Expanding Role of NMDA Receptor Antagonists in the Management of Pain.

IF 7.4 2区医学 Q1 CLINICAL NEUROLOGY

CNS drugs Pub Date : 2019-04-01 DOI:10.1007/s40263-019-00618-2

Denise Kreutzwiser, Qutaiba A Tawfic

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引用次数: 44

Abstract

Pain management is complex regardless of whether the pain is acute or chronic in nature or non-cancer or cancer related. In addition, relatively few pain pharmacotherapy options with adequate efficacy and safety data currently exist. Consequently, interest in the role of NMDA receptor antagonists as a pharmacological pain management strategy has surfaced. This narrative review provides an overview of the NMDA receptor and elaborates on the pharmacotherapeutic profile and pain management literature findings for the following NMDA receptor antagonists: ketamine, memantine, dextromethorphan, and magnesium. The literature on this topic is characterized by small studies, many of which exhibit methodological flaws. To date, ketamine is the most studied NMDA receptor antagonist for both acute and chronic pain management. Although further research about NMDA receptor antagonists for analgesia is needed and the optimal dosage/administration regimens for these drugs have yet to be determined, ketamine appears to hold the most promise and may be of particular value in the perioperative pain management realm.

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NMDA受体拮抗剂在疼痛治疗中的作用。

无论疼痛是急性的还是慢性的，或者是非癌症或癌症相关的，疼痛管理都是复杂的。此外，目前存在的具有足够疗效和安全性数据的疼痛药物治疗方案相对较少。因此，对NMDA受体拮抗剂作为一种药理学疼痛管理策略的作用的兴趣已经浮出水面。这篇叙述性综述提供了NMDA受体的概述，并详细阐述了以下NMDA受体拮抗剂的药物治疗概况和疼痛管理文献发现:氯胺酮、美金刚、右美沙芬和镁。关于这一主题的文献以小型研究为特征，其中许多研究显示出方法上的缺陷。迄今为止，氯胺酮是研究最多的NMDA受体拮抗剂，用于急性和慢性疼痛管理。虽然需要进一步研究NMDA受体拮抗剂用于镇痛，并且这些药物的最佳剂量/给药方案尚未确定，但氯胺酮似乎最有希望，并且可能在围手术期疼痛管理领域具有特殊价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS drugs 医学-精神病学

CiteScore

12.00

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： CNS Drugs promotes rational pharmacotherapy within the disciplines of clinical psychiatry and neurology. The Journal includes: - Overviews of contentious or emerging issues. - Comprehensive narrative reviews that provide an authoritative source of information on pharmacological approaches to managing neurological and psychiatric illnesses. - Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. - Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in neurology and psychiatry. - Original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in CNS Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.