administration pathway, so as to reduce the pain suffering and improve the quality of life in patients with cancer.

Key words: opioid agent, cancer pain, dosage form

中图分类号:

R730.53

俞丽华,刘孟娟,王增. 阿片类癌痛治疗药物制剂的研究进展[J]. 中国药物警戒, 2014, 11(1): 19-22.

YU Li-hua, LIU Meng-juan, WANG Zeng. Research Progress of Opioid Preparations in Cancer Pain Treatment[J]. Chinese Journal of Pharmacovigilance, 2014, 11(1): 19-22.

参考文献

[1] 欧阳学农.癌症疼痛治疗概况[J].福州总医院学报,2010,17(4):258-260.
[2] GE F, LIU J, QIU H, et al. Studies on clinical efficacy and safety of morphine sulfate suppositories in treatment of moderate to severe cancer pain[J]. Adverse Drug React J, 2009,11(2): 77-81.
[3] Wiffen P J, McQuay H J. Oral morphine for cancer pain[J]. Cochrane Database Syst Rev,2007,4(4):CD003868.
[4] 贾晓琳,蒋秋明,董松.硫酸吗啡控释片直肠给药控制晚期癌症疼痛的疗效观察[J].中国现代医药杂志,2006,8(1):12-14.
[5] 康马飞,骆梅青,涂江江,等.盐酸吗啡缓释片经直肠给药治疗癌性疼痛的临床研究[J].中国肿瘤临床与康复,2009,16(5):472-474.
[6] 贾爱华,韩健,邵军,等.美施康定阴道给药治疗重度癌痛32 例疗效观察[J].中国肿瘤临床,2005,32(1):48-49.
[7] 沈惠琴,胡袆,刘忆菁.硫酸吗啡控释片阴道给药治疗女性癌痛的疗效观察[J].解放军护理杂志,2010, 27(1B):94-98.
[8] 张志俊,朱保国,王小峰.芬太尼贴剂治疗晚期癌痛的临床疗效分析[J].中国临床研究,2012,25(2):159-160.
[9] 丁新梅,赵翌芬.芬太尼贴剂治疗晚期消化道癌痛的临床观察[J].实用诊断与治疗杂志,2008,22(1):55-56.
[10] 潘士勇,李宝石,朱小蔚.持续吗啡皮下泵注治疗老年中重度癌痛42例临床分析[J].中华保健医学杂志, 2008,10(2):102-103.
[11] 王永辉,柳伟明,李洁,等.大剂量静脉泵入吗啡治疗晚期顽固性癌痛21 例分析[J].中国肿瘤,2008,17(1):77-78.
[12] 张谦. 晚期癌痛患者持续静脉泵入吗啡的临床疗效观察[J]. 河北医学,2006, 12(9): 932.
[13] 陶蔚, 龚志毅, 王任直.鞘内药物输注系统植入术治疗顽固性疼痛基础医学与临床[J].2006,26(11):1183-1185.
[14] 葛峰,仓静,薛张纲.经皮下泵鞘内注射吗啡在晚期癌痛治疗中的安全性和有效性[J].上海医学,2007,30(6):422-424.
[15] Elsner F, Zeppetella G, Porta-Sales J, et al.Newer generation fentanyl transmucosal products for breakthrough pain in opioid-tolerant cancer patients[J]. Clin Drug Investig,2011,31(9):605-618.
[16] 于世英. 芬太尼新剂型 [J]. 实用医院临床杂志, 2006, 5(3):94-95.
[17] Mercadante S, Radbruch L, Davies A, et al. A comparison of intranasal fentanyl spray with oral transmucosal fentanyl citrate for the treatment of breakthrough cancer pain: an open-label, randomised, crossover trial[J]. Curr Med Res Opin, 2009,25(11):2805-2815.
[18] Dietrich E, Gums J G. Intranasal fentanyl spray: a novel dosage form for the treatment of breakthrough cancer pain. Ann Pharma-cother[J].2012,46(10):1382-1391.
[19] 黄鸣秋,张海霞,葛卫红.癌症患者爆发痛的药物治疗进展[J].中国药房, 2012, 23 (26) :2479-2481.
[20] Portenoy R, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain[J]. Pain, 1999, 81(1-2):129-134.
[21] Taylor D R. Single-dose fentanyl sublingual spray for breakthrough cancer pain[J]. Clin Pharmacol, 2013,24(5):131-41.
[22] Parikh N, Goskonda V, Chavan A, et al. Pharmacokinetics and dose proportionality of fentanyl sublingual spray: a single-dose 5-way crossover study[J]. Clin Drug Investig,2013,33(6):391-400.
[23] 朱维莉,时杰,陆林. 芬太尼口腔泡腾片的临床研究进展[J].中国药物依赖性杂志, 2008, 17(4): 245-247.