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Abuzarova GR, Sarmanayeva RR, Alekseeva GS, Brazhnicova YV. A clinical case of the use of a new selective μ1-opioid analgesic Tafalgin in the treatment of chronic cancer pain. JOURNAL OF MODERN ONCOLOGY 2022. [DOI: 10.26442/18151434.2022.3.201913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the Russian Federation, tetrapeptide tyrosyl-D-arginyl-phenylalanyl-glycine amide (Tafalgin), a novel analgesic, selective agonist of 1-opioid receptors, was developed and approved in 2022. The article presents the first experience of the successful use of Tafalgin in treating chronic pain in a cancer patient with poor tolerance to traditional opioids (tramadol, tapentadol, morphine). At baseline, pain severity, according to the Neurological Rating Scale (NRS), was 57 points at rest and up to 9 points in motion out of the maximum 10. The combination of 400 mg/day of tramadol with gabapentin and a non-steroidal anti-inflammatory drug was ineffective; 400 mg/day of tapentadol in combination with gabapentin and a non-steroidal anti-inflammatory drug also was ineffective. Morphine tablets 60 mg/day were effective (NRS score of 23), but unrelenting nausea and vomiting were unmanageable and significantly reduced quality of life. Reducing the dose of oral morphine to 20 mg/day mitigated adverse events but reduced the effectiveness of pain relief (resting NRS score of 4 points). Tafalgin 4 mg subcutaneously BID, then TID reduced the pain severity to an average daily NRS score of 1.22 over the first 3 days of treatment with no adverse events. Sleep, appetite, and physical activity improved. The patient received Tafalgin for 84 days, and she gained 5 kg due to improved nutrition during that time. The drug is comparable in efficacy to morphine and is associated with fewer adverse events. A limitation to widespread use is the availability of a formulation for subcutaneous injection only.
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Zhu SJ, Wang KR, Zhang XX, Zhu SM. Relationship between genetic variation in the α 2A-adrenergic receptor and the cardiovascular effects of dexmedetomidine in the Chinese Han population. J Zhejiang Univ Sci B 2019; 20:598-604. [PMID: 31168973 DOI: 10.1631/jzus.b1800647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There are differences in individual cardiovascular responses to the administration of dexmedetomidine, a highly selective α2A-adrenergic receptor (ADRA2A) agonist. The aim of this study was to investigate ADRA2A gene polymorphisms in the Chinese Han population and their association with the cardiovascular response to intravenous dexmedetomidine infusion. Sixty elective surgery patients of Chinese Han nationality were administered 1 µg/kg dexmedetomidine intravenously over 10 min as a premedication. ADRA2A C-1291G and A1780G polymorphism status was determined in these patients, and their relationships to changes in blood pressure and heart rate after dexmedetomidine administration were analyzed. There were neither significant differences in systolic or diastolic blood pressure changes in individuals with different A1780G and C-1291G genotypes after dexmedetomidine administration, nor in heart rates among the different A1780G genotypes. However, there were significant differences in changes in heart rates in patients with different C-1291G genotypes. There were no significant differences in the sedative effects of dexmedetomidine among different A1780G and C-1291G genotypes. Logistic regression revealed that the C-1291G polymorphism was associated with differential decreases in heart rate after intravenous infusion of dexmedetomidine. These findings indicate that the ADRA2A C-1291G polymorphism can affect heart rate changes in patients after intravenous infusion of dexmedetomidine.
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Affiliation(s)
- Shao-Jun Zhu
- Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Kui-Rong Wang
- Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xiong-Xin Zhang
- Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Sheng-Mei Zhu
- Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
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Owusu Obeng A, Hamadeh I, Smith M. Review of Opioid Pharmacogenetics and Considerations for Pain Management. Pharmacotherapy 2017; 37:1105-1121. [DOI: 10.1002/phar.1986] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Aniwaa Owusu Obeng
- The Charles Bronfman Institute for Personalized Medicine; Icahn School of Medicine at Mount Sinai; New York NY
- Pharmacy Department; The Mount Sinai Hospital; New York New York
- Division of General Internal Medicine; Department of Medicine; Icahn School of Medicine at Mount Sinai; New York New York
| | | | - Michael Smith
- University of Michigan College of Pharmacy; Ann Arbor Michigan
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Abstract
A significant number of commonly administered medications in anesthesia show wide clinical interpatient variability. Some of these include neuromuscular blockers, opioids, local anesthetics, and inhalation anesthetics. Individual genetic makeup may account for and predict cardiovascular outcomes after cardiac surgery. These interactions can manifest at any point in the perioperative period and may also only affect a specific system. A better understanding of pharmacogenomics will allow for more individually tailored anesthetics and may ultimately lead to better outcomes, decreased hospital stays, and improved patient satisfaction.
