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: UMLS:C0344307 (
analgesia
)
28,200
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Avinza is a once-daily, extended-release oral morphine preparation. It has a pharmacokinetic profile that exhibits less peak-to-trough fluctuations in plasma concentration whilst providing
analgesia
statistically identical to that produced by MS Contin (controlled-release morphine sulfate),
Oxycontin
(oxycodone HCl controlled-release) and six doses of oral morphine sulfate administered every 4 h. Avinza improves quality of sleep by several measures but interestingly gives the best sleep improvement when given in the morning rather than at night. It causes the same side effects of other opioids: constipation, nausea, vomiting, somnolence and mood swings. Doses of 30 - 60 mg/day have been shown to be well tolerated by patients with osteoarthritis (even in the elderly), who have failed other medications.
...
PMID:Avinza - 24-h sustained-release oral morphine therapy. 1499 42
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
Abstrsct A case is described in which a man with chronic pain syndrome (CPS) presented to a city General hospital in suicidal crisis after referral from a provincial psychiatric unit, having taken an overdose of a variety of medications, precipitated by the absence of his opioid (
Oxycontin
)
analgesia
which he had been abusing intra-nasally. This is to our knowledge the first reported case in Europe of drug diversion from oral to intranasal use of
Oxycontin
, a controlled-release preparation of the synthetic opiate, oxycodone hydrochloride. There is also a dearth of reference to the abuse potential of this agent in the European literature. As sufferers from chronic pain syndrome increase in number, and opiate prescription rates worldwide are maintained, this case highlights the potential of opiate abuse or dependence and drug diversion emerging as a significant medical problem in CPS patients in Europe.
...
PMID:Drug diversion of Oxycontin in chronic pain syndrome. 3029 May 16
