题名

淺談Naldemedine:因鴉片類藥物導致便秘的治療新選擇

并列篇名

An Overview of Naldemedine: a Novel Treatment Option for Opioid-induced Constipation

DOI

10.6647/CN.202312_30(4).0004

作者

林昱男(Yu-Nan Lin)

关键词

Naldemedine ; 鴉片類藥物 ; 便祕 ; Naldemedine ; opioids ; constipation

期刊名称

彰化護理

卷期/出版年月

30卷4期(2023 / 12 / 01)

页次

14 - 18

内容语文

繁體中文;英文

中文摘要

安寧病人的疼痛照護是一大課題,尤其癌末病人,往往會需要大量鴉片類藥物才得以緩解疼痛;然而,一些不樂見的藥物副作用也伴隨而來,便祕就是其中之一。臨床上,可能會給予軟便劑或緩瀉劑來幫助病人解便,但有時候仍效果不佳。Naldemedine是一種新機轉藥物,可以選擇性的對周邊鴉片受體(μ、δ、κ)具有拮抗作用,使鴉片類藥物造成的便秘副作用達到反轉;也因為其不穿透血腦障壁的特性,並不會影響鴉片類藥物的止痛效果。

英文摘要

Pain management for palliative patients is quite a challenge, especially for those with advanced-stage cancer, who often require large amount of opioid medications for pain relief. However, undesirable medication side effects, such as constipation, often concomitant with these treatments. Clinically, stool softeners or laxatives may be administered to help the patients, but sometimes the results are not satisfactory. Naldemedine is a novel agent that exerts selective antagonistic effects on peripheral opioid receptors (μ, δ, κ), effectively reversing the constipating side effects caused by opioid medications. Furthermore, due to its characteristic of not penetrating the blood-brain barrier, it does not compromise the analgesic effects of opioid drugs.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Brenner, D. M.,Chey, W. D.(2014).An Evidence-Based Review of Novel and Emerging Therapies for Constipation in Patients Taking Opioid Analgesics.The American Journal of Gastroenterology Supplements,2,38-46.
  2. European Society for Medical Oncology(2018).Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines.Annals of Oncology,29(Supplement 4),iv111-iv125.
  3. Katakami, N.,Harada, T.,Murata, T.,Shinozaki, K.,Tsutsumi, M.,Yokota, T.,Arai, M.,Tada, Y.,Narabayashi, M.,Boku, N.(2017).Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer.Journal of Clinical Oncology,35(34),3859-3866.
  4. National Comprehensive Cancer Network. (2023). Palliative care (version 2.2023). Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf
  5. Tassinari, D.,Sartori, S.,Tamburini, E.,Scarpi, E.,Raffaeli, W.,Tombesi, P.,Maltoni, M.(2008).Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine: a meta-analysis and systematic review of the literature.Journal of Palliative Medicine,11(3),492-501.
  6. 臺灣疼痛醫學會 (2022).2022台灣鴉片類藥物所致便秘之臨床處置指引。https://pain.org.tw/index.php/pain_page/index/17/4
  7. 衛生福利部食品藥物管理署 (2023, 8月4日).Naldemedine (Symproic®)適秘效仿單。https://mcp.fda.gov.tw/im_detail_1/%E8%A1%9B%E9%83%A8%E8%97%A5%E8%BC%B8%E5%AD%97%E7%AC%AC028189%E8%99%9F