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Affiliation(s)
- Ramsey Saba
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Alan D Kaye
- Department of Anesthesiology and Pain Medicine, LSU Health Science Center, Louisiana State University School of Medicine, 1542 Tulane Avenue, Room 659, New Orleans, LA 70112, USA
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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Morrone LA, Scuteri D, Rombolà L, Mizoguchi H, Bagetta G. Opioids Resistance in Chronic Pain Management. Curr Neuropharmacol 2017; 15:444-456. [PMID: 28503117 PMCID: PMC5405610 DOI: 10.2174/1570159x14666161101092822] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 08/11/2016] [Accepted: 10/24/2016] [Indexed: 01/07/2023] Open
Abstract
Chronic pain management represents a serious healthcare problem worldwide. Chronic pain affects approximately 20% of the adult European population and is more frequent in women and older people. Unfortunately, its management in the community remains generally unsatisfactory and rarely under the control of currently available analgesics. Opioids have been used as analgesics for a long history and are among the most used drugs; however, while there is no debate over their short term use for pain management, limited evidence supports their efficacy of long-term treatment for chronic non-cancer pain. Therapy with opioids is hampered by inter-individual variability and serious side effects and some opioids often result ineffective in the treatment of chronic pain and their use is controversial. Accordingly, for a better control of chronic pain a deeper knowledge of the molecular mechanisms underlying resistance to opiates is mandatory.
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Affiliation(s)
- Luigi A. Morrone
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
- University Consortium for Adaptive Disorders and Head Pain (UCADH), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Rende, Italy
| | - Damiana Scuteri
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Laura Rombolà
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Hirokazu Mizoguchi
- Department of Physiology and Anatomy, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Giacinto Bagetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
- University Consortium for Adaptive Disorders and Head Pain (UCADH), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Rende, Italy
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Su Y, Zhan YY, Wang BF, Wang SC, Dai DP, Hu GX, Lin H, Lian QQ, Cai JP. In vitro assessment of 24 CYP2D6 allelic isoforms on the metabolism of methadone. Drug Test Anal 2016; 9:216-220. [PMID: 26968424 DOI: 10.1002/dta.1959] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/17/2016] [Accepted: 01/17/2016] [Indexed: 12/18/2022]
Abstract
CYP2D6 is an important member of the cytochrome P450 (CYP450) enzyme super family, with at least 100 CYP2D6 alleles being previously identified. Genetic polymorphisms of CYP2D6 significantly influence the efficacy and safety of some drugs, which might cause adverse effects and therapeutic failure. The aim of this study was to clarify the catalytic activities of 24 CYP2D6 alleles on the oxidative in vitro metabolism of methadone. Reactions were incubated with 50-2000 µM methadone for 30 min at 37 °C and terminated by cooling to -80 °C immediately. Methadone and the major metabolite EDDP were analyzed by an ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) system. Compared with wild-type CYP2D6*1, most variants showed significantly altered values in Vmax and intrinsic clearance (Vmax /Km ). Only three variants (CYP2D6*88, *91 and E215K) exhibited markedly increased intrinsic clearance values, and one variant CYP2D6*94 showed no significant difference. On the other hand, the kinetic parameters of two CYP2D6 variants (CYP2D6*92 and *96) could not be determined because they had no detectable enzyme activity, whereas 18 variants exhibited significantly decreased values. To sum up, this study demonstrated that more attention should be paid in clinical administration of methadone to individuals carrying these CYP2D6 alleles. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ying Su
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Yun-Yun Zhan
- School of Pharmacy, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ben-Fu Wang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Si-Cong Wang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Da-Peng Dai
- The Key Laboratory of Geriatrics, Beijing Hospital & Beijing Institute of Geriatrics, Ministry of Health, Beijing, China
| | - Guo-Xin Hu
- School of Pharmacy, Wenzhou Medical University, Wenzhou, 325035, China
| | - Han Lin
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qing-Quan Lian
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Jian-Ping Cai
- The Key Laboratory of Geriatrics, Beijing Hospital & Beijing Institute of Geriatrics, Ministry of Health, Beijing, China
