Tetrodotoxin (TTX) is a dangerous neurotoxin, where its toxicity is due to its highly specific binding and inhibition of sodium ion channels. Because the blocking sodium ion channels could inhibit the transmission of pain, TTX is a candidate for an anesthetic drug. Trials on rats and humans have shown that TTX has anesthetic ability with minimal adverse effects under 6 μg/Kg. It has short therapeutic window, but it is still a promising substitute of morphine. The performance could be improved with modifications such as covalent conjugation with a biodegradable polymer, combination with other chemicals such as, chemical permeation enhancers, epinephrine, or a low dose of morphine alone.
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