Effects of Cyclosporine on Anesthetic Action

Cirella, Vincent N.; Pantuck, Carol B.; Lee, Young Joo; Pantuck, E. J.

doi:10.1213/00000539-198708000-00001

Cited by 56 publications

(39 citation statements)

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“…Pre-treatment of mice with the P-gp substrate and inhibitor cyclosporine A was found to significantly increase the analgesic effects of fentanyl, without affecting its plasma pharmacokinetics (128). Similarly, another mice study demonstrated that coadministration of fentanyl with a cyclosporine A analog increased sensitivity to fentanyl (129).…”

Section: Fentanylmentioning

confidence: 92%

Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions

et al. 2015

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Opioid-related deaths, abuse, and drug interactions are growing epidemic problems that have medical, social, and economic implications. Drug transporters play a major role in the disposition of many drugs, including opioids; hence they can modulate their pharmacokinetics, pharmacodynamics and their associated drug-drug interactions (DDIs). Our understanding of the interaction of transporters with many therapeutic agents is improving; however, investigating such interactions with opioids is progressing relatively slowly despite the alarming number of opioids-mediated DDIs that may be related to transporters. This review presents a comprehensive report of the current literature relating to opioids and their drug transporter interactions. Additionally, it highlights the emergence of transporters that are yet to be fully identified but may play prominent roles in the disposition of opioids, the growing interest in transporter genomics for opioids, and the potential implications of opioid-drug transporter interactions for cancer treatments. A better understanding of drug transporters interactions with opioids will provide greater insight into potential clinical DDIs and could help improve opioids safety and efficacy.

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Section: Fentanylmentioning

confidence: 92%

Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions

et al. 2015

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“…Ces interactions ont surtout été étudiées avec la ciclosporine. On retiendra que la durée d'action du fentanyl est augmentée chez la souris [4] ; que la durée d'action des curares non dépolarisants est allongée [5] ; la concentration alvéolaire minimale de l'isoflurane est augmentée, mais l'isoflurane ne modifie pas les taux plasmatiques de ciclosporine [6,7] ; le propofol ne modifie pas les concentrations sériques de ciclosporine chez l'homme [8].…”

Section: Interactions Médicamenteusesunclassified

Comment organiser la prise en charge anesthésique d’un patient transplanté en chirurgie générale ?

Quinart

Roullet

Sztark

2012

Le Praticien en Anesthésie Réanimation

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“…A report on an in vitro model of the blood-brain barrier (primary cultured bovine brain microvessel endothelial cells) showed that fentanyl was actively extruded by P-gp [29]. Cirella et al report that pretreatment with ciclosporin, a P-gp inhibitor, increased dose-dependent fentanyl-induced analgesia in mice [30]. In healthy volunteers, the administration of quinidine, a P-gp inhibitor, was associated with higher fentanyl absorption and plasma concentrations, but had no impact on oral fentanyl pharmacodynamics [31].…”

Section: Opioidsmentioning

confidence: 99%

Pharmacogenetics of Analgesics: Toward the Individualization of Prescription

et al. 2008

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The use of analgesics is based on the empiric administration of a given drug with clinical monitoring for efficacy and toxicity. However, individual responses to drugs are influenced by a combination of pharmacokinetic and pharmacodynamic factors that can sometimes be regulated by genetic factors. Whereas polymorphic drug-metabolizing enzymes and drug transporters may affect the pharmacokinetics of drugs, polymorphic drug targets and disease-related pathways may influence the pharmacodynamic action of drugs. After a usual dose, variations in drug toxicity and inefficacy can be observed depending on the polymorphism, the analgesic considered and the presence or absence of active metabolites. For opioids, the most studied being morphine, mutations in the ABCB1 gene, coding for P-glycoprotein (P-gp), and in the micro-opioid receptor reduce morphine potency. Cytochrome P450 (CYP) 2D6 mutations influence the analgesic effect of codeine and tramadol, and polymorphism of CYP2C9 is potentially linked to an increase in nonsteroidal anti-inflammatory drug-induced adverse events. Furthermore, drug interactions can mimic genetic deficiency and contribute to the variability in response to analgesics. This review summarizes the available data on the pharmacokinetic and pharmacodynamic consequences of known polymorphisms of drug-metabolizing enzymes, drug transporters, drug targets and other nonopioid biological systems on central and peripheral analgesics.

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Effects of Cyclosporine on Anesthetic Action

Cited by 56 publications

References 0 publications

Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions

Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions

Comment organiser la prise en charge anesthésique d’un patient transplanté en chirurgie générale ?

Pharmacogenetics of Analgesics: Toward the Individualization of Prescription

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