淺談Naldemedine：因鴉片類藥物導致便秘的治療新選擇

An Overview of Naldemedine: a Novel Treatment Option for Opioid-induced Constipation

安寧病人的疼痛照護是一大課題，尤其癌末病人，往往會需要大量鴉片類藥物才得以緩解疼痛；然而，一些不樂見的藥物副作用也伴隨而來，便祕就是其中之一。臨床上，可能會給予軟便劑或緩瀉劑來幫助病人解便，但有時候仍效果不佳。Naldemedine是一種新機轉藥物，可以選擇性的對周邊鴉片受體(μ、δ、κ)具有拮抗作用，使鴉片類藥物造成的便秘副作用達到反轉；也因為其不穿透血腦障壁的特性，並不會影響鴉片類藥物的止痛效果。

Pain management for palliative patients is quite a challenge, especially for those with advanced-stage cancer, who often require large amount of opioid medications for pain relief. However, undesirable medication side effects, such as constipation, often concomitant with these treatments. Clinically, stool softeners or laxatives may be administered to help the patients, but sometimes the results are not satisfactory. Naldemedine is a novel agent that exerts selective antagonistic effects on peripheral opioid receptors (μ,δ,κ), effectively reversing the constipating side effects caused by opioid medications. Furthermore, due to its characteristic of not penetrating the blood-brain barrier, it does not compromise the analgesic effects of opioid drugs.