An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerations.

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Christopher R McCurdy, Abhisheak Sharma, Kirsten E Smith, Charles A Veltri, Stephanie T Weiss, Charles M White, Oliver Grundmann
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引用次数: 0

Abstract

Introduction: Kratom (Mitragyna speciosa) has generated substantial clinical and scientific interest as a complex natural product. Its predominant alkaloid mitragynine and several stereoisomers have been studied for activity in opioid, adrenergic, and serotonin receptors. While awaiting clinical trial results, the pre-clinical evidence suggests a range of potential therapeutic applications for kratom with careful consideration of potential adverse effects.

Areas covered: The focus of this review is on the pharmacology, pharmacokinetics, and potential drug-drug interactions of kratom and its individual alkaloids. A discussion on the clinical pharmacology and toxicology of kratom is followed by a summary of user surveys and the evolving concepts of tolerance, dependence, and withdrawal associated with kratom use disorder.

Expert opinion: With the increasing use of kratom in clinical practice, clinicians should be aware of the potential benefits and adverse effects associated with kratom. While many patients may benefit from kratom use with few or no reported adverse effects, escalating dose and increased use frequency raise the risk for toxic events in the setting of polysubstance use or development of a use disorder.

桔梗临床药理学的最新进展:用途、滥用潜力和未来考虑。
导言:桔梗(Mitragyna speciosa)作为一种复杂的天然产品,引起了临床和科学界的极大兴趣。研究人员对其主要生物碱丝裂宁碱和几种立体异构体在阿片类、肾上腺素能和血清素受体上的活性进行了研究。在等待临床试验结果的同时,临床前证据表明,在谨慎考虑潜在不良反应的情况下,克拉托姆具有一系列潜在的治疗用途:本综述的重点是桔梗及其单个生物碱的药理学、药代动力学和潜在的药物相互作用。在讨论了 kratom 的临床药理学和毒理学之后,还总结了用户调查以及与 kratom 使用障碍相关的耐受性、依赖性和戒断性概念的演变:随着临床实践中越来越多地使用 kratom,临床医生应该了解与 kratom 相关的潜在益处和不良反应。虽然许多患者可能会从使用 kratom 中获益,并且很少或没有不良反应的报道,但剂量的增加和使用频率的增加会提高在使用多种药物或出现使用障碍的情况下发生毒性事件的风险。
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来源期刊
Expert Review of Clinical Pharmacology
Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.30
自引率
2.30%
发文量
127
期刊介绍: Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.
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