盐酸纳呋拉啡的适应症及不良反应管理概述

Introduction: Nalfurafine Hydrochloride (trade name: Remitch) is a highly selective kappa (kappa)-opioid receptor agonist developed by Toray Corporation of Japan. When using nalfuraphine hydrochloride, patients should strictly follow the doctor's prescription, monitor for any adverse reactions, and communicate with the doctor in a timely manner. This article mainly talks about the indications, mechanism of action, adverse reactions, management and precautions of nalfuraphine hydrochloride.

Indications

1. Hemodialysis-related uremic pruritus: used to treat pruritus in hemodialysis patients, especially when existing treatment methods are not effective.

2. Pruritus in patients with chronic liver disease: Nafurafine hydrochloride is also suitable for treating itching symptoms in patients with chronic liver disease.

3. Pruritus in peritoneal dialysis patients: This drug is also suitable for treating pruritus in peritoneal dialysis patients and has been approved in Japan.

Mechanism of action

Nalfuraphine hydrochloride reduces itching sensation by activating κ-opioid receptors in the brain, thereby improving patients' quality of life. Completely different from existing antihistamines or antiallergic drugs, nalfuraphine hydrochloride provides a new antipruritic pathway. Nafurafine hydrochloride has a strong G protein bias. In animal experiments, it has been shown that it does not cause irritability, sedation and other effects at analgesic doses, and it does not produce hallucinations in clinical practice.

Adverse reaction management

Common side effects of nalfuraphine hydrochloride include headache, nausea, vomiting, etc., but the symptoms are usually mild and do not affect the patient's continued use. Nafurafine hydrochloride may also cause some serious side effects, such as liver dysfunction and jaundice accompanied by significant increases in AST, ALT, Al-P, and γ-GTP, as well as dry mouth, palpitations, blurred vision, dizziness, and difficulty urinating. If the side effects of nalfurapine hydrochloride persist or worsen, patients should inform their doctor immediately. For side effects such as constipation and dry mouth, it is recommended to increase the intake of water and fiber to relieve symptoms. Symptoms such as dizziness, fatigue, and drowsiness may occur and may be relieved by stopping the medication or reducing the dose.

Precautions

Patients with moderate to severe (Child-Pugh classification grade C) liver injury should evaluate the risk-benefit ratio when using it, and closely observe the patient's status during the medication. Because it may cause drowsiness, dizziness, etc., patients should be careful not to engage in dangerous mechanical operations such as driving during treatment. If no effect occurs after taking this product, please be careful not to take it for a long time. Endocrine dysfunction, such as elevated prolactin levels, may occur, so appropriate investigation is best.