Pharmacogenetics of morphine: Potential implications in sickle cell disease.
Morphine is frequently used to treat painful episodes associated with sickle cell disease (SCD) but may fail to provide adequate analgesia in many patients. This concise review focuses on unique disease related changes in physiologic variables associated with SCD that impacts pharmacokinetics and pharmacodynamics of morphine and may contribute to the variability in analgesia. Emerging evidence suggests that the allelic variants in the genes involving the opioid (UGT2B7, OPRM1, and ABCB1 genes) and nonopioid system (COMT gene) can alter the efficacy of morphine.
Darbari
Deepika S
DS
Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC 20010, USA. ddarbari@cnmc.org
Minniti
Caterina P
CP
Rana
Sohail
S
van den Anker
John
J
D000755:Anemia, Sickle Cell / Q000188:drug therapy* / Q000235:genetics*; D014644:Genetic Variation; D020719:Glucuronides / Q000493:pharmacokinetics; D006801:Humans; D009020:Morphine / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D010597:Pharmacogenetics
D020719:Glucuronides; D009020:Morphine