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January 2007 Issue

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Snail Venom Painkiller Helps Chronic Sufferers

Published January 2007

A drug inspired by a tiny sea snail that stuns its prey with deadly venom is now being used in the Greater Cincinnati area to help people suffering from severe chronic pain.

The drug, ziconotide intrathecal infusion (Prialt), is approved by the U.S. Food and Drug Admini-
stration for the management of severe chronic pain and is now available at University Pointe Pain Management Center.

Ziconotide is based on a naturally occurring peptide (string of amino acids) found in the venom of Conus magus sea snails that live in the tropical waters of the South Pacific.

“This drug isn’t for all pain sufferers,” says Hammam Akbik, MD, assistant professor of anesthesiology at UC and director of pain management services. “It’s for patients in chronic and severe pain, such as those with cancer or neuropathy (diseases of the nervous system), who are not getting substantial relief with oral painkillers like opiates or are experiencing side effects with them.”

People feel pain through nerve cells, which have many openings, or calcium channels, which are normally closed by chemical “gates.” When nerve cells receive pain signals, the gates open and calcium enters a channel, which passes a pain signal on to the next nerve cell. This process continues until pain signals reach the brain.

Although it is not known how ziconotide works in humans, in animals it blocks the calcium channels in nerve cells that transmit pain signals. Without calcium, pain signals are blocked from traveling from nerve cell to nerve cell. 

Ziconotide is infused directly into the fluid in the intrathecal space, the area surrounding the spinal cord, by a small pump worn by the patient—a method known as intrathecal therapy. Synthetic drugs derived from creatures with natural venoms cannot be taken in pill form. Because of their potency, they must be delivered directly into the fluid surrounding the spinal cord, which carries them to the brain without affecting other organs. 

“Severe chronic pain affects every aspect of a person’s life,” says Akbik. “It can be debilitating for people and make everyday living like running errands and chores around the home a challenge, if not impossible.

“This therapy provides a whole new spectrum of hope for patients suffering from severe chronic pain,” he says.

Akbik has no financial interest in Elan Pharmaceuticals, the manufacturer of Prialt. For more information, call (513) 475-8282. 

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