新面孔的老朋友:钠通道阻滞剂是辅助止痛药管理的未来吗?

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托马斯AM，阿特金森TJ

新面孔的老朋友:钠通道阻滞剂是辅助止痛药管理的未来吗?

疼痛杂志。2018年1月;19(1):1-9。doi: 10.1016 / j.jpain.2017.08.001。Epub 2017 8月24日。

PubMed ID
28842369 (PubMed视图
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摘要

提供者被要求减少对长期阿片类药物治疗的重视和过度使用，但许多人在适当使用非阿片类药物治疗方面没有适当的指导。此外，治疗方案相当有限，许多提供者对区分可用的替代方案缺乏信心。当一线治疗在患者身上失败时，显然缺乏如何继续选择后续治疗的知识。要在替代药物中进行选择，必须了解药理学、药代动力学和针对各种疼痛状况的疗效。本文侧重于使用carboxamide类钠通道阻滞剂(卡马西平，奥卡西平，eslicarbazepine)辅助止痛药物管理，包括药理学、药代动力学的最新研究，以及目前的疼痛证据以及有前途的研究领域。必威国际app这是钠通道阻滞剂临床使用的最新证据，澄清了关于其使用的误解，并强调了改善疼痛靶点的新兴研究，为进一步研究提供了理由。必威国际app我们使用搜索词“奥卡西平”、“卡马西平”和“埃斯利卡西平”，结合“药代动力学”、“不良反应”、“药理学”、“电压门控钠必威国际app通道亚型”、“神经性疼痛”、“炎症性疼痛”、“代谢”、“环氧代谢物形成”、“药物相互作用”、“CYP450相互作用”、“疼痛表型”和“慢性疼痛管理”，对文献进行了完整的回顾。搜索的数据库包括Pu必威国际appbMed和谷歌Scholar。包装说明书用于药物结构说明、不良反应和生物利用度。药理学和药代动力学数据来自评估该领域的随机对照试验以及体外发表的结果。 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.

引用本文的药物库数据

药物
药物靶点
药物 目标 种类 生物 药理作用 行动
奥卡西平 钠通道蛋白(蛋白质组) 蛋白质组 人类
未知的
抑制剂
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