BJP: Kev nkag siab rau hauv cov txheej txheem thiab cov peev txheej kev kho mob ntawm opioid siv tsis meej pem

Opioid tsis meej pem yog teeb meem thoob ntiaj teb thiab teeb meem kev noj qab haus huv rau pej xeem. Cov tswv yim rau kev kho mob ntawm opioid siv tsis xwm yeem tuaj yeem faib ua cov tswv yim rau opioid receptor systems thiab cov tswv yim rau cov tsis-opioid receptor systems, suav nrog dopamine thiab glutamate receptor systems. Tam sim no, cov tshuaj siv hauv tsev kho mob los kho cov tshuaj opioid tsis zoo suav nrog opioid receptor agonists methadone thiab buprenorphine, uas txwv los ntawm lawv txoj kev nyiam ua phem, thiab opioid receptor antagonist naltrexone, uas tsis ua raws. .

Yog li ntawd, muaj qhov xav tau nrawm los tsim cov tshuaj muaj txiaj ntsig zoo nrog kev nyiam kev tsim txom qis thiab ua tau zoo dua. Raws li qhov kev nce qib tshiab kawg hauv kev nkag siab ntawm cov txheej txheem neurobiological hauv paus ntawm kev siv opioid tsis meej, muaj peev xwm kho cov tswv yim thiab lub hom phiaj tau tshwm sim. Qhov kev tshuaj xyuas no tsom mus rau kev nce qib hauv kev nrhiav lub hom phiaj muaj peev xwm thiab tsim cov tshuaj los kho kev siv tshuaj tsis haum xeeb, suav nrog kev nce qib hauv tus kws sau chav kuaj, thiab muab kev nkag siab rau kev txhim kho tshuaj yav tom ntej.

Kev quav yeeb quav tshuaj, tshuaj kho mob hu ua opioid siv tsis meej, yog lub paj hlwb tsis rov ua haujlwm niaj hnub, uas tau pom los ntawm tsev kho mob raws li lub cev vam khom, cov tsos mob tsis tu ncua, kev xav ntawm lub paj hlwb thiab rov tshwm sim. Cov tswv yim rau kev kho mob opioid siv tsis xwm yeem tuaj yeem faib ua cov tswv yim rau opioid receptor systems thiab cov tswv yim rau cov tsis-opioid receptor systems. Cov tshuaj opioid receptor agonist methadone thiab cov antagonist naltrexone yog cov tshuaj sawv cev rau lub hom phiaj cov neeg txais tshuaj opioid.

Txawm li cas los xij, muaj ntau qhov teeb meem uas txwv lawv daim ntawv thov tshuaj. Piv txwv li, txawm hais tias tshuaj txiav yeeb tuaj yeem txo qis kev xav rau opioids, nce kev kho mob ceev, txo kev siv cov tshuaj opioids tsis raug cai, thiab txhim kho kev muaj sia nyob tag nrho, nws tseem tuaj yeem ua rau kev vam khom. Naltrexone cuam tshuam nrog kev ua tsis zoo thiab tsuas yog ua tau zoo rau cov neeg mob uas tau tso tseg ua ntej pib kho, tab sis cov neeg mob uas siv cov tshuaj opioid feem ntau tsis tuaj yeem ua tiav ib-lub lim tiam opioid thim xav tau ua ntej pib kho naltrexone.

Buprenorphine yog ib nrab opioid agonist. Nws yog qhov chaw kho mob zoo dua li tshuaj txiav yeeb thiab naltrexone. Nws yog ib qho tshuaj pom zoo thiab siv dav rau kev kho mob ntawm kev siv opioid tsis meej. Txawm li cas los xij, thaum buprenorphine tau siv ntev, xws li thaum nws tau siv los ua tshuaj kho, buprenorphine muaj qhov nyiam me ntsis los ua neeg nyob. Txhawm rau txo qhov muaj peev xwm ntawm kev tsim txom, agonist/antagonist formulations (piv txwv li, ntau koob tshuaj buprenorphine/naloxone sublingual membranes, hu ua primone lossis cassipah) tau tsim los tiv thaiv kev tsim txom.

Cov kev tshawb fawb tau qhia tias ntxiv rau opioid receptor system, ntau yam uas tsis yog opioid receptor systems, suav nrog dopamine receptors, glutamate receptors, thiab Gba receptor systems, koom nrog txoj cai ntawm kev siv opioid tsis meej. Nrog qhov kev nce qib zaum kawg hauv peb qhov kev nkag siab ntawm cov txheej txheem neurobiological ntawm opioid siv tsis xwm yeem, ntau thiab ntau qhov peev xwm kho cov phiaj xwm thiab lub hom phiaj cuam tshuam nrog opioid thiab tsis-opioid receptor systems tau tshwm sim, qee qhov uas qhia tau zoo. Raws li kev tshawb fawb kev txhim kho ntawm cov txheej txheem ntawm kev siv tsis sib xws opioid, kab lus no tsom mus rau chav kuaj' kev nce qib hauv kev txiav txim siab lub peev xwm ntawm kev siv tshuaj opioid tsis zoo thiab txhim kho tshuaj, thiab muab kev qhia rau kev txhim kho tshuaj yav tom ntej.

Hauv kev xaus, kev siv tshuaj opioid tsis zoo yog teeb meem thoob ntiaj teb thiab hnyav zuj zus tuaj, thiab kev kho kom zoo yog xav tau sai. Kev tsim kho cov tswv yim kho mob thiab lub hom phiaj tau tham txog saum toj no tseem nyob rau theem pib, tab sis qee qhov opioid receptor agonists tenorphine, dopamine D3 receptor antagonist YQA14 thiab imidazoline I1 receptor agonist agmatine zoo li muaj kev cia siab.

Ib qho ntxiv, tus kws sau ntawv ceeb toom tias yuav tsum tau txiav txim siab ntau yam thaum txhais cov txiaj ntsig ntawm cov neeg siv tshuaj yeeb tshuaj hauv chaw kuaj mob mus rau qhov cuam tshuam ntawm chaw kuaj mob thiab/lossis chaw kho mob opioid siv tsis zoo rau cov neeg mob. Raws li tus sau' kev nkag siab ntawm lub hauv paus neurobiological txheej txheem ntawm kev siv tshuaj opioid txuas ntxiv mus tob zuj zus, tib neeg pheej siv zog txhim kho cov tshuaj zoo dua thiab zoo tshaj rau kev kho mob ntawm kev siv opioid tsis meej pem.