Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: EC:3.6.3.44 (
P-glycoprotein
)
13,344
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Intrathecal morphine provides superior analgesia and minimizes side effects with ~1/300th of the oral dose necessary to achieve this effect. The conversion ratios from oral route to intrathecal route vary greatly among individuals, and this may be related with polymorphisms of the
ATP-binding cassette B1
(
ABCB1
)/
multiple drug resistance 1
(
MDR1
) gene encoding the transporter
P-glycoprotein
in the blood-brain barrier. In the case presented herein, a patient with cancer pain for over 3 months was treated with oxycodone hydrochloride prolonged-release tablets (
Oxycontin
) and morphine hydrochloride tablets for breakthrough pain. The patient was admitted due to intolerable adverse effects of
Oxycontin
. During this admission, he was implanted with an intrathecal morphine pump which can deliver morphine into the cerebrospinal fluid. To our surprise, intrathecal morphine at a dose of ~1/540th of oral morphine equivalent dose produced complete analgesia. Our finding revealed homogenous CC at position 3435 (C3435T) in the
ABCB1
/
MDR1
gene in this patient, which encodes
P-glycoprotein
with good efflux pump functionality. As intrathecal morphine bypasses the blood-brain barrier that oral medications have to pass through, the good pump functionality may have contributed to the super analgesia of intrathecal morphine in this case. Genetic analysis of
ABCB1
/
MDR1
gene polymorphisms can be useful for personalized pain management in patients with intrathecal morphine pump.
...
PMID:Super analgesia of intrathecal morphine may be related to
ABCB1
(
MDR1
) gene polymorphism. 3005 Mar 19
