Pharmacogenetics and Pain Management — Clinical Use and Interpretation of the Common Pharmacogenetic Tests

In recent years, pharmacogenetic testing has become more common in pain management. During this time, a few cytochrome P450 (CYP450) enzymes have been identified as being particularly important to the metabolism of certain pharmaceutical agents commonly used in pain treatment, such as opioids, antidepressants, and anti-inflammatory agents.

More recently, 2 non-cytochrome P450 “pharmacodynamic” genetic tests have been identified that help explain opioid dosage requirements in pain patients. The first measures, opioid mu receptor 1 (OPRM1), which determines the ability of opioids to bind to the mu opioid receptor site. The other measures catechol-o methyltransferase (COMT), the enzyme that degrades catecholamines in the central nervous system.

All pain practitioners who prescribe opioids should know that a patient with an OPRM1 with a low sensitivity rating and/or a COMT with a high activity rating likely will require a higher opioid dose than normal to obtain relief from a severe pain problem.

This article presents an up-to-date status and review of the pharmacogenetic markers that have relevance to pain practice. Read the full article here:

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