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master's thesis
Farmakogenetika tramadola i individualizacija terapije
Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry, 2019. urn:nbn:hr:163:785681
Miljak, Karolina
University of Zagreb
Faculty of Pharmacy and Biochemistry
Department of medical biochemistry and haematology

Institutional repository: Repository of Faculty of Pharmacy and Biochemistry University of Zagreb

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Miljak, K. (2019). Farmakogenetika tramadola i individualizacija terapije (Master's thesis). Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry. Retrieved from https://urn.nsk.hr/urn:nbn:hr:163:785681

Miljak, Karolina. "Farmakogenetika tramadola i individualizacija terapije." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2019. https://urn.nsk.hr/urn:nbn:hr:163:785681

Miljak, Karolina. "Farmakogenetika tramadola i individualizacija terapije." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2019. https://urn.nsk.hr/urn:nbn:hr:163:785681

Miljak, K. (2019). 'Farmakogenetika tramadola i individualizacija terapije', Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, accessed 26 December 2024, https://urn.nsk.hr/urn:nbn:hr:163:785681

Miljak K. Farmakogenetika tramadola i individualizacija terapije [Master's thesis]. Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry; 2019 [cited 2024 December 26] Available at: https://urn.nsk.hr/urn:nbn:hr:163:785681

K. Miljak, "Farmakogenetika tramadola i individualizacija terapije", Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, 2019. Available at: https://urn.nsk.hr/urn:nbn:hr:163:785681

Metadata
TitleFarmakogenetika tramadola i individualizacija terapije
Title (english)The pharmacogenetics of tramadol and therapy individualization
AuthorKarolina Miljak
MentorKarmela Barišić (mentor)
Committee memberKarmela Barišić (predsjednik povjerenstva)
Committee memberVesna Bačić Vrca (član povjerenstva)
Committee memberNada Božina (član povjerenstva)
GranterUniversity of Zagreb
Faculty of Pharmacy and Biochemistry
(Department of medical biochemistry and haematology)
Zagreb
Defense date and country2019-09-12, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Pharmacy
Pharmacy
Abstract
Farmakogenetika je znanstvena disciplina koja proučava utjecaja individualnih razlika u slijedu DNA na učinkovitost i toksičnost farmakoterapije. Najčešće ispituje varijante gena koji kodiraju enzime uključene u metabolizam i prijenos lijeka preko različitih membrana. Cilj je rada ukazati na moguću važnost farmakogenetičke analize kao korisnog alata u svakodnevnoj kliničkoj praksi za optimalnu prilagodbu doziranja lijekova čija primjena može rezultirati razvojem serotoninskog sindroma. Ovim su radom prikazani enzimi i transporteri ključni za metaboličke puteve tramadola i čestih konkomitantno primijenjenih antidepresiva. Opisani su mogući patogenetski mehanizmi nastanka serotoninskog sindroma kao posljedica farmakogenetičke predispozicije te interakcija lijekova. Također su opisani i geni koji kodiraju enzime CYP2D6, CYP2C19, CYP3A4, UGT2B7 i transportere P-glikoprotein (Pgp/MDR1/ABCB1) i SERT. Na primjerima opisa slučajeva iz kliničke prakse prikazani su mogući mehanizmi interakcija lijek-lijek-gen. Rezultati analiza upućuju na utjecaj farmakogena u moduliranju interakcija konkomitantno primjenjenog tramadola i antidepresiva, u ovom slučaju escitaloprama, venlafaksina i paroksetina, koje su rezultirale razvojem serotoninskog sindroma. U zaključku treba istaknuti da bi provedba genotipizacije relevantnih gena metaboličkih enzima i transportera važnih u farmakokinetici tramadola i antidepresiva mogla značajno pridonijeti individualiziranom pristupu u primjeni navedenih lijekova te minimalizaciji rizika razvoja štetnih učinaka uključujući serotoninski sindrom. U širem kontekstu ovaj rad ukazuje na potencijal farmakogenetike u personaliziranom pristupu svakom pacijentu radi postizanja željenih terapijskih ishoda, smanjenja nastanka nuspojava, te poboljšanja opće kvalitete zdravstvene skrbi.
Abstract (english)
Pharmacogenetics is a science discipline that studies impacts of interindividual differences in DNA on pharmacotherapy efficacy and toxicity. Most frequently examined are gene variants encoding enzymes responsible for drug metabolism and transmembrane transport. The aim of this paper is to showcase the potential of pharmacogenetic analysis as an useful tool for timely dosing adjustment of medications, containing a high risk of serotonin syndrome development, in every day clinical praxis. This paper takes into account drug metabolizing enzymes and drug transporters of tramadol pathway and concominantly perscribed antidepressants. Showcased are hypothetical pathogenetic mechanisms of serotonin syndrome development as a result of pharmacogenetic predisposition and drug interactions. Genes coding for CYP2D6, CYP2C19, CYP3A4, UGT2B7, MDR1 and SERT are characterized. Clinical case examples were used to describe potential mechnisms of drug-drug-gene interactions. The results of pharmacogenetic analysis confirmed that pharmacogenes have an impact on tramadol-antidepressant polytherapy modulation, in this case escitalopram, vanlafaxine and paroxetine, causing serotonin syndrome development. In conclusion, genotyping genes coding for important metabolic enzymes and transporters of tramadol-antidepressant pharmacokinetics could significantly contribute to individual approach in administration of these drugs and minimize risks of adverse effects incidents, including serotonin syndrome. In a broader context, this paper presents potenitial of pharmacogenetics in personalized approach to every patient in terms of achieving optimal therapy results, avoiding side effects and improving health care quality.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:163:785681
Study programmeTitle: Pharmacy
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2020-02-12 12:25:54