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Open Journal of Urology 2013年第7期3卷 272-275页

作者： Benjamin F. Katz Geoffrey S. Gaunay Basir U. Tareen Erik T. Goluboff Department of Urology Beth Israel Medical Center New York USA Department of Urology Metropolitan Urologic Associates Woodbury USA

Background: Postoperative ileus (POI) is a common and frustrating patient complication after a urinary diversion by using a segment of bowel. alvimopan is an oral selective antagonist to the peripheral μ-opioid receptor. Our study investigates the effect of alvimopan on POI in patients undergoing radical cystectomy. There are no documented studies on alvimopan’s efficacy in urologic surgery literature. Methods: Approval from the Institutional Review Board was obtained to conduct a retrospective review of patients’ records from August 2009 until August 2011. The study included sixteen patients who had undergone radical cystectomy with ileal diversion. Exclusion criteria included patients with chronic opioid use, previous colostomy or ileostomy, or significant comorbidities which could cause increased postoperative complications. Statistical analysis was performed to examine the association of alvimopan use with decreased time to dietary advancement and decreased length of hospital stay. Results: The alvimopan group advanced their diet more than 24 hours earlier in comparison with the alvimopan naive group (P alvimopan group had a greater had a greater or 26% shorter hospital length (P alvimopan in reducing POI in the urological surgery literature. Our novel experience with using this drug is encouraging. Further research will ultimately determine if standard use of alvimopan to decrease POI in radical cystectomy with ileal diversion will be implemented.

关键词： Cystectomy Urinary Diversion alvimopan Ileus

Impact of a Pharmacist Implemented Protocol on Overall Use of alvimopan （Entereg） and Length of Stay in Laparoscopic Colorectal Surgeries

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Journal of Pharmacy and Pharmacology 2016年第10期4卷 521-525页

作者： Halle M. Orlinski Rachana R. Patel Bradley J. Champagne Joseph A. Trunzo Karen L. Kier University Hospitals St. John Medical Center Westlake Ohio 44145 USA

The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, in days, before and after protocol implementation. A retrospective chart review was conducted from October 2015 through March 2016 for all laparoscopic colorectal surgeries. Number of post-operative alvimopan doses received and LOS was recorded for each patient that received at least one dose of alvimopan. Comparative data, before protocol implementation, from November 2014 through June 2015 were analyzed against the study data. Number of post-operative alvimopan doses and LOS were recorded. The mean number of doses was 6.41 in the comparator group and 4.25 in the study group （probability size P 〈 0.001）, which did meet statistical significance. Although the secondary objective was not statistically significant, LOS slightly decreased as the mean LOS was 5.01 days in the comparator group versus 4.49 days in the study group （P = 0.256）. At the current price of $120 per capsule, close to $30,000 was saved during the study period, projecting an annual cost savings of approximately $68,000. Results from this study show that pharmacists can play a vital role in cost savings and ensuring appropriate use of certain high-risk medications, like alvimopan, without increasing overall length of stay.

关键词： alvimopan pharmacist-implemented colorectal cost savings.

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alvimopan的研究未达到终点

国外药讯 2004年第4期 17-18页

作者：张美珍

Adolor／GSK公司研制的、用以治疗术后肠梗阻药物Entereg(alvimopan)，在Ⅲ期试验的第四次和最近一次的研究中，未达到它的主要终点和头条数据展示(top-line data show)。但公司仍坚持这些数据会同前三次研究中的数据。

关键词： Adolor/GSK公司 alvimopan 术后肠梗阻临床试验胃肠道功能

阿片受体拮抗剂alvimopan的Ⅲ期临床试验

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国外医学（药学分册） 2003年第3期30卷 190-191页

作者：张首国王林

alvimopan改善术后肠梗阻研究的新数据

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国外医学（药学分册） 2004年第1期31卷 62-62页

作者：李丽陈莉张莉

alvimopan对接受简单腹式全子宫切除术患者安全性的一项双盲、随机、安慰剂对照Ⅲ期临床研究

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世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 7-7页

作者： Herzog T.J. Coleman R.L. Guerrieri Jr. J.P. 翁梨驹 Columbia University New YorkNYUnited States Dr.

