老藥新用－－Dextromethorphan應用於疼痛控制

Dextromethorphan in Pain Control-- An Old Drug with New Clinical Application

Dextromethorphan (DM) was originally synthesized as a pharmacological alternative to morphine more than 40 years ago. From the beginning, its clinical use was mainly confined as an antitussive, usually in syrup preparations with adult doses of 10 to 30 mg three to six times daily. The specific central sites upon which DM exerts its antitussive effect are still uncertain, but they are distinct from those of opioids, insofar as the effect is not suppressed by naloxone. Also, unlike opioids, DM has an established safety record, i.e., the therapeutic cough suppressant dose (1 mg/ kg/day) has no major opioid-like respiratory or hemodynamic side effects, nor does it induce histamine released-complications.