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IMMOBILIZING THE VULNERABLE APENNINE CHAMOIS (RUPICAPRA PYRENAICA ORNATA) WITH A LOW-DOSE XYLAZINE-KETAMINE COMBINATION, REVERSED WITH IDAZOXAN OR ATIPAMEZOLE. J Zoo Wildl Med 2015; 46:213-23. [PMID: 26056871 DOI: 10.1638/2014-0079r.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Little information is available on chemical capture of the vulnerable subspecies within the genus Rupicapra. Low-dosage combinations of xylazine and ketamine were tested for immobilization of captive and free-ranging Apennine chamois, Rupicapra pyrenaica ornata (85 and 66 immobilizations, respectively) in a retrospective analysis. Of the six dosage groups, all of them providing an acceptable level of immobilization, the optimal trade-off between safety and efficacy was found following administration of a mean dosage of 0.24±0.03 mg/kg xylazine and 1.07±0.15 mg/kg ketamine, resulting in 7.50±3.31 min induction time, deep sedation with no or limited reaction to handling in 96% of the chamois, minimal deviation of physiologic parameters from previously reported physiologic values for anesthetized or physically restrained chamois, and no mortality. Intravenous injection of idazoxan (0.05±0.01 mg/kg) or atipamezole (0.38±0.37 mg/kg) resulted in faster reversal than intravenous injection of tolazoline (1.05±0.15 mg/kg) in 1.3 vs. 4.1 min. When free-ranging chamois were darted with similar xylazine and ketamine dosages, induction time was 8.49±5.48 min, 88% of the animals were deeply sedated, and a single animal died from respiratory arrest (1.5% mortality). Intramuscular atipamezole provided smoother reversal than intravenous idazoxan. The results of this study suggest that xylazine/ketamine combinations, at remarkably lower dosage than previously published in Caprinae, may be safely and effectively used in chemical capture protocols of Apennine chamois, to facilitate conservation-oriented relocation and research.
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Mirzakhani H, van Noorden MS, Swen J, Nozari A, Guchelaar HJ. Pharmacogenetics in electroconvulsive therapy and adjunctive medications. Pharmacogenomics 2015; 16:1015-31. [DOI: 10.2217/pgs.15.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Electroconvulsive therapy (ECT) has shown apparent efficacy in treatment of patients with depression and other mental illnesses who do not respond to psychotropic medications or need urgent control of their symptoms. Pharmacogenetics contributes to an individual's sensitivity and response to a variety of drugs. Clinical insights into pharmacogenetics of ECT and adjunctive medications not only improves its safety and efficacy in the indicated patients, but can also lead to the identification of novel treatments in psychiatric disorders through understanding of potential molecular and biological mechanisms involved. In this review, we explore the indications of pharmacogenetics role in safety and efficacy of ECT and present the evidence for its role in patients with psychiatric disorders undergoing ECT.
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Affiliation(s)
- Hooman Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA
- Division of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - Martijn S van Noorden
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - Jesse Swen
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - Ala Nozari
- Department of Anesthesia, Orthopedic Anesthesia Division, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
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Pharmacogenomics and Opioid Analgesics: Clinical Implications. Int J Genomics 2015; 2015:368979. [PMID: 26075211 PMCID: PMC4446490 DOI: 10.1155/2015/368979] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 04/22/2015] [Accepted: 04/26/2015] [Indexed: 11/17/2022] Open
Abstract
Variation exists in patient response on analgesic treatment in terms of efficacy and safety. This variation may be in part explained by pharmacogenomics. This paper aimed to review data on pharmacogenomics of opioid analgesics focusing on the effect of genetic variation on the efficacy and safety of these agents. Current evidence suggests that pharmacogenomics contribute to variation in efficacy and safety of opioids. However, most data come from case control studies and case reports. In addition, a recognized drawback in the field of pharmacogenomics is the common occurrence of false positive association between polymorphisms and the investigated outcome. Prospective studies are needed to further elucidate the clinical implications of available data as well as to define the guidelines for the clinical application of pharmacogenomic data. Furthermore, basic research should focus on the identification of biologically meaningful polymorphisms enabling a hypothesis with biological plausibility driven research in the field of pharmacogenomics of analgesics. Moreover, the publication of relevant negative results should be favoured.