Objective:The purpose of this study was to investigate the safety and efficacy of alvimopan,a novel peripherally acting mu-opioid receptor antagonist,in patients who undergo simple total abdominal hysterectomy. Study design:Women (n = 519)-were randomized (4:1) to receive alvimopan 12 mg (n = 413) or placebo (n = 106)≥2 hours before the operation then twice daily for 7 days (hospital and home). Adverse events were monitored up to 30 days after the last dose of study drug was administered. Efficacy was assessed for 7 postoperative days. Results:Overall,the most common adverse events were nausea,vomiting,and constipation; alvimopan significantly accelerated the time to first bowel movement (hazard ratio,2.33; P alvimopan has a safety profile that is similar to that of placebo and provides significantly improved lower gastrointestinal recovery in women who undergo simple total abdominal hysterectomy.

关键词： alvimopan 安慰剂对照阿片受体拮抗剂排粪于术不良反应消化道功能研究设计随机分配

alvimopan加快根治性膀胱全切术后胃肠功能的恢复:一个多中心安慰剂随机对照试验

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现代泌尿外科杂志 2014年第12期19卷 827-827页

作者：范晋海西安交通大学医学院第一属附医院泌尿外科陕西西安710061

根治性膀胱全切术（Radical cystectomy ，RC）是复杂的腹盆腔联合手术，术后胃肠功能的恢复对患者的临床决策有重要意义。胃肠功能的延迟恢复（术后肠梗阻）延长住院时间，增加术后并发症（如：恶心、呕吐、腹胀、营养不良等），并增... 详细信息

根治性膀胱全切术（Radical cystectomy ，RC）是复杂的腹盆腔联合手术，术后胃肠功能的恢复对患者的临床决策有重要意义。胃肠功能的延迟恢复（术后肠梗阻）延长住院时间，增加术后并发症（如：恶心、呕吐、腹胀、营养不良等），并增加医疗成本。虽然采取了一些有效措施，但仍有超过40％的患者发生胃肠功能恢复延迟。

关键词： alvimopan 根治膀胱全切术术后恢复胃肠功能恢复

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FDA批准alvimopan胶囊

世界临床药物 2008年第8期29卷 450-450页

FDA最近批准了Adolor公司和葛兰素史克公司的alvimopan胶囊（Entereg）上市，用于辅助肠道切除术后患者早期胃肠道功能的恢复。本品剂量规格为每粒含alvimopan 12mg。

关键词： alvimopan FDA批准胶囊葛兰素史克公司胃肠道功能术后患者剂量规格

FDA批准阿片受体拮抗剂alvimopan胶囊上市

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齐鲁药事 2008年第7期27卷 427-427页

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术后肠麻痹的药物治疗

中华医学杂志 2007年第18期87卷 1271-1271页

作者：楼文晖复旦大学附属中山医院普外科上海200032

术后肠麻痹的预防和治疗始终是腹部外科学界的一个难点。目前，针对这一问题主要采取支持治疗，其他措施还包括限制麻醉剂的使用；尽可能采用硬膜外麻醉；早期进食和下床活动；必要时配合胃肠减压。但现有的治疗措施并不能影响术后肠麻... 详细信息

术后肠麻痹的预防和治疗始终是腹部外科学界的一个难点。目前，针对这一问题主要采取支持治疗，其他措施还包括限制麻醉剂的使用；尽可能采用硬膜外麻醉；早期进食和下床活动；必要时配合胃肠减压。但现有的治疗措施并不能影响术后肠麻痹的病程。阿维莫潘（alvimopan）是一种新型的外周作用的鸦片μ受体（PAM—OR）抑制剂，在既往的研究中发现可加快盆腹腔手术后胃肠道功能的恢复。最近，alvimopan在加速术后胃肠道功能恢复中作用的三期临床研究已经完成，3个随机、双盲多中心研究的汇集分析报告2007年3月出版（Annal of Surgery，2007，245：355—363）。

关键词：术后肠麻痹药物治疗胃肠道功能恢复 alvimopan Surgery 腹部外科学硬膜外麻醉腹腔手术后