Pharmacogenomics and Morphine

Morphine is an opioid analgesic indicated in the treatment of acute and chronic moderate to severe pain. From a pharmacodynamic standpoint, morphine exerts its effects by agonizing mu‐opioid receptors predominantly, resulting in analgesia and sedation. Pharmacokinetically, morphine is primarily meta...

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Bibliographic Details
Published in:Journal of clinical pharmacology 2021-09, Vol.61 (9), p.1149-1155
Main Authors: Ofoegbu, Adaku, B. Ettienne, Earl
Format: Article
Language:English
Subjects:
ABCB1
Analgesia
Analgesics
Analgesics, Opioid - pharmacokinetics
Analgesics, Opioid - pharmacology
ATP
ATP Binding Cassette Transporter, Subfamily B - genetics
ATP Binding Cassette Transporter, Subfamily B, Member 1 - genetics
Continuing Education: Review
Genetic diversity
Glucuronosyltransferase
Glucuronosyltransferase - genetics
Humans
Morphine
Morphine - pharmacokinetics
Morphine - pharmacology
Narcotics
OCT1
Opioid receptors (type mu)
OPRM1
Organic cation transporter
Organic Cation Transporter 1 - genetics
Pain perception
Pharmacodynamics
Pharmacogenetics
Pharmacogenomics
Pharmacokinetics
Polymorphism, Single Nucleotide
Protein transport
Proteins
P‐glycoprotein
Receptors, Opioid, mu - genetics
UGT2B7
Uridine
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Description
Summary:Morphine is an opioid analgesic indicated in the treatment of acute and chronic moderate to severe pain. From a pharmacodynamic standpoint, morphine exerts its effects by agonizing mu‐opioid receptors predominantly, resulting in analgesia and sedation. Pharmacokinetically, morphine is primarily metabolized in the liver via glucuronidation by the enzyme uridine diphosphate glucuronosyltransferase family 2 member B7 and encounters the transporter proteins organic cation transporter isoform 1 and P‐glycoprotein (adenosine triphosphate–binding cassette subfamily B member 1) as it is being distributed throughout the body. The genes coding for the proteins impacting either the pharmacokinetics or pharmacodynamics of morphine may bear genetic variations, also known as polymorphisms, which may alter the function of the proteins in such a manner that an individual may have disparate treatment outcomes. The purpose of this review is to highlight some of the genes coding for proteins that impact morphine pharmacokinetics and pharmacodynamics and present some treatment considerations.
ISSN:0091-2700
1552-4604
DOI:10.1002/jcph.1873