Receptores moleculares. Dr. Pascual · MRP2 - Alteraciones CYP 450. NE SGPA NRM . Plasma...
Transcript of Receptores moleculares. Dr. Pascual · MRP2 - Alteraciones CYP 450. NE SGPA NRM . Plasma...
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DOLORDOLOR
PRODUCCION
PERCEPCION
EXPRESIONFuncion cognitivaEstado anímicoCreenciasBiografíaCultura
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OPIOIDE OPIOIDE DENOMINACIONDENOMINACIONENDOGENOENDOGENO RECEPTORRECEPTOR MOLECULARMOLECULAR
BetaBeta--endorfinasendorfinas µµ MORMOREndomorfinasEndomorfinas
EncefalinasEncefalinas δδ DORDOR
DinorfinasDinorfinas κκ KORKOR
OrfaninaOrfanina -- ORLORL--11
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TOLERANCIA A OPIOIDES
Desacoplamiento receptor µ-proteina GDesensibilización receptor µInfraregulación receptor µSupraregulación adenilciclasaProteina Gs ( gangliósido GM1)Producción neuropéptidos endógenosActivación NMDAApoptosis neuronas inhibitorias
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OPIOIDE
RECEPTOR
Gi INHIBICION Gs EXCITACIÓNANALGESIA TOLERANCIA
HIPERALGESIANEUROTOXICIDAD?
Naloxona
GM1
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KETAMINA
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No dolor Máximo dolorimaginable
0 10X
PACIENTE 1 PACIENTE 2
Nocicepción 65% 20%
Somatización 5% 25%
D. Química 0% 35%
Incidental 25% 5%
Tolerancia 5% 15%
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FACTORES QUE INFLUYEN EN ANALGESIA?
- Variantes splicingReceptor µ
- Polimorfismos nucleótidos
- Polimorfismos MDR1MRP2
- Alteraciones CYP 450
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