Ziconotide, A New N-Type Calcium Channel Blocker, Administered Intrathecally for Acute Postoperative Pain

Atanassoff, Peter G.; Hartmannsgruber, Maximilian W.B.; Thrasher, J. Brantley; Wermeling, Daniel P.; Longton, William; Gaeta, Raymond; Singh, Tej; Mayo, Martha; McGuire, Dawn; Luther, Robert R.

doi:10.1097/00115550-200005000-00011

Cited by 45 publications

(60 citation statements)

References 8 publications

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“…A 25-amino acid Ca V 2.2 channel pore-blocking toxin, v-conotoxin MVIIA, has been isolated from the Conus magus snail and mediates potent analgesia after intrathecal delivery to rodents (Chaplan et al, 1994;Bowersox and Luther, 1998;Wang et al, 2000;Scott et al, 2002) and human patients with persistent cancer pain (Atanassoff et al, 2000;Miljanich, 2004;Staats et al, 2004;Thompson et al, 2006;Wallace et al, 2006;Ver Donck et al, 2008). This fits with the important role of Ca V 2.2 channels in neurotransmitter release from afferent terminals.…”

Section: Ca V 2 Channel Pathophysiologymentioning

confidence: 75%

The Physiology, Pathology, and Pharmacology of Voltage-Gated Calcium Channels and Their Future Therapeutic Potential

Zamponi¹,

Striessnig²,

Koschak³

et al. 2015

Pharmacol Rev

841

992

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Section: Ca V 2 Channel Pathophysiologymentioning

confidence: 75%

The Physiology, Pathology, and Pharmacology of Voltage-Gated Calcium Channels and Their Future Therapeutic Potential

Zamponi¹,

Striessnig²,

Koschak³

et al. 2015

Pharmacol Rev

841

992

View full text Add to dashboard Cite

“…Thirty patients undergoing elective abdominal hysterectomy, radical prostatectomy or total hip replacement were treated with an it infusion of SNX-111 (ziconotide, 0.7 to 7.0 µg/h), which was started before the surgical incision and continued for 48 to 72 h postoperatively. It was shown that the daily patient-controlled administration of morphine was significantly lower in ziconotide-treated than in placebo-treated patients (59). However, dosedependent adverse effects such as dizziness, blurred vision, nystagmus and sedation were noticed in both studies.…”

Section: Clinical Studiesmentioning

confidence: 90%

Involvement of calcium in pain and antinociception

2001

Braz J Med Biol Res

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Calcium ions are widely recognized to play a fundamental role in the regulation of several biological processes. Transient changes in cytoplasmic calcium ion concentration represent a key step for neurotransmitter release and the modulation of cell membrane excitability. Evidence has accumulated for the involvement of calcium ions also in nociception and antinociception, including the analgesic effects produced by opioids. The combination of opioids with drugs able to interfere with calcium ion functions in neurons has been pointed out as a useful alternative for safer clinical pain management. Alternatively, drugs that reduce the flux of calcium ions into neurons have been indicated as analgesic alternatives to opioids. This article reviews the manners by which calcium ions penetrate cell membranes and the changes in these mechanisms caused by opioids and calcium antagonists regarding nociceptive and antinociceptive events.

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“…90 Spinal administration of ziconotide diminished the morphine requirement for postsurgical pain relief. 91 Ziconotide provided complete pain relief in a patient with intractable severe deafferentation pain. 92 In a multicenter series of placebo-controlled, double-blind randomized clinical trials, spinal ziconotide produced moderate to complete pain relief in chronic pain patients with cancer or acquired immune deficiency syndrome (AIDS).…”

Section: Calcium Channelsmentioning

confidence: 99%

Challenges in the development of novel treatment strategies for neuropathic pain

Ossipov

Porreca

2005

Neurotherapeutics

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Summary:Neuropathic pain might best be considered as a collection of various pain states with a common feature, that being symptoms suggestive of dysfunction of peripheral nerves. The development of therapeutic options for the treatment of neuropathic pain is complicated significantly by several factors. Neuropathic pain may arise from widely diverse etiologies such as physical trauma, disease, infection, or chemotherapy. Symptoms indicative of neuropathic pain may also arise in individuals with no evidence of any type of nerve trauma (idiopathic). Although neuropathic pain is a substantial health care issue, it is relatively uncommon and only occurs in a small fraction (Ͻ10%) of individuals with these initiating factors. Moreover, the efficacy of treatment protocols, even against the same type of symptoms, differ depending on the underlying initiating cause of the neuropathy. Although these observations strongly suggest that there are predisposing factors that may impart susceptibility to the development of neuropathic pain, no common predisposing factors or genetic markers have been satisfactorily identified. Because of these vagaries, treatment of neuropathic pain has been based on trial and error. However, recent progress in the understanding of neurophysiologic changes that accompany peripheral nerve dysfunction indicate that regulation of ion channels that maintain membrane potentials or generate action potentials may provide an important therapeutic approach. Neuropathic pain is accompanied by increased activity of peripheral nociceptors, which is produced in part by changes in levels of specific calcium and sodium channels. The identification of sodium and/or calcium channels subtypes that are expressed almost exclusively on nocicpetors may provide a way of regulating the activity of exaggerated nociceptor function without altering other sensory modalities. Thus, the selective targeting of ion channels may represent a viable therapeutic target for the management of the neuropathic pain state, regardless of etiology.

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Ziconotide, A New N-Type Calcium Channel Blocker, Administered Intrathecally for Acute Postoperative Pain

Cited by 45 publications

References 8 publications

The Physiology, Pathology, and Pharmacology of Voltage-Gated Calcium Channels and Their Future Therapeutic Potential

The Physiology, Pathology, and Pharmacology of Voltage-Gated Calcium Channels and Their Future Therapeutic Potential

Involvement of calcium in pain and antinociception

Challenges in the development of novel treatment strategies for neuropathic pain

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