European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Aug 2011
Randomized Controlled TrialEffects of lornoxicam on the hemodynamic and catecholamine response to laryngoscopy and tracheal intubation.
Laryngoscopy and tracheal intubation are associated with hemodynamic responses that might increase morbidity and mortality in some patients. Lornoxicam is a nonsteroidal anti-inflammatory drug, which, when added to fentanyl, successfully attenuated the pressor response of intubation. The aim of this study was to evaluate the effect of lornoxicam on the hemodynamic response and serum catecholamine levels following laryngoscopy and tracheal intubation. ⋯ Lornoxicam 16 mg attenuates the pressor response to laryngoscopy and intubation of the trachea.
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Eur. J. Clin. Pharmacol. · Aug 2011
Impact of interleukin-10 gene polymorphisms on tacrolimus dosing requirements in Chinese liver transplant patients during the early posttransplantation period.
Pharmacogenetics holds the potential to elucidate the inherited basis of differences between individual responses to drugs. Impacts of CYP3A5 and ABCB1 gene polymorphisms on the immunosuppressant tacrolimus have been reported in previous studies of liver transplantation. The functions of interleukin-10 (IL-10) gene expression are complex in the early period after liver transplantation. In this study, we examined the IL-10 genotypes of both recipients and donors to clarify the influence of these genetic variants on tacrolimus dose requirements and pharmacokinetics. ⋯ Determining IL-10 and CYP3A5 polymorphisms of donors may allow individualized tacrolimus dosage regimens to be determined for liver transplant patients during the early posttransplantation period.
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Eur. J. Clin. Pharmacol. · Aug 2011
Case ReportsNear-fatal tramadol cardiotoxicity in a CYP2D6 ultrarapid metabolizer.
Tramadol is a synthetic, centrally acting analgesic for the treatment of moderate to severe pain. The marketed tramadol is a racemic mixture containing 50% (+)tramadol and 50% (-)tramadol and is mainly metabolized to O-desmethyltramadol (M1) by the cytochrome P450 CYP2D6. Tramadol is generally considered to be devoid of any serious adverse effects of traditional opioid receptor agonists, such as respiratory depression and drug dependence. ⋯ We here report a case of near-fatal isolated tramadol cardiotoxicity. Because of the inhibition of norepinephrine reuptake, excessive blood epinephrine levels in this CYP2D6R UM patient following excessive tramadol ingestion could explain the observed strong myocardial stunning. This patient admitted intermittent tramadol consumption to gain a "high" sensation. In patients with excessive morphinomimetic effects, levels of tramadol and its main metabolite M1could be measured, ideally combined with CYP2D6 genotyping, to identify individuals at risk of tramadol-related cardiotoxicity. Tramadol treatment could be optimized in these at-risk individuals, consequently improving patient outcome and safety.