Gender differences in drug effects: implications for anesthesiologists

Pleym, Hilde; Spigset, Olav; Kharasch, Evan D.; Dale, Ola

doi:10.1034/j.1399-6576.2003.00036.x

Cited by 205 publications

(186 citation statements)

References 122 publications

Supporting

Mentioning

143

Contrasting

Unclassified

Order By: Relevance

“…Recently, several reports have demonstrated sex differences for propofol, with the average time of emergence after anesthesia shorter in females than in males 10)21)30) 31) , suggesting that males have a higher susceptibility to propofol than females 32) . Several studies have also demonstrated significantly higher levels of the propofol metabolites propofol glucuro- .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Genetic Polymorphism of CYP2B6 and UGT1A9 and Sex Differences on Pharmacokinetics of Propofol

Kobayashi

Yokozuka

Miyakawa

et al. 2015

J St. Marianna Univ

View full text Add to dashboard Cite

Background: Genetic polymorphisms of metabolic enzymes, as well as a patient's sex, age, and individual susceptibility, affect the pharmacokinetics of propofol. Several reports show that polymorphisms of metabolic enzymes of propofol affect loss of consciousness during propofol anesthesia. We investigated whether genetic polymorphisms of the liver cytochrome P450 2B6 (CYP2B6), the main metabolic enzyme for propofol, and UDP-glucuronosyltransferase 1A9 (UGT1A9), as well as sex differences, affect the pharmacokinetics of propofol.Methods: Between June 2009 and May 2011, 94 patients (51 males, 43 females) who underwent respiratory surgery with total intravenous anesthesia were examined. Arterial blood samples were collected immediately or 5, 10, 20, 30 and 60 min after the termination of propofol infusion for the determination of the propofol blood concentrations and genetic polymorphisms of CYP2B6 and UGT1A9. We analyzed blood pharmacokinetics of propofol and assessed the association between genetic polymorphisms, sex differences, and blood pharmacokinetics. Stepwise multiple linear regression analysis was used to detect important factors of pharmacokinetics of propofol.Results: Although C 0 (the blood concentrations of propofol immediately after the termination of propofol infusion) rose for the T/T mutation in CYP2B6, there were no significant differences in changes of blood propofol concentrations after the termination of drug infusion and in waking times for both genetic polymorphisms. C 0 was significantly higher in females than in males (1.7: 1.4 μg/mL, female: male, P=0.015) and the rate of decline in the blood propofol concentration from C 0 to C 5 was faster in females than in males (67: 60%, P=0.015). Stepwise multiple regression analysis revealed that sex (B = 0.32, P = 0.01) was a contributor to C 0 (R = 0.27, P = 0.01).Conclusions: We suggest that differences between females and males for C 0 and the rate of decline in the blood propofol concentration may cause individual differences in both sensitivity and recovery of consciousness from propofol anesthesia. We conclude that polymorphisms of CYP2B6, but not UGT1A, and sex differences affect the pharmacokinetics of propofol.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Because males have more muscle and females have more fat, this would be expected to affect the distribution and times of emergence of a lipid soluble drug such as propofol, with shorter times of emergence in females 32) . In our study, there were significant differences in BMI between males and females.…”

Section: Discussionmentioning

confidence: 99%

Effects of Genetic Polymorphism of CYP2B6 and UGT1A9 and Sex Differences on Pharmacokinetics of Propofol

Kobayashi

Yokozuka

Miyakawa

et al. 2015

J St. Marianna Univ

View full text Add to dashboard Cite

show abstract

“…Therapeutische Wirkungen Bei Frauen können vergleichbare analgetische Wirkungen mit geringeren Dosen an Opiaten als bei Männern erzielt werden [23,24]. Dies wird auf eine vermehrte Expression von Opioid-Rezeptoren zurückgeführt [25].…”

Section: Pharmakodynamikunclassified

Medikamentöse Therapie bei Frauen – Was gilt es zu beachten?

Ravens

2013

Clin Res Cardiol Suppl

View full text Add to dashboard Cite

“…-com as criações tecnológicas, culturais e folclóricas do próprio homem em sua vivência comunitária e cósmica: eletricidade, magnetismo, ultra-som, calor, música, agulha, massagem, religiosidade, espiritualidade, meditação, jogo, realidade virtual, auto-sugestão, riso, toque das mãos, entre outras 3,[6][7][8][9][10][11][12][13] . Os dados demográficos de cada paciente -idade, sexo, raça -também interferem na resposta dolorosa e na sua expressão clínica: desde o nascimento a criança sente dor; a mulher é mais resistente ao fenômeno doloroso, embora apresente mais efeitos secundários na sua cronicidade; além disso, já é anedótica a resistência à dor dos pacientes orientais com relação aos latinos [14][15][16][17] . Diante de uma dor persistente, métodos da AAA podem ser verificados no paciente antes dos farmacológicos consagrados desde que as intervenções cirúrgicas sejam a última opção terapêutica.…”

Section: Adjuvant and Alternative Analgesiaunclassified

“…-and technological, cultural, and folk creations in community and cosmic living: electricity, magnetism, ultrasound, heat, music, needle, massage, religiosity, spirituality, meditation, games, virtual reality, selfsuggestion, laughter, and touch of hands among others 3,6-13 . The demographic data for each patient -age, gender, race -also interfere with the response to pain and its clinical expression: the child experiences pain since birth; women have a higher pain threshold, although they present more secondary effects in its chronicity pain; besides, the resistance to pain of Oriental patients when compared to Latin is anedoctal [14][15][16][17] . When faced with a case of chronic pain, one should use AAA methods before the classical pharmacological methods, and surgical treatment should be the last option.…”

Section: Introductionmentioning

confidence: 99%