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首页> 外文期刊>Psychosomatics >Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II.
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Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II.

机译：吗啡，可待因及其衍生物的药代动力学药物相互作用：理论与临床现实，第二部分。

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摘要

Pharmacokinetic drug-drug interactions with codeine, dihydrocodeine, hydrocodone, oxycodone, and buprenorphine are reviewed in this column. These compounds have a very similar chemical structure to morphine. Unlike morphine, which is metabolized chiefly through conjugation reactions with uridine diphosphate glucuronosyl transferase (UGT) enzymes, these five drugs are metabolized both through oxidative reactions by the cytochrome P450 (CYP450) enzyme and conjugation by UGT enzymes. There is controversy as to whether codeine, dihydrocodeine, and hydrocodone are actually prodrugs requiring activation by the CYP450 2D6 enzyme or UGT enzymes. Oxycodone and buprenorphine, however, are clearly not prodrugs and are metabolized by the CYP450 2D6 and 3A4 enzymes, respectively. Knowledge of this metabolism assists in the understanding for the potential of drug-drug interactions with these drugs. This understanding is important so that clinicians can choose the proper dosages for analgesia and anticipate potentialdrug-drug interactions.
机译：与可待因，二氢可待因，氢可酮，羟考酮和丁丙诺啡的药代动力学药物相互作用在本专栏中进行了综述。这些化合物具有与吗啡非常相似的化学结构。与吗啡不同，吗啡主要通过与尿苷二磷酸葡糖醛酸糖基转移酶（UGT）的偶联反应而代谢，这五种药物通过细胞色素P450（CYP450）酶的氧化反应和通过UGT酶的偶联而代谢。关于可待因，二氢可待因和氢可酮是否实际上是需要被CYP450 2D6酶或UGT酶激活的前药存在争议。但是，羟考酮和丁丙诺啡显然不是前药，它们分别由CYP450 2D6和3A4酶代谢。这种新陈代谢的知识有助于理解药物与这些药物相互作用的潜能。这种理解很重要，因此临床医生可以选择合适的镇痛剂量并预测潜在的药物相互作用。

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