[Genetic variation-- important for the clinical effect of opioids?]
Pål Klepstad1, Ola Dale, Petter C Borchgrevink
1Avdeling for anestesi og akuttmedisin, St. Olavs Hospital, 7006 Trondheim. pal.klepstad@ntnu.no
Abstract:
The individual variability of opioid pharmacology suggests that the patients' genetic disposition influences the response to opioids. Given the complexity of morphine pharmacology, variability may be caused by several genes. Data suggest that variability in genes encoding the enzyme metabolising morphine (UGT2B7 gene), mu-opioid receptors (OPRM1 gene) and BBB transport of morphine by multidrug resistance transporters (MDR1 gene) influence the clinical efficacy of morphine. Furthermore, variability in an enzyme-degrading catecholamines (COMT gene) may also alter the efficacy of morphine, which shows that genetic variability in non-opioid systems may indirectly influence the clinical opioid efficacy. Results obtained so far strongly suggest that opioid efficacy is partly related to inborn properties caused by genetic variability.
Related Concept Videos
Opioid Analgesics: Morphine and Other Natural Cogeners
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu
Analgesia and Pain Management
Principles of Pharmacogenetics: Types of Genetic Variants
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Opioid Receptors: Overview
