Pain Management
Federico Corletto Cert VA, Diploma ECVAA, MRCVS
I am taking responsibility for the pain management section of the AVA eduactional updates. This is a new addition to the educational updates section in 2009, I hope that you find it both educational and infomative.
January 2009 Update
Pharmacogenetic, P-Glycoproteins and MDR gene: a possible role in analgesia?
Many drugs are transported by P-Glycoproteins, including steroids, cyclosporine, ivermectin, verapamil, ondansetron, digoxin, morphine, methadone and pethidine. Some dog breeds have a deletion mutation of the MDR1 gene, which results in production of a malfunctional P-glycoprotein. Consequently, macrocyclic lactones, such as ivermectin and moxidectin, reach significantly higher concentration in the central nervous system compared to other dogs, and may cause toxic reactions, as observed in collies. Interestingly, the limited capability of morphine to penetrate the CNS has been related, at least in part, with extrusion activity by P-Glycoproteins located on the BBB. Co-administration of morphine and P-Glycoprotein inhibitors resulted in an increased anti-nociceptive effect of morphine in rats, confirming the important role of MDR and P-Glycoproteins in regulating bioavailability, disposition, efficacy and also toxicity of certain drugs.
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