- 期刊
Acute and Chronic Opioid Tolerance: A Pharmacological Review
對於類鴉片藥物之急慢性耐藥性之藥理觀
摘要
Opioid tolerance is a significant clinical phenomenon. Patients may develop opioid tolerance within several hours even after a single bolus of opioid. Animal studies have revealed that there were two kinds of opioid tolerance, namely acute opioid tolerance and chronic opioid tolerance. Acute opioid tolerance may develop within 4 hours after a single bolus of fentanyl or morphine, and 1 hour after a single injection of alfentanil. Chronic opioid tolerance may develop with an incubation period of 8-10 days and last for a long period. The characteristics of acute opioid tolerance may differ from those of chronic opioid tolerance. The mechanisms underlying acute and chronic opioid tolerance are not well studied and need to be further explored. However, in the future, the combined administration of delta opioid receptor antagonists or opioid agonist-antagonists along with opioid agonist (such as morphine) may not only provide less opioid tolerance but also maintain adequate analgesia in clinical practice.
並列摘要
類鴉片類藥物之耐藥性爲一具有臨床意義之現象。在單一劑量注射後的數小時內，病人可能已產生了耐藥性。動物實驗方面已證實有兩種耐藥性，一爲急性，一爲慢性。急性類鴉片藥物之耐藥性可在嗎啡單劑量注射後之四小時及亞芬坦尼注射後之一小時後產生。慢性耐藥性可在約8－10天後產生，而且可持續很久。急性耐藥性的藥理特性有些是和慢性耐藥性不同，而其中機轉則尚不明瞭。而是急性耐藥性及慢性耐藥性之生成機轉充滿了研究的空間。在現今的臨床使用中若能將某些類型的拮抗劑與嗎啡共同使用，將會減低耐藥性的產生而且不會影響嗎啡之止痛效果。