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The influence of naloxone on pharmacokinetics and pharmacodynamics of ticagrelor in patients with unstable angina pectoris receiving concomitant treatment with morphine — a protocol of a randomized trial
Affiliations- Katedra Kardiologii i Chorób Wewnętrznych, Szpital Uniwersytecki nr 1 im. dr. A. Jurasza ul. Curie Skłodowskiej 9, 85-094 Bydgoszcz, Poland
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Abstract
Rapid platelet inhibition plays pivotal role in contemporary treatment of patients presenting with acute coronary syndromes. Morphine, the most commonly used analgesic has been proven to impair both absorption and onset of action of P2Y12 receptor inhibitors, which can be described as “the morphine effect”. Most negative effects of morphine are caused by its undesirable influence on gastrointestinal tract. We hypothesized that naloxone, widely administered intravenous opioid reversing drug, may turn out to be beneficial if given orally in acute coronary syndrome patients previously treated with morphine. Therefore, a phase IV, randomized pilot study was designed so as to evaluate the impact of naloxone administration on pharmacokinetics and pharmacodynamics of P2Y12 inhibitor, ticagrelor in unstable angina patients. A group of 30 consecutive unstable angina patients treated with ticagrelor and morphine will be randomized in a 1:1 ratio into the study arms. To the best of our knowledge, no such approaches to overcome negative
influence of morphine in acute coronary syndrome patients have been described in literature so far.
Abstract
Rapid platelet inhibition plays pivotal role in contemporary treatment of patients presenting with acute coronary syndromes. Morphine, the most commonly used analgesic has been proven to impair both absorption and onset of action of P2Y12 receptor inhibitors, which can be described as “the morphine effect”. Most negative effects of morphine are caused by its undesirable influence on gastrointestinal tract. We hypothesized that naloxone, widely administered intravenous opioid reversing drug, may turn out to be beneficial if given orally in acute coronary syndrome patients previously treated with morphine. Therefore, a phase IV, randomized pilot study was designed so as to evaluate the impact of naloxone administration on pharmacokinetics and pharmacodynamics of P2Y12 inhibitor, ticagrelor in unstable angina patients. A group of 30 consecutive unstable angina patients treated with ticagrelor and morphine will be randomized in a 1:1 ratio into the study arms. To the best of our knowledge, no such approaches to overcome negative
influence of morphine in acute coronary syndrome patients have been described in literature so far.
Keywords
ticagrelor, morphine, naloxone, pharmacokinetic, pharmacodynamics
About this articleTitle
The influence of naloxone on pharmacokinetics and pharmacodynamics of ticagrelor in patients with unstable angina pectoris receiving concomitant treatment with morphine — a protocol of a randomized trial
Journal
Issue
Pages
227-231
Published online
2018-12-18
Page views
984
Article views/downloads
761
DOI
Bibliographic record
Medical Research Journal 2018;3(4):227-231.
Keywords
ticagrelor
morphine
naloxone
pharmacokinetic
pharmacodynamics
Authors
Malwina Aldona Barańska
Piotr Niezgoda
Jacek Kubica
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