经CYP 450酶代谢的常见阿片类药物比较  

Comparison of Common Opioids Metabolized by CYP450 Enzymes

作　　者：杨焱 YANG Yan(Chongqing Institute for Food and Drug Control·NMPA Key Laboratory for Quality Monitoring of Narcotic Drugs and Psychotropic Substances,Chongqing,China 401121)

机构地区：[1]重庆市食品药品检验检测研究院·国家药品监督管理局麻醉精神药品质量监测重点实验室,重庆401121

出　　处：《中国药业》2024年第9期14-19,共6页China Pharmaceuticals

基　　金：重庆市科研机构绩效激励引导专项[CQIFDC-YJKT-2021-12]。

摘　　要：目的总结常见阿片类药物羟考酮、美沙酮、曲马多和丁丙诺啡涉及细胞色素P450(CYP450)酶的代谢过程。方法采用计算机检索PubMed自建库起至2024年3月关于羟考酮、美沙酮、曲马多和丁丙诺啡等阿片类药物经CYP450酶的代谢研究,以及CYP450酶涉及的药物相互作用。结果CYP450酶是羟考酮、美沙酮、曲马多和丁丙诺啡阿片类药物代谢过程中最重要的酶。CYP3A4和CYP2D6不仅参与大多数阿片类药物代谢,还参与大量其他药物的代谢,阿片类药物在用药过程中易与其他药物发生相互作用。结论了解阿片类药物在肝脏中的代谢,以及药物间相互作用涉及重叠的药效动力学、药代动力学,可避免用药过程中可能发生的药品不良反应。Objective To summarize the cytochrome P450(CYP450)enzyme metabolism processes involved in common opioid drugs such as oxycodone,methadone,tramadol,and buprenorphine.Methods PubMed was searched from its inception to March 2024 for studies on the metabolism of opioids such as oxycodone,methadone,tramadol and buprenorphine via the CYP450 enzyme,as well as drug-drug interactions involved in the CYP450 enzyme.Results CYP450 enzyme was the most important enzyme in the metabolism of opioid drugs such as oxycodone,methadone,tramadol,and buprenorphine.CYP3A4 and CYP2D6 were not only involved in the metabolism of most opioid but also a large number of other drugs,and opioid drugs were prone to have drug-drug interactions with other drugs during the medication.Conclusion Knowledge of the metabolism of opioids in the liver,and the overlapping pharmacodynamics and pharmacokinetics involved in drug-drug interactions can help to circumvent possible adverse drug reactions during the medication.

关 键 词：阿片类药物 细胞色素P450酶 代谢 药品不良反应 药物相互作用 

分 类 号：R969.1[医药卫生—药理学] R971.1[医药卫生—药学]