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Yokoyama C, Onoe H. Positron emission tomography imaging of the social brain of common marmosets. Neurosci Res 2015; 93:82-90. [DOI: 10.1016/j.neures.2014.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 12/08/2014] [Accepted: 12/11/2014] [Indexed: 01/07/2023]
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Sadhasivam S, Chidambaran V. Pharmacogenomics of opioids and perioperative pain management. Pharmacogenomics 2013; 13:1719-40. [PMID: 23171337 DOI: 10.2217/pgs.12.152] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Inadequate pain relief and adverse effects from analgesics remain common in children and adults during the perioperative period. Opioids are the most commonly used analgesics in children and adults to treat perioperative pain. Narrow therapeutic index and a large interpatient variability in response to opioids are clinically significant, with inadequate pain relief at one end of the spectrum and serious side effects, such as respiratory depression and excessive sedation due to relative overdosing, at the other end. Personalizing analgesia during the perioperative period attempts to maximize pain relief while minimizing adverse events from therapy. While various factors influence response to treatment among surgical patients, age, sex, race and pharmacogenetic differences appear to play major roles in predicting outcome. Genetic factors include a subset of genes that modulate the proteins involved in pain perception, pain pathway, analgesic metabolism (pharmacokinetics), transport and receptor signaling (pharmacodynamics). While results from adult genetic studies can provide direction for pediatric studies, they have limited direct applicability, as children's genetic predispositions to analgesic response may be influenced by developmental and behavioral components, altered sensitivity to analgesics and variation in gene-expression patterns. We have reviewed the available evidence on improving and personalizing pain management with opioids and the significance of individualizing analgesia, in order to maximize analgesic effect with minimal adverse effects with opioids. While the early evidence on individual genotype associations with pain, analgesia and opioid adverse outcome are promising, the large amount of conflicting data in the literature suggests that there is a need for larger and more robust studies with appropriate population stratification and consideration of nongenetic and other genetic risk factors. Although the clinical evidence and the prospect of being able to provide point-of-care genotyping to enable clinicians to deliver personalized analgesia for individual patients is still not available, positioning our research to identify all possible major genetic and nongenetic risk factors of an individual patient, advancing less expensive point-of-care genotyping technology and developing easy-to-use personalized clinical decision algorithms will help us to improve current clinical and economic outcomes associated with pain and opioid pain management.
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Affiliation(s)
- Senthilkumar Sadhasivam
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2001, Cincinnati, OH 45229, USA.
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Landau R, Bollag LA, Kraft JC. Pharmacogenetics and anaesthesia: the value of genetic profiling. Anaesthesia 2012; 67:165-79. [DOI: 10.1111/j.1365-2044.2011.06918.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Welch E. Anaesthetic genetics and genomics. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2011. [DOI: 10.1080/22201173.2011.10872802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- E Welch
- Dunkeld Anaesthetic Practice, Johannesburg
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Jannetto PJ, Bratanow NC. Pharmacogenomic considerations in the opioid management of pain. Genome Med 2010; 2:66. [PMID: 20854646 PMCID: PMC3092117 DOI: 10.1186/gm187] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Physicians continue to struggle with the clinical management of pain, in part because of the large interindividual variability in the efficacy, occurrence of side effects and undesired severe adverse drug reactions from the prescribed analgesics. Pharmacogenomics, the study of how an individual's genetic inheritance affects the body's response to medications, has an important role and can explain some of this interindividual variability. Genetic identification of known variant alleles that affect the pharmacokinetics or pharmacodynamics of medications used for pain management can enable physicians to select the appropriate analgesic drug and dosing regimen for an individual patient, instead of empirical selection and dosing escalation. In this article, clinically relevant pharmacogenomic targets for the management of opioid pain, including efflux transporters, proteins that metabolize drugs, enzymes that regulate the neurotransmitters that modulate pain, and opioid receptors, will be reviewed.
