神经性疼痛的奇特病例及其管理:概述

I. Ara, Mudasir Maqbool
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摘要

神经性疼痛是由于神经系统损伤或病变而发生的一种疾病。可能是外周或中枢神经性疼痛,这取决于损伤的位置。糖尿病、脊髓损伤、多种感染、癌症和自身免疫性疾病都是这种情况的潜在原因。据估计,慢性疼痛在全世界的患病率约为3% -17%。在大多数情况下,神经性疼痛被认为是“特发性”的,这意味着其具体的病因尚不清楚;因此,对这种疾病的药物治疗仅限于治疗其症状。用于治疗神经性疼痛的药物分为三类:三环抗抑郁药、加巴喷丁类药物和5 -羟色胺-去甲肾上腺素再摄取抑制剂(SNRIs)。抗惊厥药、阿片类药物和局部用药是不同类型药物的例子。强效阿片类药物、神经毒素和外科手术也可用于治疗。一般来说,药物治疗经常伴随着高剂量,这导致了许多副作用。这些药物通常是口服给药,药物在体循环中的吸收导致在全身的分散,导致外周循环高,并伴有副作用。酶降解降低了生物利用度,而肝脏代谢将药物转化为无活性代谢物。在这种情况下,由于血脑屏障阻碍了药物分子的渗透性,使足够的药物无法到达大脑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The curious case of Neuropathic Pain and its management: An overview
Abstract Neuropathic pain is a condition that occurs as a result of neural system damage or lesions. It could be peripheral or central neuropathic pain, depending on the location of the damage. Diabetes, spinal cord injury, numerous infections, cancer, and autoimmune illnesses are all potential causes of this condition. According to estimates, chronic pain has a prevalence rate of roughly 3% -17% worldwide. In most cases, neuropathic pain is stated to be “idiopathic” in origin, which means that its specific etiology is unknown; hence, pharmaceutical care of this condition is limited to treating its symptoms. The medications used to treat neuropathic pain fall into three categories: tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors (SNRIs). Anticonvulsants, opioids, and topical medications are examples of different types of medications. Strong opioids, neurotoxins, and surgical alternatives are also used in treatment. In general, pharmacotherapy is frequently accompanied with accompanied with high doses, which results in a number of side effects. These medications are typically delivered orally, and drug absorption in systemic circulation leads to dispersion throughout the body, resulting in high peripheral circulation and concomitant side effects. Enzymatic degradation reduces bioavailability, while hepatic metabolism converts medicines to inactive metabolites. In such circumstances, an adequate amount of drug is unable to reach the brain due to the blood brain barrier, which hinders drug molecule permeability.
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