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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Could pharmacogenetic data explain part of the interindividual sensitivity to methadone-induced respiratory depression? | Available online http ccforum.eom content 11 1 119 Commentary Could pharmacogenetic data explain part of the interindividual sensitivity to methadone-induced respiratory depression Séverine Crettol1 Martine Monnat2 and Chin B Eap1 11 Unit of Biochemistry and Clinical Psychopharmacology Centre for Psychiatric Neurosciences University Psychiatry Department Cery Hospital CH-1008 Prilly-Lausanne Switzerland 22 Center St Martin Unit of toxicodependency University Psychiatry Department Rue St-Martin 7 CH-1003 Lausanne Switzerland Corresponding author Chin B Eap Chin.Eap@chuv.ch Published 27 February 2007 This article is online at http ccforum.com content 11 1 119 2007 BioMed Central Ltd Critical Care 2007 11 119 doi 10.1186 cc5699 See related research by Megarbane et al. http ccforum.com content 11 1 R5 Abstract In this issue of Critical Care Megarbane and colleagues present a case report of methadone-induced respiratory depression and conduct a toxieokinetie toxieodynamie evaluation. An opioiddependent patient receiving methadone maintenance treatment daily dose 70 mg was found unconscious after ingesting 240 mg methadone and 2 mg flunitrazepam. Significant improvement in consciousness was achieved after an intravenous bolus of 0.3 mg naloxone followed by a continuous infusion of naloxone at 0.3 mg hour. In patients receiving methadone maintenance treatment an occasional intake of two to four times the usual daily dose of methadone is not an exceptional occurrence. However few such patients experience episodes of life-threatening respiratory depression. Here we discuss whether recent pharmacogenetic data could help us to understand interindividual variability in sensitivity to respiratory depression and ultimately to predict which patients are most likely to be affected. The case report by Megarbane and colleagues 1 reminds us that full tolerance to the opioid effects of methadone may never fully develop even after long-term methadone maintenance treatment. Thus even in
