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Allied Journal of Medical Research
|
Volume 2
Page 34
Note:
allied
academies
CANCER THERAPY AND ONCOLOGY
NEUROLOGY AND BRAIN DISORDERS
&
International Conference on
International Conference on
J u n e 2 1 - 2 2 , 2 0 1 8 | O s a k a , J a p a n
Joint Event on
PHARMACOGENETICS
OF EXTRAPYRAMIDAL
SYNDROMES ASSOCIATED WITH
COADMINISTRATION OF OPIOIDS AND
ANTIDEPRESSANTS
Helena Sarac, Neven Henigsberg, Nada Božina
and
Ervina
Bilić
University Hospital Centre Zagreb, Croatia
O
pioid analgesics are widely used for the pain relief. More than 0.8% of
theglobal populationbetween15and65usedopioidanalgesics, in last
years. The currently marketed alkaloid opiates are codeine, hydrocodone,
oxycodone, methadone, tramadol, fentanyl, morphine, hydromorphone
and oxymorphone. Opioids have a narrow therapeutic index, and can be
associatedwith severe adverse reaction, addiction, dependance, tolerance
and fatal overdose. Opioid’s adverse effects have been shown to increase
the risk of seizures and serotonin syndrome characterized as a triad of
neuro-excitatoty features; alteredmental sttaus(e.g. sedationoragitation),
autonomic hyperactivity (e.g. diaphoresis, mydriasis, tachycardia, nausea,
urinary retention, diarrhea) and neuromuscular hyperactivity (tremor,
myoclonus, hyper-reflexia, pyramidal rigidity). Although the development
of extrapyramidal symptoms is under-recognized in clinical practice,
with the widespread use of opioid analgesics, increasing numbers of
patients with movement disorders following exposure to these drugs
have been reported. Chronic pain syndromes are commonly associated
with depression and clinicians simultaneously treat both of these
conditions prescribing opioids for pain while also administer a selective
serotonin reuptake inhibitor (SSRI) for depression. Although there are
much efforts has been directed to prevention of misuse, the importance
of pharmacokinetic drug-drug interactions related to opioids has received
little attention. Drug-drug-interactions-induced serotonin syndrome
caused by treatment with oxycodone and SSRI antidepressants is widely
known.2,3,4 Herein, we report a cases of extrapyramidal syndromes
induced by coadministration of antidepressants and opioids, caused by
cytochrome 450 polymorphisms and drug-drug interactions.
Helena Sarac was born in 1968 in Zagreb. She
graduated from Medical School in 1992 and at-
tained her PhD from Medical School University
of Zagreb in 2013. She was a visiting research
scientist at the Mount Sinai Hospital,New York.
Since 1999 she had headed the Diagnostic Cen-
ter Neuron at the Croatian Institute for Brain
Research, Medical School University of Zagreb.
She is neurologist at the Depratment of neurol-
ogy, University Hospital Centre Zagreb, Croatia
and scientist at the Centre of Research Excel-
lence for Clinical and Translational Neurosci-
ence. Her research topics are movement disor-
ders, neurodegeneration, and pharmacogenetic
of extrapyramidal syndromes. Her significant
contribution to the development of science in
the neuroimmunology. Dr Sarac has long been
interested in how serotonergic system is influ-
enced by autoimmune disorders. She authored
multiple scientific publications that have been
cited, and has been serving as an editorial board
member of reputed Journals and has been serv-
ing as an editorial board member of reputed
Journals. Dr Sarac has been guest speaker at
the international conferences worldwide.
helenasarac57@gmail.comBIOGRAPHY
Helena Sarac et al., Allied J Med Res 2018, Volume 2