Pharmacogenomics, concepts for the future of perioperative medicine and pain management: A review

Kaye, Alan D.; Koress, Cody M.; Novitch, Matthew B.; Jung, Jai Won; Urits, Ivan; Viswanath, Omar; Renschler, Jordan S.; Alpaugh, E. Saunders; Cornett, Elyse M.

doi:10.1016/j.bpa.2020.07.004

Cited by 8 publications

(13 citation statements)

References 75 publications

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“…The exact mechanism of their action is still not fully understood and has historically been explained by two main theories. The fi rst theory, now largely abandoned, proposed a non-specifi c interaction of the anesthetic with hydrophobic lipid components of the cell, while another theory proposed specifi c membrane proteins as sites for anesthetic binding [1]. Among these membrane proteins, neuronal ion channels are the most likely molecular targets.…”

Section: Inhalation Anestheticsmentioning

confidence: 99%

“…With rapid changes in concentration, it may cause transient tachycardia and hypertension as a result of sympathetic nervous system stimulation [4]. Nearly 99 % of the drug is eliminated unchanged through the lungs [1].…”

Section: Inhalation Anestheticsmentioning

confidence: 99%

“…Nitrous oxide is the least soluble of all general anesthetics and therefore causes rapid onset and rapid recovery from anesthesia. It also has a signifi cant analgesic eff ect by stimulating the central opioid and adrenergic systems [1]. N2O stimulates the sympathetic nervous system and, when administered in combination with halogenated drugs, increases blood pressure, heart rate and cardiac output, while the opposite response is observed when administered concurrently with opioids.…”

Section: Inhalation Anestheticsmentioning

confidence: 99%

“…If necessary, taking into account the duration and type of surgery, as well as in patients with absolute or relative contraindications to IA, intravenous anesthetics may be used not only for induction but also for maintenance of general anesthesia. The dosage of intravenous anesthetics should be carefully determined, taking into account the patient's age, cardiovascular, hepatic and renal status, concomitant drug therapy, and genetic factors [1].…”

Section: Intravenous Anestheticsmentioning

confidence: 99%

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Pharmacogenetics of Anesthesiological Support

Skavinska,

Fishchuk,

Cherniavska

et al. 2024

Neonatol. hìr. perinat. med.

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Pharmacogenetics studies the relationship between a person’s individual genetic characteristics and the human body’sresponse to the action of various drugs, particularly the occurrence of undesirable side eff ects. Thanks to the development of the latest technologies and methods, this branch of medical genetics and clinical pharmacology is developing very actively. Data are being accumulated, special databases are being created with the aim of creating individual genetic passports in the future, which will allow the selection of personalized treatment schemes.Anesthesiology is a special area of pharmacogenetic research because, more than any other medical specialty, it ischaracterized by polypharmacy-the simultaneous or sequential administration of many drugs. The same dose of a drug may be inadequate for some patients and may be life-threatening or cause unwanted side eff ects for others. Today, information about genetic factors is being used by clinicians to prescribe drugs to tailor drug therapy to a patient’s genome. In anesthesiology, the principles of pharmacogenetics have been explained for neuromuscular blocking agents, opioid metabolism, different types of anesthetics, and postoperative nausea and vomiting. On the other hand, a large number of anesthetics have a narrow therapeutic index.This review summarizes the most recent data from the scientifi c literature on the pharmacogenetics of diff erent types ofanesthetics. Inhalational anesthetics are halogenated derivatives of methyl ethyl ether, the exact mechanism of action of which is not yet fully understood. One of the rare but very serious side eff ects of all halogenated anesthetics is malignant hyperthermia, a genetically determined autosomal dominant disorder that manifests as a hypermetabolic response to drug administration. The dosage of intravenous anesthetics should also be carefully determined, taking into account the patient’s age, cardiovascular, hepatic, and renal status, concomitant drug therapy, and genetic factors. Ontogeny and genetic variability of drug-metabolizing enzymes are interrelated because genetic variability in drug-metabolizing enzyme expression cannot be assessed until the required protein is suffi ciently expressed. Pharmacogenetic variants may contribute to unpredictable drug exposure at the same weight- based drug dose.There are a number of potentially clinically applicable pharmacogenetic data in newborns, but more research is needed toconfi rm these fi ndings and understand how to incorporate them into clinical care.The selection of drugs and dosing regimens based on a patient’s pharmacogenomic profi le may be an important part of thefuture of medicine. Personalized treatment based on the specifi c variants in the genome will ultimately reduce the incidence of side eff ects and length of hospital stay for patients and save healthcare costs. Although pharmacogenomics and its application in clinical practice are still in their infancy, different variants and their implications for many clinical areas, including anesthesiology, are emerging every day.

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Section: Inhalation Anestheticsmentioning

confidence: 99%

Section: Inhalation Anestheticsmentioning

confidence: 99%

Section: Inhalation Anestheticsmentioning

confidence: 99%

Section: Intravenous Anestheticsmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacogenetics of Anesthesiological Support

Skavinska,

Fishchuk,

Cherniavska

et al. 2024

Neonatol. hìr. perinat. med.

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“…Physicians should consider PGX-guided medication to prevent occurrences of this nature [11,16]. Even in surgical settings, PGxguided perioperative care not only informs anesthesiologists and surgeons on how to avoid adverse drug reactions (ADRs) caused by certain medications in patients but may also assist in pain management, thereby increasing patient satisfaction and reducing costs [17].…”

Section: Pgx and Personalized Medicinementioning

confidence: 99%

Translational Pharmacogenomics Augmenting Pharmacotherapy

Uppaluri¹

2023

J Clin Genet Hered.

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Pharmacogenomics (PGx), the intertwined knowledge of pharmacology and genomics, is well known. Taking PGx in pace with modern sequencing technological advancements is essential for effective clinical utilization, implementation, and personalized treatment care. Molecular profiling is a technique used to analyze the genetic and molecular makeup of an individual's cancer or other diseases. Decisions on a patient's course of treatment, including the choice of an appropriate pharmacotherapy, can be made using this information. For example, molecular analysis can pinpoint genetic changes that increase a patient's propensity to respond to a particular treatment. It can also reveal potential resistance mechanisms, which helps choose effective treatments for patients. In addition, molecular profiling can help to identify possible side effects that a patient may experience when taking certain medications. Overall, molecular profiling can be a valuable tool in helping to optimize pharmacotherapy for an individual patient. This review highlights the history of PGx, the role of pharmacogenes, PGx guidelines, the interrelation between PGx and personalized medicine, PGx technologies, challenges, and solutions in the implementation of PGx, international and national execution of PGx, and PGx in geriatric patient care, pediatric patient care, maternal, fetal medicine, general medicine, and oncology with a focus on the international and national scenarios. This review aims to better elucidate PGx for clinical implementation by healthcare workers, clinicians, and researchers to ensure efficient, safe, and cost-effective pharmacotherapeutic treatment plans for patients.

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The Future of Perioperative Pain Management

Scholzen,

Schroeder

2024

Perioperative Pain Management

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Pharmacogenomics, concepts for the future of perioperative medicine and pain management: A review

Cited by 8 publications

References 75 publications

Pharmacogenetics of Anesthesiological Support

Pharmacogenetics of Anesthesiological Support

Translational Pharmacogenomics Augmenting Pharmacotherapy

The Future of Perioperative Pain Management

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