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Affiliation(s)
- Paul J Jannetto
- Department of Pathology, Medical College of Wisconsin, 9200 W, Wisconsin Avenue, Milwaukee, WI 53226, USA.
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Landau R. Pharmacogenetic influences in obstetric anaesthesia. Best Pract Res Clin Obstet Gynaecol 2010; 24:277-87. [DOI: 10.1016/j.bpobgyn.2009.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 11/25/2009] [Indexed: 10/20/2022]
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Jaramillo KS, Scruth E, Cheng E. Prolonged paralysis and apnea after receiving a neuromuscular blocking agent: what nurses should know. Am J Crit Care 2009; 18:592, 588-91. [PMID: 19880962 DOI: 10.4037/ajcc2009572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
After receiving mivacurium, a short-acting neuromuscular blocking agent used for intubation before surgery, a patient experienced prolonged paralysis and prolonged apnea that required ventilator support. Although this complication is rare, all critical care nurses should be aware of it so they can be competent in managing and providing holistic and comprehensive nursing care to the patient and the patient's family. Although this complication has been documented in the anesthesia literature, it has received little mention in critical care nursing journals.
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Affiliation(s)
- Kathryn S. Jaramillo
- Kathryn S. Jaramillo is a graduate student in the cardiovascular genomics clinical nurse specialist program in the School of Nursing, University of California, San Francisco. Elizabeth Scruth is a critical care clinical nurse specialist in the Department of Educational Services and Eugene Cheng is chief of intensivists in the Department of Anesthesia at Kaiser Permanente Medical Center, San Jose, California
| | - Elizabeth Scruth
- Kathryn S. Jaramillo is a graduate student in the cardiovascular genomics clinical nurse specialist program in the School of Nursing, University of California, San Francisco. Elizabeth Scruth is a critical care clinical nurse specialist in the Department of Educational Services and Eugene Cheng is chief of intensivists in the Department of Anesthesia at Kaiser Permanente Medical Center, San Jose, California
| | - Eugene Cheng
- Kathryn S. Jaramillo is a graduate student in the cardiovascular genomics clinical nurse specialist program in the School of Nursing, University of California, San Francisco. Elizabeth Scruth is a critical care clinical nurse specialist in the Department of Educational Services and Eugene Cheng is chief of intensivists in the Department of Anesthesia at Kaiser Permanente Medical Center, San Jose, California
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Dahan A. The importance of individual differences in response to opioid therapy. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/thy.09.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kaymak C, Kocabaş NA, Durmaz E, Oztuna D. beta2 adrenoceptor (ADRB2) pharmacogenetics and cardiovascular phenotypes during laryngoscopy and tracheal intubation. Int J Toxicol 2007; 25:443-9. [PMID: 17132602 DOI: 10.1080/10915810600959519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pharmacogenetics is the study of genetic variations that cause a variable drug response characterized by alteration in drug metabolism or in pharmacodynamics. The polymorphisms in genes encoding receptors relevant to treatment cause variation in sensitivity to many drugs. beta2 Adrenoceptor genetic variation contributes to regulation of blood pressure and hemodynamic changes by mediating peripheral vasodilatation. Laryngoscopy and tracheal intubation associated with hemodynamic changes. Although there are four nonsynomic single-nucleotide polymorphisms (SNPs) of beta2 adrenoceptor gene, codon 16 (Arg16Gly) and codon 27 (Gln27Glu) SNPs are both common and functionally important. In this paper, the authors investigated the beta2 adrenoceptor Gly16 and Glu27 SNPs in response to drugs relevant to anesthesia and how these SNPs impacted upon the cardiovascular phenotypes. The authors measured arterial systolic and diastolic blood pressure, heart rate, and rate-pressure product before induction of anesthesia and 1 min following laryngoscopy and tracheal intubation. Genomic DNA was amplified and genotyped using allele-specific polymerase chain reaction (ASPCR) and restriction fragment length polymorphism (RFLP) assays, respectively. When the authors compared hemodynamic results according to genotypes, the patients with Gln homozygote allele at codon 27 exhibited significant increase of heart rate than patients with Glu allele after laryngoscope and tracheal intubation.
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Affiliation(s)
- Cetin Kaymak
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Kirikkale University, Turkey
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