疼痛管理中的药物基因组学

Pharmacogenomics in Pain Management.

作者信息

Saba Ramsey, Kaye Alan D, Urman Richard D

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

Department of Anesthesiology and Pain Medicine, Louisiana State University School of Medicine, LSU Health Science Center, 1542 Tulane Avenue, Room 659, New Orleans, LA 70112, USA.

出版信息

Anesthesiol Clin. 2017 Jun;35(2):295-304. doi: 10.1016/j.anclin.2017.01.015.

DOI:10.1016/j.anclin.2017.01.015

PMID:28526150

Abstract

There is interpatient variability to analgesic administration. Much can be traced to pharmacogenomics variations between individuals. Certain ethnicities are more prone to reduced function of CYP2D6. Weak opioids are subject to interpatient variation based on their CYP2D6 type. Strong opioids have variations based on their transport and individual metabolism. Several cytochrome enzymes have been found to be involved with ketamine but there is no strong evidence of individual polymorphisms manifesting in clinical outcomes. Nonsteroidal anti-inflammatory drugs have adverse outcomes that certain CYP variants are more prone toward. There are now recommendations for dosing based on specific genomic makeup.

摘要

镇痛药物的使用存在个体差异。其中很大一部分可归因于个体之间的药物基因组学差异。某些种族更易出现细胞色素P450 2D6（CYP2D6）功能降低的情况。弱阿片类药物的个体差异与其CYP2D6类型有关。强阿片类药物的差异则基于其转运和个体代谢情况。已发现几种细胞色素酶与氯胺酮有关，但尚无有力证据表明个体基因多态性会在临床结果中体现。非甾体抗炎药的不良后果在某些CYP变体中更易出现。现在已有基于特定基因组构成的给药建议。